|
STEM MONO SLVD SO SZ23 240MM
|
Facility
|
OP
|
$36,154.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,846.22 |
| Max. Negotiated Rate |
$34,707.90 |
| Rate for Payer: Aetna Commercial |
$27,838.63
|
| Rate for Payer: Anthem Medicaid |
$12,433.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,200.17
|
| Rate for Payer: Cash Price |
$18,077.03
|
| Rate for Payer: Cigna Commercial |
$30,007.87
|
| Rate for Payer: First Health Commercial |
$34,346.36
|
| Rate for Payer: Humana Commercial |
$30,730.95
|
| Rate for Payer: Humana KY Medicaid |
$12,433.38
|
| Rate for Payer: Kentucky WC Medicaid |
$12,559.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,646.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,681.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,846.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,682.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,815.57
|
| Rate for Payer: Ohio Health Group HMO |
$27,115.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,923.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,454.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,946.30
|
| Rate for Payer: PHCS Commercial |
$34,707.90
|
| Rate for Payer: United Healthcare All Payer |
$31,815.57
|
|
|
STEM MONO SLVD SO SZ24 240MM
|
Facility
|
IP
|
$36,154.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,846.22 |
| Max. Negotiated Rate |
$34,707.90 |
| Rate for Payer: Aetna Commercial |
$27,838.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,200.17
|
| Rate for Payer: Cash Price |
$18,077.03
|
| Rate for Payer: Cigna Commercial |
$30,007.87
|
| Rate for Payer: First Health Commercial |
$34,346.36
|
| Rate for Payer: Humana Commercial |
$30,730.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,646.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,681.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,846.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,815.57
|
| Rate for Payer: Ohio Health Group HMO |
$27,115.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,923.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,454.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,946.30
|
| Rate for Payer: PHCS Commercial |
$34,707.90
|
| Rate for Payer: United Healthcare All Payer |
$31,815.57
|
|
|
STEM MONO SLVD SO SZ24 240MM
|
Facility
|
OP
|
$36,154.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,846.22 |
| Max. Negotiated Rate |
$34,707.90 |
| Rate for Payer: Aetna Commercial |
$27,838.63
|
| Rate for Payer: Anthem Medicaid |
$12,433.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,200.17
|
| Rate for Payer: Cash Price |
$18,077.03
|
| Rate for Payer: Cigna Commercial |
$30,007.87
|
| Rate for Payer: First Health Commercial |
$34,346.36
|
| Rate for Payer: Humana Commercial |
$30,730.95
|
| Rate for Payer: Humana KY Medicaid |
$12,433.38
|
| Rate for Payer: Kentucky WC Medicaid |
$12,559.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,646.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,681.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,846.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,682.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,815.57
|
| Rate for Payer: Ohio Health Group HMO |
$27,115.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,923.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,454.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,946.30
|
| Rate for Payer: PHCS Commercial |
$34,707.90
|
| Rate for Payer: United Healthcare All Payer |
$31,815.57
|
|
|
STEM MONO SLVD SO SZ25 240MM
|
Facility
|
OP
|
$36,154.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,846.22 |
| Max. Negotiated Rate |
$34,707.90 |
| Rate for Payer: Aetna Commercial |
$27,838.63
|
| Rate for Payer: Anthem Medicaid |
$12,433.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,200.17
|
| Rate for Payer: Cash Price |
$18,077.03
|
| Rate for Payer: Cigna Commercial |
$30,007.87
|
| Rate for Payer: First Health Commercial |
$34,346.36
|
| Rate for Payer: Humana Commercial |
$30,730.95
|
| Rate for Payer: Humana KY Medicaid |
$12,433.38
|
| Rate for Payer: Kentucky WC Medicaid |
$12,559.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,646.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,681.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,846.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,682.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,815.57
|
| Rate for Payer: Ohio Health Group HMO |
$27,115.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,923.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,454.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,946.30
|
| Rate for Payer: PHCS Commercial |
$34,707.90
|
| Rate for Payer: United Healthcare All Payer |
$31,815.57
|
|
|
STEM MONO SLVD SO SZ25 240MM
|
