|
SYN CEM HO FEM COMP SZ 17
|
Facility
|
IP
|
$7,545.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.85 |
| Max. Negotiated Rate |
$7,243.20 |
| Rate for Payer: Aetna Commercial |
$5,809.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,885.10
|
| Rate for Payer: Cash Price |
$3,772.50
|
| Rate for Payer: Cigna Commercial |
$6,262.35
|
| Rate for Payer: First Health Commercial |
$7,167.75
|
| Rate for Payer: Humana Commercial |
$6,413.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,186.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,568.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,263.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,639.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,658.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,509.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$980.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,338.95
|
| Rate for Payer: PHCS Commercial |
$7,243.20
|
| Rate for Payer: United Healthcare All Payer |
$6,639.60
|
|
|
SYN CEM HO FEM COMP SZ 17
|
Facility
|
OP
|
$7,545.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.85 |
| Max. Negotiated Rate |
$7,243.20 |
| Rate for Payer: Aetna Commercial |
$5,809.65
|
| Rate for Payer: Anthem Medicaid |
$2,594.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,885.10
|
| Rate for Payer: Cash Price |
$3,772.50
|
| Rate for Payer: Cigna Commercial |
$6,262.35
|
| Rate for Payer: First Health Commercial |
$7,167.75
|
| Rate for Payer: Humana Commercial |
$6,413.25
|
| Rate for Payer: Humana KY Medicaid |
$2,594.73
|
| Rate for Payer: Kentucky WC Medicaid |
$2,621.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,186.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,568.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,263.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,646.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,639.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,658.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,509.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$980.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,338.95
|
| Rate for Payer: PHCS Commercial |
$7,243.20
|
| Rate for Payer: United Healthcare All Payer |
$6,639.60
|
|
|
SYN CEM HO FEM COMP SZ 9
|
Facility
|
IP
|
$7,545.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.85 |
| Max. Negotiated Rate |
$7,243.20 |
| Rate for Payer: Aetna Commercial |
$5,809.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,885.10
|
| Rate for Payer: Cash Price |
$3,772.50
|
| Rate for Payer: Cigna Commercial |
$6,262.35
|
| Rate for Payer: First Health Commercial |
$7,167.75
|
| Rate for Payer: Humana Commercial |
$6,413.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,186.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,568.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,263.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,639.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,658.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,509.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$980.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,338.95
|
| Rate for Payer: PHCS Commercial |
$7,243.20
|
| Rate for Payer: United Healthcare All Payer |
$6,639.60
|
|
|
SYN CEM HO FEM COMP SZ 9
|
Facility
|
OP
|
$7,545.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.85 |
| Max. Negotiated Rate |
$7,243.20 |
| Rate for Payer: Aetna Commercial |
$5,809.65
|
| Rate for Payer: Anthem Medicaid |
$2,594.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,885.10
|
| Rate for Payer: Cash Price |
$3,772.50
|
| Rate for Payer: Cigna Commercial |
$6,262.35
|
| Rate for Payer: First Health Commercial |
$7,167.75
|
| Rate for Payer: Humana Commercial |
$6,413.25
|
| Rate for Payer: Humana KY Medicaid |
$2,594.73
|
| Rate for Payer: Kentucky WC Medicaid |
$2,621.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,186.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,568.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,263.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,646.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,639.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,658.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,509.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$980.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,338.95
|
| Rate for Payer: PHCS Commercial |
$7,243.20
|
| Rate for Payer: United Healthcare All Payer |
$6,639.60
|
|
|
SYN CEM SEL HO 11 10/12 SZ9
|
Facility
|
IP
|
$7,545.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.85 |
| Max. Negotiated Rate |
$7,243.20 |
| Rate for Payer: Aetna Commercial |
$5,809.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,885.10
|
| Rate for Payer: Cash Price |
$3,772.50
|
| Rate for Payer: Cigna Commercial |
$6,262.35
|
| Rate for Payer: First Health Commercial |
$7,167.75
|
| Rate for Payer: Humana Commercial |
