|
STERLING ES 2.5*30
|
Facility
|
IP
|
$3,429.88
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,028.96 |
| Max. Negotiated Rate |
$3,292.68 |
| Rate for Payer: Aetna Commercial |
$2,641.01
|
| Rate for Payer: Aetna Commercial |
$2,863.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,675.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,900.94
|
| Rate for Payer: Cash Price |
$1,714.94
|
| Rate for Payer: Cash Price |
$1,859.58
|
| Rate for Payer: Cigna Commercial |
$2,846.80
|
| Rate for Payer: Cigna Commercial |
$3,086.89
|
| Rate for Payer: First Health Commercial |
$3,533.19
|
| Rate for Payer: First Health Commercial |
$3,258.39
|
| Rate for Payer: Humana Commercial |
$3,161.28
|
| Rate for Payer: Humana Commercial |
$2,915.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,812.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,049.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,531.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,744.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,115.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,028.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,018.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,272.85
|
| Rate for Payer: Ohio Health Group HMO |
$2,572.41
|
| Rate for Payer: Ohio Health Group HMO |
$2,789.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,743.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,975.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,984.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,235.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,566.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,366.62
|
| Rate for Payer: PHCS Commercial |
$3,292.68
|
| Rate for Payer: PHCS Commercial |
$3,570.38
|
| Rate for Payer: United Healthcare All Payer |
$3,018.29
|
| Rate for Payer: United Healthcare All Payer |
$3,272.85
|
|
|
STERLING ES 2.5*30
|
Facility
|
OP
|
$3,429.88
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,028.96 |
| Max. Negotiated Rate |
$3,292.68 |
| Rate for Payer: Aetna Commercial |
$2,641.01
|
| Rate for Payer: Aetna Commercial |
$2,863.75
|
| Rate for Payer: Anthem Medicaid |
$1,179.54
|
| Rate for Payer: Anthem Medicaid |
$1,279.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,675.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,900.94
|
| Rate for Payer: Cash Price |
$1,714.94
|
| Rate for Payer: Cash Price |
$1,859.58
|
| Rate for Payer: Cigna Commercial |
$3,086.89
|
| Rate for Payer: Cigna Commercial |
$2,846.80
|
| Rate for Payer: First Health Commercial |
$3,533.19
|
| Rate for Payer: First Health Commercial |
$3,258.39
|
| Rate for Payer: Humana Commercial |
$2,915.40
|
| Rate for Payer: Humana Commercial |
$3,161.28
|
| Rate for Payer: Humana KY Medicaid |
$1,179.54
|
| Rate for Payer: Humana KY Medicaid |
$1,279.02
|
| Rate for Payer: Kentucky WC Medicaid |
$1,292.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,191.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,812.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,049.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,744.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,531.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,115.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,028.96
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,203.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,304.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,018.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,272.85
|
| Rate for Payer: Ohio Health Group HMO |
$2,572.41
|
| Rate for Payer: Ohio Health Group HMO |
$2,789.36
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,743.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,975.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,984.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,235.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,366.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,566.21
|
| Rate for Payer: PHCS Commercial |
$3,570.38
|
| Rate for Payer: PHCS Commercial |
$3,292.68
|
| Rate for Payer: United Healthcare All Payer |
$3,272.85
|
| Rate for Payer: United Healthcare All Payer |
$3,018.29
|
|
|
STERLING ES 2.5*40
|
Facility
|
IP
|
$3,368.38
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,010.51 |
| Max. Negotiated Rate |
$3,233.64 |
| Rate for Payer: Aetna Commercial |
$2,593.65
|
| Rate for Payer: Aetna Commercial |
$2,641.01
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,627.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,675.31
|
| Rate for Payer: Cash Price |
$1,684.19
|
| Rate for Payer: Cash Price |
$1,714.94
|
| Rate for Payer: Cigna Commercial |
$2,795.76
|
| Rate for Payer: Cigna Commercial |
$2,846.80
|
| Rate for Payer: First Health Commercial |
$3,258.39
|
| Rate for Payer: First Health Commercial |
$3,199.96
|
| Rate for Payer: Humana Commercial |
$2,915.40
|
| Rate for Payer: Humana Commercial |
