|
STERLING ES 2*20
|
Facility
|
OP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Aetna Commercial |
$2,721.60
|
| Rate for Payer: Anthem Medicaid |
$1,195.79
|
| Rate for Payer: Anthem Medicaid |
$1,215.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,756.95
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cash Price |
$1,767.28
|
| Rate for Payer: Cigna Commercial |
$2,933.68
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,357.82
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Humana Commercial |
$3,004.37
|
| Rate for Payer: Humana KY Medicaid |
$1,195.79
|
| Rate for Payer: Humana KY Medicaid |
$1,215.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,227.90
|
| Rate for Payer: Kentucky WC Medicaid |
$1,207.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,898.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,608.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,060.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,219.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,239.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,110.40
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group HMO |
$2,650.91
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$706.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$459.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,095.71
|
| Rate for Payer: PHCS Commercial |
$3,393.17
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,110.40
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 2*30
|
Facility
|
IP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Aetna Commercial |
$2,721.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,756.95
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cash Price |
$1,767.28
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: Cigna Commercial |
$2,933.68
|
| Rate for Payer: First Health Commercial |
$3,357.82
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$3,004.37
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,898.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,608.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,060.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,110.40
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group HMO |
$2,650.91
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$706.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$459.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,095.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: PHCS Commercial |
$3,393.17
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
| Rate for Payer: United Healthcare All Payer |
$3,110.40
|
|
|
STERLING ES 2*30
|
Facility
|
OP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Aetna Commercial |
$2,721.60
|
| Rate for Payer: Anthem Medicaid |
$1,195.79
|
| Rate for Payer: Anthem Medicaid |
$1,215.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,756.95
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cash Price |
$1,767.28
|
| Rate for Payer: Cigna Commercial |
$2,933.68
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,357.82
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Humana Commercial |
$3,004.37
|
| Rate for Payer: Humana KY Medicaid |
$1,195.79
|
| Rate for Payer: Humana KY Medicaid |
$1,215.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,227.90
|
| Rate for Payer: Kentucky WC Medicaid |
$1,207.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,898.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,608.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,060.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,219.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,239.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,110.40
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group HMO |
$2,650.91
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$706.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$459.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,095.71
|
| Rate for Payer: PHCS Commercial |
$3,393.17
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,110.40
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 2*40
|
Facility
|
OP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Aetna Commercial |
$2,721.60
|
| Rate for Payer: Anthem Medicaid |
$1,195.79
|
| Rate for Payer: Anthem Medicaid |
$1,215.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,756.95
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cash Price |
$1,767.28
|
| Rate for Payer: Cigna Commercial |
$2,933.68
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,357.82
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Humana Commercial |
$3,004.37
|
| Rate for Payer: Humana KY Medicaid |
$1,195.79
|
| Rate for Payer: Humana KY Medicaid |
$1,215.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,227.90
|
| Rate for Payer: Kentucky WC Medicaid |
$1,207.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,898.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,608.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,060.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,219.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,239.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,110.40
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group HMO |
$2,650.91
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$706.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$459.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,095.71
|
| Rate for Payer: PHCS Commercial |
$3,393.17
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,110.40
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 2*40
|
Facility
|
IP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Aetna Commercial |
$2,721.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,756.95
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cash Price |
$1,767.28
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: Cigna Commercial |
$2,933.68
|
| Rate for Payer: First Health Commercial |
$3,357.82
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$3,004.37