$6,413.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,186.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,568.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,263.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,639.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,658.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,509.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$980.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,338.95
|
| Rate for Payer: PHCS Commercial |
$7,243.20
|
| Rate for Payer: United Healthcare All Payer |
$6,639.60
|
|
|
SYN CEM SEL HO 11 10/12 SZ9
|
Facility
|
OP
|
$7,545.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$980.85 |
| Max. Negotiated Rate |
$7,243.20 |
| Rate for Payer: Aetna Commercial |
$5,809.65
|
| Rate for Payer: Anthem Medicaid |
$2,594.73
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,885.10
|
| Rate for Payer: Cash Price |
$3,772.50
|
| Rate for Payer: Cigna Commercial |
$6,262.35
|
| Rate for Payer: First Health Commercial |
$7,167.75
|
| Rate for Payer: Humana Commercial |
$6,413.25
|
| Rate for Payer: Humana KY Medicaid |
$2,594.73
|
| Rate for Payer: Kentucky WC Medicaid |
$2,621.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,186.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,568.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,263.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,646.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,639.60
|
| Rate for Payer: Ohio Health Group HMO |
$5,658.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,509.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$980.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,338.95
|
| Rate for Payer: PHCS Commercial |
$7,243.20
|
| Rate for Payer: United Healthcare All Payer |
$6,639.60
|
|
|
SYNCOPE AND COLLAPSE
|
Facility
|
IP
|
$10,101.41
|
|
|
Service Code
|
MSDRG 312
|
| Min. Negotiated Rate |
$6,854.53 |
| Max. Negotiated Rate |
$10,101.41 |
| Rate for Payer: Anthem Medicaid |
$6,854.53
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$7,215.29
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$10,101.41
|
| Rate for Payer: CareSource Just4Me Medicare |
$9,740.64
|
| Rate for Payer: Humana KY Medicaid |
$6,854.53
|
| Rate for Payer: Humana Medicare Advantage |
$7,215.29
|
| Rate for Payer: Kentucky WC Medicaid |
$6,923.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,658.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,991.62
|
|
|
SYN FRAC MGMT FEM SZ 10
|
Facility
|
OP
|
$15,546.48
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,021.04 |
| Max. Negotiated Rate |
$14,924.62 |
| Rate for Payer: Aetna Commercial |
$11,970.79
|
| Rate for Payer: Anthem Medicaid |
$5,346.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,126.25
|
| Rate for Payer: Cash Price |
$7,773.24
|
| Rate for Payer: Cigna Commercial |
$12,903.58
|
| Rate for Payer: First Health Commercial |
$14,769.16
|
| Rate for Payer: Humana Commercial |
$13,214.51
|
| Rate for Payer: Humana KY Medicaid |
$5,346.43
|
| Rate for Payer: Kentucky WC Medicaid |
$5,400.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,748.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,473.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,663.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,453.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,680.90
|
| Rate for Payer: Ohio Health Group HMO |
$11,659.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,109.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,021.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,819.41
|
| Rate for Payer: PHCS Commercial |
$14,924.62
|
| Rate for Payer: United Healthcare All Payer |
$13,680.90
|
|
|
SYN FRAC MGMT FEM SZ 10
|
Facility
|
IP
|
$15,546.48
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,021.04 |
| Max. Negotiated Rate |
$14,924.62 |
| Rate for Payer: Aetna Commercial |
$11,970.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,126.25
|
| Rate for Payer: Cash Price |
$7,773.24
|
| Rate for Payer: Cigna Commercial |
$12,903.58
|
| Rate for Payer: First Health Commercial |
$14,769.16
|
| Rate for Payer: Humana Commercial |
$13,214.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,748.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,473.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,663.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,680.90
|
| Rate for Payer: Ohio Health Group HMO |
$11,659.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,109.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,021.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,819.41
|
| Rate for Payer: PHCS Commercial |
$14,924.62
|
| Rate for Payer: United Healthcare All Payer |
$13,680.90
|
|
|
SYN FRAC MGMT FEM SZ 11
|
Facility
|
IP
|
$15,546.48
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,021.04 |
| Max. Negotiated Rate |
$14,924.62 |
| Rate for Payer: Aetna Commercial |