Facility
|
IP
|
$36,154.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,846.22 |
| Max. Negotiated Rate |
$34,707.90 |
| Rate for Payer: Aetna Commercial |
$27,838.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,200.17
|
| Rate for Payer: Cash Price |
$18,077.03
|
| Rate for Payer: Cigna Commercial |
$30,007.87
|
| Rate for Payer: First Health Commercial |
$34,346.36
|
| Rate for Payer: Humana Commercial |
$30,730.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,646.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,681.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,846.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,815.57
|
| Rate for Payer: Ohio Health Group HMO |
$27,115.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,923.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,454.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,946.30
|
| Rate for Payer: PHCS Commercial |
$34,707.90
|
| Rate for Payer: United Healthcare All Payer |
$31,815.57
|
|
|
STEM MONO SLVD SO SZ26 240MM
|
Facility
|
IP
|
$36,154.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,846.22 |
| Max. Negotiated Rate |
$34,707.90 |
| Rate for Payer: Aetna Commercial |
$27,838.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,200.17
|
| Rate for Payer: Cash Price |
$18,077.03
|
| Rate for Payer: Cigna Commercial |
$30,007.87
|
| Rate for Payer: First Health Commercial |
$34,346.36
|
| Rate for Payer: Humana Commercial |
$30,730.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,646.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,681.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,846.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,815.57
|
| Rate for Payer: Ohio Health Group HMO |
$27,115.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,923.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,454.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,946.30
|
| Rate for Payer: PHCS Commercial |
$34,707.90
|
| Rate for Payer: United Healthcare All Payer |
$31,815.57
|
|
|
STEM MONO SLVD SO SZ26 240MM
|
Facility
|
OP
|
$36,154.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,846.22 |
| Max. Negotiated Rate |
$34,707.90 |
| Rate for Payer: Aetna Commercial |
$27,838.63
|
| Rate for Payer: Anthem Medicaid |
$12,433.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,200.17
|
| Rate for Payer: Cash Price |
$18,077.03
|
| Rate for Payer: Cigna Commercial |
$30,007.87
|
| Rate for Payer: First Health Commercial |
$34,346.36
|
| Rate for Payer: Humana Commercial |
$30,730.95
|
| Rate for Payer: Humana KY Medicaid |
$12,433.38
|
| Rate for Payer: Kentucky WC Medicaid |
$12,559.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,646.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,681.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,846.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,682.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,815.57
|
| Rate for Payer: Ohio Health Group HMO |
$27,115.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,923.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,454.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,946.30
|
| Rate for Payer: PHCS Commercial |
$34,707.90
|
| Rate for Payer: United Healthcare All Payer |
$31,815.57
|
|
|
STEM MONO SLVD SO SZ27 240MM
|
Facility
|
IP
|
$36,154.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,846.22 |
| Max. Negotiated Rate |
$34,707.90 |
| Rate for Payer: Aetna Commercial |
$27,838.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,200.17
|
| Rate for Payer: Cash Price |
$18,077.03
|
| Rate for Payer: Cigna Commercial |
$30,007.87
|
| Rate for Payer: First Health Commercial |
$34,346.36
|
| Rate for Payer: Humana Commercial |
$30,730.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,646.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,681.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,846.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,815.57
|
| Rate for Payer: Ohio Health Group HMO |
$27,115.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,923.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,454.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,946.30
|
| Rate for Payer: PHCS Commercial |
$34,707.90
|
| Rate for Payer: United Healthcare All Payer |
$31,815.57
|
|
|
STEM MONO SLVD SO SZ27 240MM
|
Facility
|
OP
|
$36,154.06
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,846.22 |
| Max. Negotiated Rate |
$34,707.90 |
| Rate for Payer: Aetna Commercial |
$27,838.63
|
| Rate for Payer: Anthem Medicaid |
$12,433.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$28,200.17
|
| Rate for Payer: Cash Price |
$18,077.03
|
| Rate for Payer: Cigna Commercial |
$30,007.87
|
| Rate for Payer: First Health Commercial |
$34,346.36
|
| Rate for Payer: Humana Commercial |
