|
STEM MONO SLVLS SO SZ14 240MM
|
Facility
|
IP
|
$40,004.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,001.33 |
| Max. Negotiated Rate |
$38,404.27 |
| Rate for Payer: Aetna Commercial |
$30,803.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31,203.47
|
| Rate for Payer: Cash Price |
$20,002.22
|
| Rate for Payer: Cigna Commercial |
$33,203.69
|
| Rate for Payer: First Health Commercial |
$38,004.23
|
| Rate for Payer: Humana Commercial |
$34,003.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$32,803.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,523.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12,001.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$35,203.92
|
| Rate for Payer: Ohio Health Group HMO |
$30,003.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32,003.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$34,803.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,603.07
|
| Rate for Payer: PHCS Commercial |
$38,404.27
|
| Rate for Payer: United Healthcare All Payer |
$35,203.92
|
|
|
STEM MONO SLVLS SO SZ14 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 SO SZ14 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 SO SZ15 240MM
|
Facility
|
IP
|
$40,493.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,148.12 |
| Max. Negotiated Rate |
$38,874.00 |
| Rate for Payer: Aetna Commercial |
$31,180.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31,585.12
|
| Rate for Payer: Cash Price |
$20,246.88
|
| Rate for Payer: Cigna Commercial |
$33,609.81
|
| Rate for Payer: First Health Commercial |
$38,469.06
|
| Rate for Payer: Humana Commercial |
$34,419.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$33,204.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,884.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12,148.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$35,634.50
|
| Rate for Payer: Ohio Health Group HMO |
$30,370.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32,395.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35,229.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,940.69
|
| Rate for Payer: PHCS Commercial |
$38,874.00
|
| Rate for Payer: United Healthcare All Payer |
$35,634.50
|
|
|
STEM MONO SLVLS SO SZ15 240MM
|
Facility
|
OP
|
$40,493.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,148.12 |
| Max. Negotiated Rate |
$38,874.00 |
| Rate for Payer: Aetna Commercial |
$31,180.19
|
| Rate for Payer: Anthem Medicaid |
$13,925.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31,585.12
|
| Rate for Payer: Cash Price |
$20,246.88
|
| Rate for Payer: Cigna Commercial |
$33,609.81
|
| Rate for Payer: First Health Commercial |
$38,469.06
|
| Rate for Payer: Humana Commercial |
$34,419.69
|
| Rate for Payer: Humana KY Medicaid |
$13,925.80
|
| Rate for Payer: Kentucky WC Medicaid |
$14,067.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$33,204.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,884.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12,148.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,205.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$35,634.50
|
| Rate for Payer: Ohio Health Group HMO |
$30,370.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32,395.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35,229.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,940.69
|
| Rate for Payer: PHCS Commercial |
$38,874.00
|
| Rate for Payer: United Healthcare All Payer |
$35,634.50
|
|
|
STEM MONO SLVLS SO SZ15 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 SO SZ15 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 SO SZ16 240MM
|
Facility
|
OP
|
$40,493.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,148.12 |
| Max. Negotiated Rate |
$38,874.00 |
| Rate for Payer: Aetna Commercial |
$31,180.19
|
| Rate for Payer: Anthem Medicaid |
$13,925.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31,585.12
|
| Rate for Payer: Cash Price |
$20,246.88
|
| Rate for Payer: Cigna Commercial |
$33,609.81
|
| Rate for Payer: First Health Commercial |
$38,469.06
|
| Rate for Payer: Humana Commercial |
$34,419.69
|
| Rate for Payer: Humana KY Medicaid |
$13,925.80
|
| Rate for Payer: Kentucky WC Medicaid |
$14,067.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$33,204.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,884.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12,148.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,205.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$35,634.50
|
| Rate for Payer: Ohio Health Group HMO |
$30,370.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32,395.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35,229.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,940.69
|
| Rate for Payer: PHCS Commercial |
$38,874.00
|
| Rate for Payer: United Healthcare All Payer |
$35,634.50
|
|
|
STEM MONO SLVLS SO SZ16 240MM
|
Facility
|
IP
|
$40,493.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,148.12 |
| Max. Negotiated Rate |
$38,874.00 |
| Rate for Payer: Aetna Commercial |
$31,180.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31,585.12
|
| Rate for Payer: Cash Price |
$20,246.88
|
| Rate for Payer: Cigna Commercial |
$33,609.81
|
| Rate for Payer: First Health Commercial |
$38,469.06
|
| Rate for Payer: Humana Commercial |
$34,419.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$33,204.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,884.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12,148.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$35,634.50
|
| Rate for Payer: Ohio Health Group HMO |
$30,370.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32,395.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35,229.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,940.69
|
| Rate for Payer: PHCS Commercial |
$38,874.00
|
| Rate for Payer: United Healthcare All Payer |
$35,634.50
|
|
|
STEM MONO SLVLS SO SZ16 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 SO SZ16 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 SO SZ17 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 SO SZ17 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 SO SZ17 240MM
|
Facility
|
IP
|
$40,493.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,148.12 |
| Max. Negotiated Rate |
$38,874.00 |
| Rate for Payer: Aetna Commercial |
$31,180.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31,585.12
|
| Rate for Payer: Cash Price |
$20,246.88
|
| Rate for Payer: Cigna Commercial |
$33,609.81
|
| Rate for Payer: First Health Commercial |
$38,469.06
|
| Rate for Payer: Humana Commercial |