$11,970.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,126.25
|
| Rate for Payer: Cash Price |
$7,773.24
|
| Rate for Payer: Cigna Commercial |
$12,903.58
|
| Rate for Payer: First Health Commercial |
$14,769.16
|
| Rate for Payer: Humana Commercial |
$13,214.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,748.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,473.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,663.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,680.90
|
| Rate for Payer: Ohio Health Group HMO |
$11,659.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,109.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,021.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,819.41
|
| Rate for Payer: PHCS Commercial |
$14,924.62
|
| Rate for Payer: United Healthcare All Payer |
$13,680.90
|
|
|
SYN FRAC MGMT FEM SZ 11
|
Facility
|
OP
|
$15,546.48
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,021.04 |
| Max. Negotiated Rate |
$14,924.62 |
| Rate for Payer: Aetna Commercial |
$11,970.79
|
| Rate for Payer: Anthem Medicaid |
$5,346.43
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,126.25
|
| Rate for Payer: Cash Price |
$7,773.24
|
| Rate for Payer: Cigna Commercial |
$12,903.58
|
| Rate for Payer: First Health Commercial |
$14,769.16
|
| Rate for Payer: Humana Commercial |
$13,214.51
|
| Rate for Payer: Humana KY Medicaid |
$5,346.43
|
| Rate for Payer: Kentucky WC Medicaid |
$5,400.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,748.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,473.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,663.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,453.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,680.90
|
| Rate for Payer: Ohio Health Group HMO |
$11,659.86
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,109.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,021.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,819.41
|
| Rate for Payer: PHCS Commercial |
$14,924.62
|
| Rate for Payer: United Healthcare All Payer |
$13,680.90
|
|
|
SYN FRAC MGMT FEM SZ 12
|
Facility
|
OP
|
$9,141.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,188.40 |
| Max. Negotiated Rate |
$8,775.85 |
| Rate for Payer: Aetna Commercial |
$7,038.96
|
| Rate for Payer: Anthem Medicaid |
$3,143.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,130.38
|
| Rate for Payer: Cash Price |
$4,570.76
|
| Rate for Payer: Cigna Commercial |
$7,587.45
|
| Rate for Payer: First Health Commercial |
$8,684.43
|
| Rate for Payer: Humana Commercial |
$7,770.28
|
| Rate for Payer: Humana KY Medicaid |
$3,143.77
|
| Rate for Payer: Kentucky WC Medicaid |
$3,175.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,496.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,746.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,742.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,206.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,044.53
|
| Rate for Payer: Ohio Health Group HMO |
$6,856.13
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,828.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,188.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,833.87
|
| Rate for Payer: PHCS Commercial |
$8,775.85
|
| Rate for Payer: United Healthcare All Payer |
$8,044.53
|
|
|
SYN FRAC MGMT FEM SZ 12
|
Facility
|
IP
|
$9,141.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,188.40 |
| Max. Negotiated Rate |
$8,775.85 |
| Rate for Payer: Aetna Commercial |
$7,038.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,130.38
|
| Rate for Payer: Cash Price |
$4,570.76
|
| Rate for Payer: Cigna Commercial |
$7,587.45
|
| Rate for Payer: First Health Commercial |
$8,684.43
|
| Rate for Payer: Humana Commercial |
$7,770.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,496.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,746.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,742.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,044.53
|
| Rate for Payer: Ohio Health Group HMO |
$6,856.13
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,828.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,188.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,833.87
|
| Rate for Payer: PHCS Commercial |
$8,775.85
|
| Rate for Payer: United Healthcare All Payer |
$8,044.53
|
|
|
SYN FRAC MGMT FEM SZ 13
|
Facility
|
IP
|
$9,141.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,188.40 |
| Max. Negotiated Rate |
$8,775.85 |
| Rate for Payer: Aetna Commercial |
$7,038.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,130.38
|
| Rate for Payer: Cash Price |
$4,570.76
|
| Rate for Payer: Cigna Commercial |
$7,587.45
|
| Rate for Payer: First Health Commercial |
$8,684.43
|
| Rate for Payer: Humana Commercial |
$7,770.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,496.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,746.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,742.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,044.53