$30,730.95
|
| Rate for Payer: Humana KY Medicaid |
$12,433.38
|
| Rate for Payer: Kentucky WC Medicaid |
$12,559.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,646.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,681.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,846.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,682.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,815.57
|
| Rate for Payer: Ohio Health Group HMO |
$27,115.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$28,923.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$31,454.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,946.30
|
| Rate for Payer: PHCS Commercial |
$34,707.90
|
| Rate for Payer: United Healthcare All Payer |
$31,815.57
|
|
|
STEM MONO SLVLS HO SZ12 190MM
|
Facility
|
IP
|
$34,796.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,439.02 |
| Max. Negotiated Rate |
$33,404.88 |
| Rate for Payer: Aetna Commercial |
$26,793.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,141.47
|
| Rate for Payer: Cash Price |
$17,398.38
|
| Rate for Payer: Cigna Commercial |
$28,881.30
|
| Rate for Payer: First Health Commercial |
$33,056.91
|
| Rate for Payer: Humana Commercial |
$29,577.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,533.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,680.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,439.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,621.14
|
| Rate for Payer: Ohio Health Group HMO |
$26,097.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$27,837.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$30,273.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,009.76
|
| Rate for Payer: PHCS Commercial |
$33,404.88
|
| Rate for Payer: United Healthcare All Payer |
$30,621.14
|
|
|
STEM MONO SLVLS HO SZ12 190MM
|
Facility
|
OP
|
$34,796.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,439.02 |
| Max. Negotiated Rate |
$33,404.88 |
| Rate for Payer: Aetna Commercial |
$26,793.50
|
| Rate for Payer: Anthem Medicaid |
$11,966.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,141.47
|
| Rate for Payer: Cash Price |
$17,398.38
|
| Rate for Payer: Cigna Commercial |
$28,881.30
|
| Rate for Payer: First Health Commercial |
$33,056.91
|
| Rate for Payer: Humana Commercial |
$29,577.24
|
| Rate for Payer: Humana KY Medicaid |
$11,966.60
|
| Rate for Payer: Kentucky WC Medicaid |
$12,088.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,533.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,680.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,439.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,206.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,621.14
|
| Rate for Payer: Ohio Health Group HMO |
$26,097.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$27,837.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$30,273.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,009.76
|
| Rate for Payer: PHCS Commercial |
$33,404.88
|
| Rate for Payer: United Healthcare All Payer |
$30,621.14
|
|
|
STEM MONO SLVLS HO SZ12 240MM
|
Facility
|
OP
|
$37,714.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,314.33 |
| Max. Negotiated Rate |
$36,205.86 |
| Rate for Payer: Aetna Commercial |
$29,040.12
|
| Rate for Payer: Anthem Medicaid |
$12,970.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,417.26
|
| Rate for Payer: Cash Price |
$18,857.22
|
| Rate for Payer: Cigna Commercial |
$31,302.99
|
| Rate for Payer: First Health Commercial |
$35,828.72
|
| Rate for Payer: Humana Commercial |
$32,057.27
|
| Rate for Payer: Humana KY Medicaid |
$12,970.00
|
| Rate for Payer: Kentucky WC Medicaid |
$13,102.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,925.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,833.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,314.33
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,230.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,188.71
|
| Rate for Payer: Ohio Health Group HMO |
$28,285.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$30,171.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$32,811.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$26,022.96
|
| Rate for Payer: PHCS Commercial |
$36,205.86
|
| Rate for Payer: United Healthcare All Payer |
$33,188.71
|
|
|
STEM MONO SLVLS HO SZ12 240MM
|
Facility
|
IP
|
$37,714.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,314.33 |
| Max. Negotiated Rate |
$36,205.86 |
| Rate for Payer: Aetna Commercial |
$29,040.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,417.26
|
| Rate for Payer: Cash Price |
$18,857.22
|
| Rate for Payer: Cigna Commercial |
$31,302.99
|
| Rate for Payer: First Health Commercial |
$35,828.72
|
| Rate for Payer: Humana Commercial |