$2,863.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,762.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,812.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,485.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,531.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,028.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,010.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,964.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,018.29
|
| Rate for Payer: Ohio Health Group HMO |
$2,526.28
|
| Rate for Payer: Ohio Health Group HMO |
$2,572.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,694.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,743.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,930.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,984.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,366.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,324.18
|
| Rate for Payer: PHCS Commercial |
$3,233.64
|
| Rate for Payer: PHCS Commercial |
$3,292.68
|
| Rate for Payer: United Healthcare All Payer |
$2,964.17
|
| Rate for Payer: United Healthcare All Payer |
$3,018.29
|
|
|
STERLING ES 2.5*40
|
Facility
|
OP
|
$3,368.38
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,010.51 |
| Max. Negotiated Rate |
$3,233.64 |
| Rate for Payer: Aetna Commercial |
$2,593.65
|
| Rate for Payer: Aetna Commercial |
$2,641.01
|
| Rate for Payer: Anthem Medicaid |
$1,158.39
|
| Rate for Payer: Anthem Medicaid |
$1,179.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,627.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,675.31
|
| Rate for Payer: Cash Price |
$1,684.19
|
| Rate for Payer: Cash Price |
$1,714.94
|
| Rate for Payer: Cigna Commercial |
$2,846.80
|
| Rate for Payer: Cigna Commercial |
$2,795.76
|
| Rate for Payer: First Health Commercial |
$3,258.39
|
| Rate for Payer: First Health Commercial |
$3,199.96
|
| Rate for Payer: Humana Commercial |
$2,863.12
|
| Rate for Payer: Humana Commercial |
$2,915.40
|
| Rate for Payer: Humana KY Medicaid |
$1,158.39
|
| Rate for Payer: Humana KY Medicaid |
$1,179.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,191.54
|
| Rate for Payer: Kentucky WC Medicaid |
$1,170.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,762.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,812.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,531.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,485.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,028.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,010.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,181.63
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,203.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,964.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,018.29
|
| Rate for Payer: Ohio Health Group HMO |
$2,526.28
|
| Rate for Payer: Ohio Health Group HMO |
$2,572.41
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,694.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,743.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,930.49
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,984.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,324.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,366.62
|
| Rate for Payer: PHCS Commercial |
$3,292.68
|
| Rate for Payer: PHCS Commercial |
$3,233.64
|
| Rate for Payer: United Healthcare All Payer |
$3,018.29
|
| Rate for Payer: United Healthcare All Payer |
$2,964.17
|
|
|
STERLING ES 3*20 OTW
|
Facility
|
IP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING ES 3*20 OTW
|
Facility
|
OP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem Medicaid |
$665.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Humana KY Medicaid |
$665.31
|
| Rate for Payer: Kentucky WC Medicaid |
$672.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING ES 3*30
|
Facility
|
IP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING ES 3*30
|
Facility
|
OP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem Medicaid |
$665.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Humana KY Medicaid |
$665.31
|
| Rate for Payer: Kentucky WC Medicaid |
$672.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING ES 3.5*30
|
Facility
|
IP
|
$3,012.50
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$903.75 |
| Max. Negotiated Rate |
$2,892.00 |
| Rate for Payer: Aetna Commercial |
$2,319.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,349.75
|
| Rate for Payer: Cash Price |
$1,506.25
|
| Rate for Payer: Cigna Commercial |
$2,500.38
|
| Rate for Payer: First Health Commercial |
$2,861.88
|
| Rate for Payer: Humana Commercial |
$2,560.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,470.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,223.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$903.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,651.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,259.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,410.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,620.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,078.62
|
| Rate for Payer: PHCS Commercial |
$2,892.00
|
| Rate for Payer: United Healthcare All Payer |
$2,651.00
|
|
|
STERLING ES 3.5*30
|
Facility
|
OP
|
$3,012.50
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$903.75 |
| Max. Negotiated Rate |
$2,892.00 |