|
| Rate for Payer: Ohio Health Group HMO |
$6,856.13
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,828.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,188.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,833.87
|
| Rate for Payer: PHCS Commercial |
$8,775.85
|
| Rate for Payer: United Healthcare All Payer |
$8,044.53
|
|
|
SYN FRAC MGMT FEM SZ 13
|
Facility
|
OP
|
$9,141.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,188.40 |
| Max. Negotiated Rate |
$8,775.85 |
| Rate for Payer: Aetna Commercial |
$7,038.96
|
| Rate for Payer: Anthem Medicaid |
$3,143.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,130.38
|
| Rate for Payer: Cash Price |
$4,570.76
|
| Rate for Payer: Cigna Commercial |
$7,587.45
|
| Rate for Payer: First Health Commercial |
$8,684.43
|
| Rate for Payer: Humana Commercial |
$7,770.28
|
| Rate for Payer: Humana KY Medicaid |
$3,143.77
|
| Rate for Payer: Kentucky WC Medicaid |
$3,175.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,496.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,746.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,742.45
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,206.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,044.53
|
| Rate for Payer: Ohio Health Group HMO |
$6,856.13
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,828.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,188.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,833.87
|
| Rate for Payer: PHCS Commercial |
$8,775.85
|
| Rate for Payer: United Healthcare All Payer |
$8,044.53
|
|
|
SYN HA HO PRESFIT FEM CMP SZ10
|
Facility
|
OP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem Medicaid |
$8,260.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Humana KY Medicaid |
$8,260.47
|
| Rate for Payer: Kentucky WC Medicaid |
$8,344.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,426.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
|
SYN HA HO PRESFIT FEM CMP SZ10
|
Facility
|
IP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
|
SYN HA HO PRESFIT FEM CMP SZ11
|
Facility
|
OP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem Medicaid |
$8,260.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Humana KY Medicaid |
$8,260.47
|
| Rate for Payer: Kentucky WC Medicaid |
$8,344.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,426.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
|
SYN HA HO PRESFIT FEM CMP SZ11
|
Facility
|
IP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
|
SYN HA HO PRESFIT FEM CMP SZ12
|
Facility
|
OP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem Medicaid |
$8,260.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Humana KY Medicaid |
$8,260.47
|
| Rate for Payer: Kentucky WC Medicaid |
$8,344.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,426.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
|
SYN HA HO PRESFIT FEM CMP SZ12
|
Facility
|
IP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
|
SYN HA HO PRESFIT FEM CMP SZ13
|
Facility
|
OP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem Medicaid |
$8,260.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Humana KY Medicaid |
$8,260.47
|
| Rate for Payer: Kentucky WC Medicaid |
$8,344.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,426.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
|
SYN HA HO PRESFIT FEM CMP SZ13
|
Facility
|
IP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
|
SYN HA HO PRESFIT FEM CMP SZ14
|
Facility
|
OP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem Medicaid |
$8,260.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Humana KY Medicaid |
$8,260.47
|
| Rate for Payer: Kentucky WC Medicaid |
$8,344.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,426.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
|
SYN HA HO PRESFIT FEM CMP SZ14
|
Facility
|
IP
|
$24,019.99
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,122.60 |
| Max. Negotiated Rate |
$23,059.19 |
| Rate for Payer: Aetna Commercial |
$18,495.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,735.59
|
| Rate for Payer: Cash Price |
$12,009.99
|
| Rate for Payer: Cigna Commercial |
$19,936.59
|
| Rate for Payer: First Health Commercial |
$22,818.99
|
| Rate for Payer: Humana Commercial |
$20,416.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,696.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,726.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,206.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,137.59
|
| Rate for Payer: Ohio Health Group HMO |
$18,014.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,804.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,122.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,446.20
|
| Rate for Payer: PHCS Commercial |
$23,059.19
|
| Rate for Payer: United Healthcare All Payer |
$21,137.59
|
|