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,898.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,608.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,060.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,110.40
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group HMO |
$2,650.91
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$706.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$459.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,095.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: PHCS Commercial |
$3,393.17
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
| Rate for Payer: United Healthcare All Payer |
$3,110.40
|
|
|
STERLING ES 2.5*20
|
Facility
|
IP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 2.5*20
|
Facility
|
OP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Anthem Medicaid |
$1,195.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Humana KY Medicaid |
$1,195.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,207.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,219.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 2.5*30
|
Facility
|
IP
|
$3,534.55
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$459.49 |
| Max. Negotiated Rate |
$3,393.17 |
| Rate for Payer: Aetna Commercial |
$2,721.60
|
| Rate for Payer: Aetna Commercial |
$2,929.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,756.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,967.54
|
| Rate for Payer: Cash Price |
$1,767.28
|
| Rate for Payer: Cash Price |
$1,902.27
|
| Rate for Payer: Cigna Commercial |
$2,933.68
|
| Rate for Payer: Cigna Commercial |
$3,157.77
|
| Rate for Payer: First Health Commercial |
$3,614.31
|
| Rate for Payer: First Health Commercial |
$3,357.82
|
| Rate for Payer: Humana Commercial |
$3,233.86
|
| Rate for Payer: Humana Commercial |
$3,004.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,898.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,119.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,608.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,807.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,141.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,060.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,110.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,348.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,650.91
|
| Rate for Payer: Ohio Health Group HMO |
$2,853.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$706.91
|
| Rate for Payer: Ohio Health Group PPO Differential |
$760.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$459.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$494.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,179.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,095.71
|
| Rate for Payer: PHCS Commercial |
$3,393.17
|
| Rate for Payer: PHCS Commercial |
$3,652.36
|
| Rate for Payer: United Healthcare All Payer |
$3,110.40
|
| Rate for Payer: United Healthcare All Payer |
$3,348.00
|
|
|
STERLING ES 2.5*30
|
Facility
|
OP
|
$3,534.55
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$459.49 |
| Max. Negotiated Rate |
$3,393.17 |
| Rate for Payer: Aetna Commercial |
$2,721.60
|
| Rate for Payer: Aetna Commercial |
$2,929.50
|
| Rate for Payer: Anthem Medicaid |
$1,215.53
|
| Rate for Payer: Anthem Medicaid |
$1,308.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,756.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,967.54
|
| Rate for Payer: Cash Price |
$1,767.28
|
| Rate for Payer: Cash Price |
$1,902.27
|
| Rate for Payer: Cigna Commercial |
$3,157.77
|
| Rate for Payer: Cigna Commercial |
$2,933.68
|
| Rate for Payer: First Health Commercial |
$3,614.31
|
| Rate for Payer: First Health Commercial |
$3,357.82
|
| Rate for Payer: Humana Commercial |
$3,004.37
|
| Rate for Payer: Humana Commercial |
$3,233.86
|
| Rate for Payer: Humana KY Medicaid |
$1,215.53
|
| Rate for Payer: Humana KY Medicaid |
$1,308.38
|
| Rate for Payer: Kentucky WC Medicaid |
$1,321.70
|
| Rate for Payer: Kentucky WC Medicaid |
$1,227.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,898.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,119.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,807.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,608.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,141.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,060.36
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,239.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,334.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,110.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,348.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,650.91
|
| Rate for Payer: Ohio Health Group HMO |
$2,853.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$706.91
|
| Rate for Payer: Ohio Health Group PPO Differential |
$760.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$459.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$494.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,095.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,179.41
|
| Rate for Payer: PHCS Commercial |
$3,652.36
|
| Rate for Payer: PHCS Commercial |
$3,393.17
|
| Rate for Payer: United Healthcare All Payer |
$3,348.00
|
| Rate for Payer: United Healthcare All Payer |
$3,110.40
|
|
|
STERLING ES 2.5*40
|
Facility
|
OP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Aetna Commercial |
$2,721.60
|
| Rate for Payer: Anthem Medicaid |
$1,195.79
|
| Rate for Payer: Anthem Medicaid |
$1,215.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,756.95
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cash Price |
$1,767.28
|
| Rate for Payer: Cigna Commercial |
$2,933.68
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,357.82
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Humana Commercial |
$3,004.37
|
| Rate for Payer: Humana KY Medicaid |
$1,195.79
|
| Rate for Payer: Humana KY Medicaid |
$1,215.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,227.90
|