| Rate for Payer: Aetna Commercial |
$2,319.62
|
| Rate for Payer: Anthem Medicaid |
$1,036.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,349.75
|
| Rate for Payer: Cash Price |
$1,506.25
|
| Rate for Payer: Cigna Commercial |
$2,500.38
|
| Rate for Payer: First Health Commercial |
$2,861.88
|
| Rate for Payer: Humana Commercial |
$2,560.62
|
| Rate for Payer: Humana KY Medicaid |
$1,036.00
|
| Rate for Payer: Kentucky WC Medicaid |
$1,046.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,470.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,223.22
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$903.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,056.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,651.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,259.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,410.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,620.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,078.62
|
| Rate for Payer: PHCS Commercial |
$2,892.00
|
| Rate for Payer: United Healthcare All Payer |
$2,651.00
|
|
|
STERLING ES 3.5*40
|
Facility
|
IP
|
$3,368.38
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,010.51 |
| Max. Negotiated Rate |
$3,233.64 |
| Rate for Payer: Aetna Commercial |
$2,593.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,627.34
|
| Rate for Payer: Cash Price |
$1,684.19
|
| Rate for Payer: Cigna Commercial |
$2,795.76
|
| Rate for Payer: First Health Commercial |
$3,199.96
|
| Rate for Payer: Humana Commercial |
$2,863.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,762.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,485.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,010.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,964.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,526.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,694.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,930.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,324.18
|
| Rate for Payer: PHCS Commercial |
$3,233.64
|
| Rate for Payer: United Healthcare All Payer |
$2,964.17
|
|
|
STERLING ES 3.5*40
|
Facility
|
OP
|
$3,368.38
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,010.51 |
| Max. Negotiated Rate |
$3,233.64 |
| Rate for Payer: Aetna Commercial |
$2,593.65
|
| Rate for Payer: Anthem Medicaid |
$1,158.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,627.34
|
| Rate for Payer: Cash Price |
$1,684.19
|
| Rate for Payer: Cigna Commercial |
$2,795.76
|
| Rate for Payer: First Health Commercial |
$3,199.96
|
| Rate for Payer: Humana Commercial |
$2,863.12
|
| Rate for Payer: Humana KY Medicaid |
$1,158.39
|
| Rate for Payer: Kentucky WC Medicaid |
$1,170.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,762.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,485.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,010.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,181.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,964.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,526.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,694.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,930.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,324.18
|
| Rate for Payer: PHCS Commercial |
$3,233.64
|
| Rate for Payer: United Healthcare All Payer |
$2,964.17
|
|
|
STERLING ES 4*30
|
Facility
|
IP
|
$3,368.38
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,010.51 |
| Max. Negotiated Rate |
$3,233.64 |
| Rate for Payer: Aetna Commercial |
$2,593.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,627.34
|
| Rate for Payer: Cash Price |
$1,684.19
|
| Rate for Payer: Cigna Commercial |
$2,795.76
|
| Rate for Payer: First Health Commercial |
$3,199.96
|
| Rate for Payer: Humana Commercial |
$2,863.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,762.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,485.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,010.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,964.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,526.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,694.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,930.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,324.18
|
| Rate for Payer: PHCS Commercial |
$3,233.64
|
| Rate for Payer: United Healthcare All Payer |
$2,964.17
|
|
|
STERLING ES 4*30
|
Facility
|
OP
|
$3,368.38
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,010.51 |
| Max. Negotiated Rate |
$3,233.64 |
| Rate for Payer: Aetna Commercial |
$2,593.65
|
| Rate for Payer: Anthem Medicaid |
$1,158.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,627.34
|
| Rate for Payer: Cash Price |
$1,684.19
|
| Rate for Payer: Cigna Commercial |
$2,795.76
|
| Rate for Payer: First Health Commercial |
$3,199.96
|
| Rate for Payer: Humana Commercial |
$2,863.12
|
| Rate for Payer: Humana KY Medicaid |
$1,158.39
|
| Rate for Payer: Kentucky WC Medicaid |
$1,170.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,762.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,485.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,010.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,181.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,964.17