$34,419.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$33,204.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,884.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12,148.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$35,634.50
|
| Rate for Payer: Ohio Health Group HMO |
$30,370.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32,395.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35,229.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,940.69
|
| Rate for Payer: PHCS Commercial |
$38,874.00
|
| Rate for Payer: United Healthcare All Payer |
$35,634.50
|
|
|
STEM MONO SLVLS SO SZ17 240MM
|
Facility
|
OP
|
$40,493.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,148.12 |
| Max. Negotiated Rate |
$38,874.00 |
| Rate for Payer: Aetna Commercial |
$31,180.19
|
| Rate for Payer: Anthem Medicaid |
$13,925.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31,585.12
|
| Rate for Payer: Cash Price |
$20,246.88
|
| Rate for Payer: Cigna Commercial |
$33,609.81
|
| Rate for Payer: First Health Commercial |
$38,469.06
|
| Rate for Payer: Humana Commercial |
$34,419.69
|
| Rate for Payer: Humana KY Medicaid |
$13,925.80
|
| Rate for Payer: Kentucky WC Medicaid |
$14,067.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$33,204.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,884.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12,148.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,205.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$35,634.50
|
| Rate for Payer: Ohio Health Group HMO |
$30,370.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32,395.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35,229.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,940.69
|
| Rate for Payer: PHCS Commercial |
$38,874.00
|
| Rate for Payer: United Healthcare All Payer |
$35,634.50
|
|
|
STEM MONO SLVLS SO SZ17 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 SO SZ17 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 SO SZ18 190MM
|
Facility
|
OP
|
$16,610.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,983.00 |
| Max. Negotiated Rate |
$15,945.60 |
| Rate for Payer: Aetna Commercial |
$12,789.70
|
| Rate for Payer: Anthem Medicaid |
$5,712.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,955.80
|
| Rate for Payer: Cash Price |
$8,305.00
|
| Rate for Payer: Cigna Commercial |
$13,786.30
|
| Rate for Payer: First Health Commercial |
$15,779.50
|
| Rate for Payer: Humana Commercial |
$14,118.50
|
| Rate for Payer: Humana KY Medicaid |
$5,712.18
|
| Rate for Payer: Kentucky WC Medicaid |
$5,770.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,620.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,258.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,983.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,826.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,616.80
|
| Rate for Payer: Ohio Health Group HMO |
$12,457.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,288.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,450.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,460.90
|
| Rate for Payer: PHCS Commercial |
$15,945.60
|
| Rate for Payer: United Healthcare All Payer |
$14,616.80
|
|
|
STEM MONO SLVLS SO SZ18 190MM
|
Facility
|
IP
|
$16,610.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,983.00 |
| Max. Negotiated Rate |
$15,945.60 |
| Rate for Payer: Aetna Commercial |
$12,789.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,955.80
|
| Rate for Payer: Cash Price |
$8,305.00
|
| Rate for Payer: Cigna Commercial |
$13,786.30
|
| Rate for Payer: First Health Commercial |
$15,779.50
|
| Rate for Payer: Humana Commercial |
$14,118.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,620.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,258.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,983.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,616.80
|
| Rate for Payer: Ohio Health Group HMO |
$12,457.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,288.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,450.70
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,460.90
|
| Rate for Payer: PHCS Commercial |
$15,945.60
|
| Rate for Payer: United Healthcare All Payer |
$14,616.80
|
|
|
STEM MONO SLVLS SO SZ18 240MM
|
Facility
|
OP
|
$40,493.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,148.12 |
| Max. Negotiated Rate |
$38,874.00 |
| Rate for Payer: Aetna Commercial |
$31,180.19
|
| Rate for Payer: Anthem Medicaid |
$13,925.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31,585.12
|
| Rate for Payer: Cash Price |
$20,246.88
|
| Rate for Payer: Cigna Commercial |
$33,609.81
|
| Rate for Payer: First Health Commercial |
$38,469.06
|
| Rate for Payer: Humana Commercial |
$34,419.69
|
| Rate for Payer: Humana KY Medicaid |
$13,925.80
|
| Rate for Payer: Kentucky WC Medicaid |
$14,067.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$33,204.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,884.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12,148.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$14,205.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$35,634.50
|
| Rate for Payer: Ohio Health Group HMO |
$30,370.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32,395.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35,229.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,940.69
|
| Rate for Payer: PHCS Commercial |
$38,874.00
|
| Rate for Payer: United Healthcare All Payer |
$35,634.50
|
|
|
STEM MONO SLVLS SO SZ18 240MM
|
Facility
|
IP
|
$40,493.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,148.12 |
| Max. Negotiated Rate |
$38,874.00 |
| Rate for Payer: Aetna Commercial |
$31,180.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$31,585.12
|
| Rate for Payer: Cash Price |
$20,246.88
|
| Rate for Payer: Cigna Commercial |
$33,609.81
|
| Rate for Payer: First Health Commercial |
$38,469.06
|
| Rate for Payer: Humana Commercial |
$34,419.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$33,204.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$29,884.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$12,148.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$35,634.50
|
| Rate for Payer: Ohio Health Group HMO |
$30,370.31
|
| Rate for Payer: Ohio Health Group PPO Differential |
$32,395.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$35,229.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$27,940.69
|
| Rate for Payer: PHCS Commercial |
$38,874.00
|
| Rate for Payer: United Healthcare All Payer |
$35,634.50
|
|
|
STEM MONO SLVLS SO SZ18 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 SO SZ18 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 SO SZ19 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 SO SZ19 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
|
|
