|
STEM MONO SLVLS SO SZ19 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 SZ19 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 SZ19 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 SZ19 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 SZ20 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 SZ20 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 SZ20 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 SO SZ20 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 SO SZ20 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 SZ20 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 SZ21 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 SZ21 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 SZ21 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 SO SZ21 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 SO SZ21 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 SZ21 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 SZ22 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 SO SZ22 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 SO SZ22 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 SZ22 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 SZ23 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 SO SZ23 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 SO SZ23 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 SZ23 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 SZ24 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
|
|