|
| Rate for Payer: Ohio Health Group HMO |
$2,526.28
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,694.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,930.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,324.18
|
| Rate for Payer: PHCS Commercial |
$3,233.64
|
| Rate for Payer: United Healthcare All Payer |
$2,964.17
|
|
|
STERLING ES 4*40
|
Facility
|
IP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING ES 4*40
|
Facility
|
OP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem Medicaid |
$665.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Humana KY Medicaid |
$665.31
|
| Rate for Payer: Kentucky WC Medicaid |
$672.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING MONORAIL 3*30*135
|
Facility
|
OP
|
$2,975.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$892.50 |
| Max. Negotiated Rate |
$2,856.00 |
| Rate for Payer: Aetna Commercial |
$2,290.75
|
| Rate for Payer: Anthem Medicaid |
$1,023.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,320.50
|
| Rate for Payer: Cash Price |
$1,487.50
|
| Rate for Payer: Cigna Commercial |
$2,469.25
|
| Rate for Payer: First Health Commercial |
$2,826.25
|
| Rate for Payer: Humana Commercial |
$2,528.75
|
| Rate for Payer: Humana KY Medicaid |
$1,023.10
|
| Rate for Payer: Kentucky WC Medicaid |
$1,033.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,439.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,195.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,618.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,231.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,380.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,588.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,052.75
|
| Rate for Payer: PHCS Commercial |
$2,856.00
|
| Rate for Payer: United Healthcare All Payer |
$2,618.00
|
|
|
STERLING MONORAIL 3*30*135
|
Facility
|
IP
|
$2,975.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$892.50 |
| Max. Negotiated Rate |
$2,856.00 |
| Rate for Payer: Aetna Commercial |
$2,290.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,320.50
|
| Rate for Payer: Cash Price |
$1,487.50
|
| Rate for Payer: Cigna Commercial |
$2,469.25
|
| Rate for Payer: First Health Commercial |
$2,826.25
|
| Rate for Payer: Humana Commercial |
$2,528.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,439.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,195.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$892.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,618.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,231.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,380.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,588.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,052.75
|
| Rate for Payer: PHCS Commercial |
$2,856.00
|
| Rate for Payer: United Healthcare All Payer |
$2,618.00
|
|
|
STERLING MONORAIL 4*20*135
|
Facility
|
OP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem Medicaid |
$665.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Humana KY Medicaid |
$665.31
|
| Rate for Payer: Kentucky WC Medicaid |
$672.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING MONORAIL 4*20*135
|
Facility
|
IP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING MONORAIL 4*3 CATH
|
Facility
|
IP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING MONORAIL 4*3 CATH
|
Facility
|
OP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem Medicaid |
$665.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Humana KY Medicaid |
$665.31
|
| Rate for Payer: Kentucky WC Medicaid |
$672.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING MONORAIL 5*10
|
Facility
|
IP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING MONORAIL 5*10
|
Facility
|
OP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem Medicaid |
$665.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Humana KY Medicaid |
$665.31
|
| Rate for Payer: Kentucky WC Medicaid |
$672.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$678.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
|
STERLING MONORAIL 5*20*135
|
Facility
|
IP
|
$1,934.60
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.38 |
| Max. Negotiated Rate |
$1,857.22 |
| Rate for Payer: Aetna Commercial |
$1,489.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,508.99
|
| Rate for Payer: Cash Price |
$967.30
|
| Rate for Payer: Cigna Commercial |
$1,605.72
|
| Rate for Payer: First Health Commercial |
$1,837.87
|
| Rate for Payer: Humana Commercial |
$1,644.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,586.37
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,427.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$580.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,702.45
|
| Rate for Payer: Ohio Health Group HMO |
$1,450.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,547.68
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,683.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,334.87
|
| Rate for Payer: PHCS Commercial |
$1,857.22
|
| Rate for Payer: United Healthcare All Payer |
$1,702.45
|
|