| Rate for Payer: Kentucky WC Medicaid |
$1,207.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,898.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,608.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,060.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,219.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,239.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,110.40
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group HMO |
$2,650.91
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$706.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$459.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,095.71
|
| Rate for Payer: PHCS Commercial |
$3,393.17
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,110.40
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 2.5*40
|
Facility
|
IP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Aetna Commercial |
$2,721.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,756.95
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cash Price |
$1,767.28
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: Cigna Commercial |
$2,933.68
|
| Rate for Payer: First Health Commercial |
$3,357.82
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$3,004.37
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,898.33
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,608.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,060.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,110.40
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group HMO |
$2,650.91
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO Differential |
$706.91
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$459.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,095.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: PHCS Commercial |
$3,393.17
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
| Rate for Payer: United Healthcare All Payer |
$3,110.40
|
|
|
STERLING ES 3*20 OTW
|
Facility
|
OP
|
$1,934.50
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.48 |
| Max. Negotiated Rate |
$1,857.12 |
| Rate for Payer: Aetna Commercial |
$1,489.56
|
| Rate for Payer: Anthem Medicaid |
$665.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.91
|
| Rate for Payer: Cash Price |
$967.25
|
| Rate for Payer: Cigna Commercial |
$1,605.64
|
| Rate for Payer: First Health Commercial |
$1,837.78
|
| Rate for Payer: Humana Commercial |
$1,644.32
|
| Rate for Payer: Humana KY Medicaid |
$665.27
|
| Rate for Payer: Kentucky WC Medicaid |
$672.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.36
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$386.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$251.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$599.70
|
| Rate for Payer: PHCS Commercial |
$1,857.12
|
| Rate for Payer: United Healthcare All Payer |
$1,702.36
|
|
|
STERLING ES 3*20 OTW
|
Facility
|
IP
|
$1,934.50
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.48 |
| Max. Negotiated Rate |
$1,857.12 |
| Rate for Payer: Aetna Commercial |
$1,489.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.91
|
| Rate for Payer: Cash Price |
$967.25
|
| Rate for Payer: Cigna Commercial |
$1,605.64
|
| Rate for Payer: First Health Commercial |
$1,837.78
|
| Rate for Payer: Humana Commercial |
$1,644.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.36
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$386.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$251.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$599.70
|
| Rate for Payer: PHCS Commercial |
$1,857.12
|
| Rate for Payer: United Healthcare All Payer |
$1,702.36
|
|
|
STERLING ES 3*30
|
Facility
|
OP
|
$1,934.50
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.48 |
| Max. Negotiated Rate |
$1,857.12 |
| Rate for Payer: Aetna Commercial |
$1,489.56
|
| Rate for Payer: Anthem Medicaid |
$665.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.91
|
| Rate for Payer: Cash Price |
$967.25
|
| Rate for Payer: Cigna Commercial |
$1,605.64
|
| Rate for Payer: First Health Commercial |
$1,837.78
|
| Rate for Payer: Humana Commercial |
$1,644.32
|
| Rate for Payer: Humana KY Medicaid |
$665.27
|
| Rate for Payer: Kentucky WC Medicaid |
$672.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.36
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$386.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$251.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$599.70
|
| Rate for Payer: PHCS Commercial |
$1,857.12
|
| Rate for Payer: United Healthcare All Payer |
$1,702.36
|
|
|
STERLING ES 3*30
|
Facility
|
IP
|
$1,934.50
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.48 |
| Max. Negotiated Rate |
$1,857.12 |
| Rate for Payer: Aetna Commercial |
$1,489.56
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.91
|
| Rate for Payer: Cash Price |
$967.25
|
| Rate for Payer: Cigna Commercial |
$1,605.64
|
| Rate for Payer: First Health Commercial |
$1,837.78
|
| Rate for Payer: Humana Commercial |
$1,644.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.29
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.36
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$386.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$251.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$599.70
|
| Rate for Payer: PHCS Commercial |
$1,857.12
|
| Rate for Payer: United Healthcare All Payer |
$1,702.36
|
|
|
STERLING ES 3.5*30
|
Facility
|
IP
|
$3,145.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$408.85 |
| Max. Negotiated Rate |
$3,019.20 |
| Rate for Payer: Aetna Commercial |
$2,421.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,453.10
|
| Rate for Payer: Cash Price |
$1,572.50
|
| Rate for Payer: Cigna Commercial |
$2,610.35
|
| Rate for Payer: First Health Commercial |
$2,987.75
|
| Rate for Payer: Humana Commercial |
