|
STERLING SL OTW 2*120*150
|
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 SL OTW 2*120*150
|
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 SL OTW 2*150*150
|
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 SL OTW 2*150*150
|
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 SL OTW 2.5*100*150
|
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 SL OTW 2.5*100*150
|
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 SL OTW 2.5*120*150
|
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 SL OTW 2.5*120*150
|
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 SL OTW 2.5*150*150
|
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 SL OTW 2.5*150*150
|
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 SL OTW 2.5*80*150
|
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 SL OTW 2.5*80*150
|
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 SL OTW 2*80*150
|
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 SL OTW 2*80*150
|
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 SL OTW 3*100*150
|
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 SL OTW 3*100*150
|
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 SL OTW 3*120*150
|
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 SL OTW 3*120*150
|
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 SL OTW 3*150*150
|
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 SL OTW 3*150*150
|
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 SL OTW 3*80*150
|
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 SL OTW 3*80*150
|
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 SL OTW 4*100*150
|
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 SL OTW 4*100*150
|
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 SL OTW 4*120*150
|
Facility
|
OP
|
$3,668.74
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$476.94 |
| Max. Negotiated Rate |
$3,521.99 |
| Rate for Payer: Aetna Commercial |
$2,824.93
|
| Rate for Payer: Anthem Medicaid |
$1,261.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,861.62
|
| Rate for Payer: Cash Price |
$1,834.37
|
| Rate for Payer: Cigna Commercial |
$3,045.05
|
| Rate for Payer: First Health Commercial |
$3,485.30
|
| Rate for Payer: Humana Commercial |
$3,118.43
|
| Rate for Payer: Humana KY Medicaid |
$1,261.68
|
| Rate for Payer: Kentucky WC Medicaid |
$1,274.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,008.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,707.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,100.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,286.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,228.49
|
| Rate for Payer: Ohio Health Group HMO |
$2,751.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$733.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$476.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,137.31
|
| Rate for Payer: PHCS Commercial |
$3,521.99
|
| Rate for Payer: United Healthcare All Payer |
$3,228.49
|
|
