|
STERLING MONORAIL 4*20*135
|
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 MONORAIL 4*20*135
|
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 MONORAIL 4*3 CATH
|
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 MONORAIL 4*3 CATH
|
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 MONORAIL 5*10
|
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 MONORAIL 5*10
|
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 MONORAIL 5*20*135
|
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 MONORAIL 5*20*135
|
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 MONORAIL 5*20*80
|
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 MONORAIL 5*20*80
|
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 MONORAIL 5*30*135
|
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 MONORAIL 5*30*135
|
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 MONORAIL 5*60* 135 CA
|
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 MONORAIL 5*60* 135 CA
|
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 MONORAIL 6*20*135
|
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 MONORAIL 6*20*135
|
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 MONORAIL6*30*135 CATH
|
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 MONORAIL6*30*135 CATH
|
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 MONORAIL 6*40*135
|
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 MONORAIL 6*40*135
|
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 MONORAIL 6*6
|
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 MONORAIL 6*6
|
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 MONORAIL 7*20*135
|
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 MONORAIL 7*20*135
|
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 MONORAIL 7*3 CATH
|
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
|
|