$2,673.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,578.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,321.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$943.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,767.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,358.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$629.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$408.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$974.95
|
| Rate for Payer: PHCS Commercial |
$3,019.20
|
| Rate for Payer: United Healthcare All Payer |
$2,767.60
|
|
|
STERLING ES 3.5*30
|
Facility
|
OP
|
$3,145.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$408.85 |
| Max. Negotiated Rate |
$3,019.20 |
| Rate for Payer: Aetna Commercial |
$2,421.65
|
| Rate for Payer: Anthem Medicaid |
$1,081.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,453.10
|
| Rate for Payer: Cash Price |
$1,572.50
|
| Rate for Payer: Cigna Commercial |
$2,610.35
|
| Rate for Payer: First Health Commercial |
$2,987.75
|
| Rate for Payer: Humana Commercial |
$2,673.25
|
| Rate for Payer: Humana KY Medicaid |
$1,081.57
|
| Rate for Payer: Kentucky WC Medicaid |
$1,092.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,578.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,321.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$943.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,103.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,767.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,358.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$629.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$408.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$974.95
|
| Rate for Payer: PHCS Commercial |
$3,019.20
|
| Rate for Payer: United Healthcare All Payer |
$2,767.60
|
|
|
STERLING ES 3.5*40
|
Facility
|
IP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 3.5*40
|
Facility
|
OP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Anthem Medicaid |
$1,195.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Humana KY Medicaid |
$1,195.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,207.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,219.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 4*30
|
Facility
|
IP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 4*30
|
Facility
|
OP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Anthem Medicaid |
$1,195.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Humana KY Medicaid |
$1,195.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,207.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,219.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 4*40
|
Facility
|
IP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING ES 4*40
|
Facility
|
OP
|
$3,477.15
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.03 |
| Max. Negotiated Rate |
$3,338.06 |
| Rate for Payer: Aetna Commercial |
$2,677.41
|
| Rate for Payer: Anthem Medicaid |
$1,195.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,712.18
|
| Rate for Payer: Cash Price |
$1,738.58
|
| Rate for Payer: Cigna Commercial |
$2,886.03
|
| Rate for Payer: First Health Commercial |
$3,303.29
|
| Rate for Payer: Humana Commercial |
$2,955.58
|
| Rate for Payer: Humana KY Medicaid |
$1,195.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,207.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,851.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,566.14
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,043.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,219.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,059.89
|
| Rate for Payer: Ohio Health Group HMO |
$2,607.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$695.43
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$452.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,077.92
|
| Rate for Payer: PHCS Commercial |
$3,338.06
|
| Rate for Payer: United Healthcare All Payer |
$3,059.89
|
|
|
STERLING MONORAIL 3*30*135
|
Facility
|
IP
|
$3,110.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$404.30 |
| Max. Negotiated Rate |
$2,985.60 |
| Rate for Payer: Aetna Commercial |
$2,394.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,425.80
|
| Rate for Payer: Cash Price |
$1,555.00
|
| Rate for Payer: Cigna Commercial |
$2,581.30
|
| Rate for Payer: First Health Commercial |
$2,954.50
|
| Rate for Payer: Humana Commercial |
$2,643.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,550.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,295.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$933.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,736.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,332.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$622.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$404.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$964.10
|
| Rate for Payer: PHCS Commercial |
$2,985.60
|
| Rate for Payer: United Healthcare All Payer |
$2,736.80
|
|
|
STERLING MONORAIL 3*30*135
|
Facility
|
OP
|
$3,110.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$404.30 |
| Max. Negotiated Rate |
$2,985.60 |
| Rate for Payer: Aetna Commercial |
$2,394.70
|
| Rate for Payer: Anthem Medicaid |
$1,069.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,425.80
|
| Rate for Payer: Cash Price |
$1,555.00
|
| Rate for Payer: Cigna Commercial |
$2,581.30
|
| Rate for Payer: First Health Commercial |
$2,954.50
|
| Rate for Payer: Humana Commercial |
$2,643.50
|
| Rate for Payer: Humana KY Medicaid |
$1,069.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,080.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,550.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,295.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$933.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,090.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,736.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,332.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$622.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$404.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$964.10
|
| Rate for Payer: PHCS Commercial |
$2,985.60
|
| Rate for Payer: United Healthcare All Payer |
$2,736.80
|
|