$32,057.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,925.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,833.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,314.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,188.71
|
| Rate for Payer: Ohio Health Group HMO |
$28,285.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$30,171.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$32,811.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$26,022.96
|
| Rate for Payer: PHCS Commercial |
$36,205.86
|
| Rate for Payer: United Healthcare All Payer |
$33,188.71
|
|
|
STEM MONO SLVLS HO SZ12 300MM
|
Facility
|
OP
|
$39,499.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,849.77 |
| Max. Negotiated Rate |
$37,919.28 |
| Rate for Payer: Aetna Commercial |
$30,414.42
|
| Rate for Payer: Anthem Medicaid |
$13,583.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$30,809.42
|
| Rate for Payer: Cash Price |
$19,749.62
|
| Rate for Payer: Cigna Commercial |
$32,784.38
|
| Rate for Payer: First Health Commercial |
$37,524.29
|
| Rate for Payer: Humana Commercial |
$33,574.36
|
| Rate for Payer: Humana KY Medicaid |
$13,583.79
|
| Rate for Payer: Kentucky WC Medicaid |
$13,722.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$32,389.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,150.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,849.77
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,856.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$34,759.34
|
| Rate for Payer: Ohio Health Group HMO |
$29,624.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$31,599.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$34,364.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,254.48
|
| Rate for Payer: PHCS Commercial |
$37,919.28
|
| Rate for Payer: United Healthcare All Payer |
$34,759.34
|
|
|
STEM MONO SLVLS HO SZ12 300MM
|
Facility
|
IP
|
$39,499.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,849.77 |
| Max. Negotiated Rate |
$37,919.28 |
| Rate for Payer: Aetna Commercial |
$30,414.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$30,809.42
|
| Rate for Payer: Cash Price |
$19,749.62
|
| Rate for Payer: Cigna Commercial |
$32,784.38
|
| Rate for Payer: First Health Commercial |
$37,524.29
|
| Rate for Payer: Humana Commercial |
$33,574.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$32,389.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,150.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,849.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$34,759.34
|
| Rate for Payer: Ohio Health Group HMO |
$29,624.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$31,599.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$34,364.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,254.48
|
| Rate for Payer: PHCS Commercial |
$37,919.28
|
| Rate for Payer: United Healthcare All Payer |
$34,759.34
|
|
|
STEM MONO SLVLS HO SZ13 190MM
|
Facility
|
IP
|
$34,796.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,439.02 |
| Max. Negotiated Rate |
$33,404.88 |
| Rate for Payer: Aetna Commercial |
$26,793.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,141.47
|
| Rate for Payer: Cash Price |
$17,398.38
|
| Rate for Payer: Cigna Commercial |
$28,881.30
|
| Rate for Payer: First Health Commercial |
$33,056.91
|
| Rate for Payer: Humana Commercial |
$29,577.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,533.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,680.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,439.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,621.14
|
| Rate for Payer: Ohio Health Group HMO |
$26,097.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$27,837.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$30,273.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,009.76
|
| Rate for Payer: PHCS Commercial |
$33,404.88
|
| Rate for Payer: United Healthcare All Payer |
$30,621.14
|
|
|
STEM MONO SLVLS HO SZ13 190MM
|
Facility
|
OP
|
$34,796.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,439.02 |
| Max. Negotiated Rate |
$33,404.88 |
| Rate for Payer: Aetna Commercial |
$26,793.50
|
| Rate for Payer: Anthem Medicaid |
$11,966.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,141.47
|
| Rate for Payer: Cash Price |
$17,398.38
|
| Rate for Payer: Cigna Commercial |
$28,881.30
|
| Rate for Payer: First Health Commercial |
$33,056.91
|
| Rate for Payer: Humana Commercial |
$29,577.24
|
| Rate for Payer: Humana KY Medicaid |
$11,966.60
|
| Rate for Payer: Kentucky WC Medicaid |
$12,088.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,533.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,680.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,439.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,206.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,621.14
|
| Rate for Payer: Ohio Health Group HMO |
$26,097.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$27,837.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$30,273.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,009.76
|
| Rate for Payer: PHCS Commercial |
$33,404.88
|
| Rate for Payer: United Healthcare All Payer |
$30,621.14
|
|
|
STEM MONO SLVLS HO SZ13 240MM
|
Facility
|
IP
|
$37,714.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,314.33 |
| Max. Negotiated Rate |
$36,205.86 |
| Rate for Payer: Aetna Commercial |
$29,040.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,417.26
|
| Rate for Payer: Cash Price |
$18,857.22
|
| Rate for Payer: Cigna Commercial |
$31,302.99
|
| Rate for Payer: First Health Commercial |
$35,828.72
|
| Rate for Payer: Humana Commercial |
$32,057.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,925.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,833.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,314.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,188.71
|
| Rate for Payer: Ohio Health Group HMO |
$28,285.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$30,171.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$32,811.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$26,022.96
|
| Rate for Payer: PHCS Commercial |
$36,205.86
|
| Rate for Payer: United Healthcare All Payer |
$33,188.71
|
|
|
STEM MONO SLVLS HO SZ13 240MM
|
Facility
|
OP
|
$37,714.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,314.33 |
| Max. Negotiated Rate |
$36,205.86 |
| Rate for Payer: Aetna Commercial |
$29,040.12
|
| Rate for Payer: Anthem Medicaid |
$12,970.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,417.26
|
| Rate for Payer: Cash Price |
$18,857.22
|
| Rate for Payer: Cigna Commercial |
$31,302.99
|
| Rate for Payer: First Health Commercial |
$35,828.72
|
| Rate for Payer: Humana Commercial |
$32,057.27
|
| Rate for Payer: Humana KY Medicaid |
$12,970.00
|
| Rate for Payer: Kentucky WC Medicaid |
$13,102.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,925.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,833.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,314.33
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,230.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,188.71
|
| Rate for Payer: Ohio Health Group HMO |
$28,285.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$30,171.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$32,811.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$26,022.96
|
| Rate for Payer: PHCS Commercial |
$36,205.86
|
| Rate for Payer: United Healthcare All Payer |
$33,188.71
|
|
|
STEM MONO SLVLS HO SZ13 300MM
|
Facility
|
OP
|
$39,499.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,849.77 |
| Max. Negotiated Rate |
$37,919.28 |
| Rate for Payer: Aetna Commercial |
$30,414.42
|
| Rate for Payer: Anthem Medicaid |
$13,583.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$30,809.42
|
| Rate for Payer: Cash Price |
$19,749.62
|
| Rate for Payer: Cigna Commercial |
$32,784.38
|
| Rate for Payer: First Health Commercial |
$37,524.29
|
| Rate for Payer: Humana Commercial |
$33,574.36
|
| Rate for Payer: Humana KY Medicaid |
$13,583.79
|
| Rate for Payer: Kentucky WC Medicaid |
$13,722.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$32,389.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,150.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,849.77
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,856.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$34,759.34
|
| Rate for Payer: Ohio Health Group HMO |
$29,624.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$31,599.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$34,364.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,254.48
|
| Rate for Payer: PHCS Commercial |
$37,919.28
|
| Rate for Payer: United Healthcare All Payer |
$34,759.34
|
|
|
STEM MONO SLVLS HO SZ13 300MM
|
Facility
|
IP
|
$39,499.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,849.77 |
| Max. Negotiated Rate |
$37,919.28 |
| Rate for Payer: Aetna Commercial |
$30,414.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$30,809.42
|
| Rate for Payer: Cash Price |
$19,749.62
|
| Rate for Payer: Cigna Commercial |
$32,784.38
|
| Rate for Payer: First Health Commercial |
$37,524.29
|
| Rate for Payer: Humana Commercial |
$33,574.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$32,389.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,150.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,849.77
|
| Rate for Payer: Ohio Health Choice Commercial |
$34,759.34
|
| Rate for Payer: Ohio Health Group HMO |
$29,624.44
|
| Rate for Payer: Ohio Health Group PPO Differential |
$31,599.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$34,364.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,254.48
|
| Rate for Payer: PHCS Commercial |
$37,919.28
|
| Rate for Payer: United Healthcare All Payer |
$34,759.34
|
|
|
STEM MONO SLVLS HO SZ14 190MM
|
Facility
|
OP
|
$34,796.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,439.02 |
| Max. Negotiated Rate |
$33,404.88 |
| Rate for Payer: Aetna Commercial |
$26,793.50
|
| Rate for Payer: Anthem Medicaid |
$11,966.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,141.47
|
| Rate for Payer: Cash Price |
$17,398.38
|
| Rate for Payer: Cigna Commercial |
$28,881.30
|
| Rate for Payer: First Health Commercial |
$33,056.91
|
| Rate for Payer: Humana Commercial |
$29,577.24
|
| Rate for Payer: Humana KY Medicaid |
$11,966.60
|
| Rate for Payer: Kentucky WC Medicaid |
$12,088.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,533.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,680.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,439.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,206.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,621.14
|
| Rate for Payer: Ohio Health Group HMO |
$26,097.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$27,837.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$30,273.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,009.76
|
| Rate for Payer: PHCS Commercial |
$33,404.88
|
| Rate for Payer: United Healthcare All Payer |
$30,621.14
|
|
|
STEM MONO SLVLS HO SZ14 190MM
|
Facility
|
IP
|
$34,796.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,439.02 |
| Max. Negotiated Rate |
$33,404.88 |
| Rate for Payer: Aetna Commercial |
$26,793.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,141.47
|
| Rate for Payer: Cash Price |
$17,398.38
|
| Rate for Payer: Cigna Commercial |
$28,881.30
|
| Rate for Payer: First Health Commercial |
$33,056.91
|
| Rate for Payer: Humana Commercial |
$29,577.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$28,533.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$25,680.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,439.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$30,621.14
|
| Rate for Payer: Ohio Health Group HMO |
$26,097.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$27,837.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$30,273.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$24,009.76
|
| Rate for Payer: PHCS Commercial |
$33,404.88
|
| Rate for Payer: United Healthcare All Payer |
$30,621.14
|
|
|
STEM MONO SLVLS HO SZ14 240MM
|
Facility
|
OP
|
$37,714.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,314.33 |
| Max. Negotiated Rate |
$36,205.86 |
| Rate for Payer: Aetna Commercial |
$29,040.12
|
| Rate for Payer: Anthem Medicaid |
$12,970.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,417.26
|
| Rate for Payer: Cash Price |
$18,857.22
|
| Rate for Payer: Cigna Commercial |
$31,302.99
|
| Rate for Payer: First Health Commercial |
$35,828.72
|
| Rate for Payer: Humana Commercial |
$32,057.27
|
| Rate for Payer: Humana KY Medicaid |
$12,970.00
|
| Rate for Payer: Kentucky WC Medicaid |
$13,102.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,925.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,833.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,314.33
|
| Rate for Payer: Molina Healthcare Medicaid |
$13,230.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,188.71
|
| Rate for Payer: Ohio Health Group HMO |
$28,285.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$30,171.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$32,811.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$26,022.96
|
| Rate for Payer: PHCS Commercial |
$36,205.86
|
| Rate for Payer: United Healthcare All Payer |
$33,188.71
|
|
|
STEM MONO SLVLS HO SZ14 240MM
|
Facility
|
IP
|
$37,714.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,314.33 |
| Max. Negotiated Rate |
$36,205.86 |
| Rate for Payer: Aetna Commercial |
$29,040.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$29,417.26
|
| Rate for Payer: Cash Price |
$18,857.22
|
| Rate for Payer: Cigna Commercial |
$31,302.99
|
| Rate for Payer: First Health Commercial |
$35,828.72
|
| Rate for Payer: Humana Commercial |
$32,057.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$30,925.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$27,833.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,314.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$33,188.71
|
| Rate for Payer: Ohio Health Group HMO |
$28,285.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$30,171.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$32,811.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$26,022.96
|
| Rate for Payer: PHCS Commercial |
$36,205.86
|
| Rate for Payer: United Healthcare All Payer |
$33,188.71
|
|
