|
THORACIC LYMPHADENECTOMY
|
Facility
|
OP
|
$850.00
|
|
|
Service Code
|
HCPCS 38746
|
| Hospital Charge Code |
76101608
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.50 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna Commercial |
$654.50
|
| Rate for Payer: Anthem Medicaid |
$292.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$663.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$705.50
|
| Rate for Payer: First Health Commercial |
$807.50
|
| Rate for Payer: Humana Commercial |
$722.50
|
| Rate for Payer: Humana KY Medicaid |
$292.32
|
| Rate for Payer: Kentucky WC Medicaid |
$295.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$697.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$627.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$255.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$298.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$748.00
|
| Rate for Payer: Ohio Health Group HMO |
$637.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$170.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$110.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$263.50
|
| Rate for Payer: PHCS Commercial |
$816.00
|
| Rate for Payer: United Healthcare All Payer |
$748.00
|
|
|
THORACIC LYMPHADENECTOMY
|
Facility
|
IP
|
$850.00
|
|
|
Service Code
|
HCPCS 38746
|
| Hospital Charge Code |
76101608
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.50 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna Commercial |
$654.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$663.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$705.50
|
| Rate for Payer: First Health Commercial |
$807.50
|
| Rate for Payer: Humana Commercial |
$722.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$697.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$627.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$255.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$748.00
|
| Rate for Payer: Ohio Health Group HMO |
$637.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$170.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$110.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$263.50
|
| Rate for Payer: PHCS Commercial |
$816.00
|
| Rate for Payer: United Healthcare All Payer |
$748.00
|
|
|
THORACIC LYMPHADENECTOMY(P
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 38746
|
| Hospital Charge Code |
761P1608
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$203.12 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$417.00
|
| Rate for Payer: Anthem Medicaid |
$203.12
|
| Rate for Payer: Buckeye Medicare Advantage |
$850.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cash Price |
$425.00
|
| Rate for Payer: Cigna Commercial |
$386.57
|
| Rate for Payer: Healthspan PPO |
$333.43
|
| Rate for Payer: Humana Medicaid |
$203.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$349.93
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$207.18
|
| Rate for Payer: Molina Healthcare Passport |
$203.12
|
| Rate for Payer: Multiplan PHCS |
$510.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$595.00
|
| Rate for Payer: UHCCP Medicaid |
$297.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$205.15
|
|
|
THORACOSCOPIC DIAPHRAGM PLICAT
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 39599
|
| Hospital Charge Code |
76102696
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Buckeye Medicare Advantage |
$1,100.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Multiplan PHCS |
$660.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$770.00
|
| Rate for Payer: UHCCP Medicaid |
$385.00
|
|
|
THORACOSCOPIC DIAPHRAGM PLIC(P
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 39599
|
| Hospital Charge Code |
761P2696
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Buckeye Medicare Advantage |
$1,100.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Healthspan PPO |
$0.60
|
| Rate for Payer: Multiplan PHCS |
$660.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$770.00
|
| Rate for Payer: UHCCP Medicaid |
$385.00
|
|
|
THORACOSCOP W/ESOPH MUSC EXC
|
Professional
|
Both
|
$3,085.00
|
|
|
Service Code
|
HCPCS 32665
|
| Hospital Charge Code |
76101223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$880.74 |
| Max. Negotiated Rate |
$3,085.00 |
| Rate for Payer: Aetna Commercial |
$2,012.31
|
| Rate for Payer: Anthem Medicaid |
$880.74
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,085.00
|
| Rate for Payer: Cash Price |
$1,542.50
|
| Rate for Payer: Cash Price |
$1,542.50
|
| Rate for Payer: Cigna Commercial |
$1,866.06
|
| Rate for Payer: Healthspan PPO |
$1,571.16
|
| Rate for Payer: Humana Medicaid |
$880.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,679.02
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$898.35
|
| Rate for Payer: Molina Healthcare Passport |
$880.74
|
| Rate for Payer: Multiplan PHCS |
$1,851.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,159.50
|
| Rate for Payer: UHCCP Medicaid |
$1,079.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$889.55
|
|
|
THORACOSCOP W/ESOPH MUSC EXC
|
Facility
|
OP
|
$3,085.00
|
|
|
Service Code
|
HCPCS 32665
|
| Hospital Charge Code |
76101223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$401.05 |
| Max. Negotiated Rate |
$2,961.60 |
| Rate for Payer: Aetna Commercial |
$2,375.45
|
| Rate for Payer: Anthem Medicaid |
$1,060.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,406.30
|
| Rate for Payer: Cash Price |
$1,542.50
|
| Rate for Payer: Cigna Commercial |
$2,560.55
|
| Rate for Payer: First Health Commercial |
$2,930.75
|
| Rate for Payer: Humana Commercial |
$2,622.25
|
| Rate for Payer: Humana KY Medicaid |
$1,060.93
|
| Rate for Payer: Kentucky WC Medicaid |
$1,071.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,529.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,276.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$925.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,082.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,714.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,313.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$617.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$401.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$956.35
|
| Rate for Payer: PHCS Commercial |
$2,961.60
|
| Rate for Payer: United Healthcare All Payer |
$2,714.80
|
|
|
THORACOSCOP W/ESOPH MUSC EXC
|
Facility
|
IP
|
$3,085.00
|
|
|
Service Code
|
HCPCS 32665
|
| Hospital Charge Code |
76101223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$401.05 |
| Max. Negotiated Rate |
$2,961.60 |
| Rate for Payer: Aetna Commercial |
$2,375.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,406.30
|
| Rate for Payer: Cash Price |
$1,542.50
|
| Rate for Payer: Cigna Commercial |
$2,560.55
|
| Rate for Payer: First Health Commercial |
$2,930.75
|
| Rate for Payer: Humana Commercial |
$2,622.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,529.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,276.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$925.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,714.80
|
| Rate for Payer: Ohio Health Group HMO |
$2,313.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$617.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$401.05
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$956.35
|
| Rate for Payer: PHCS Commercial |
$2,961.60
|
| Rate for Payer: United Healthcare All Payer |
$2,714.80
|
|
|
THORACOSCOP W/ESOPH MUSC EX(P
|
Professional
|
Both
|
$3,085.00
|
|
|
Service Code
|
HCPCS 32665
|
| Hospital Charge Code |
761P1223
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$880.74 |
| Max. Negotiated Rate |
$3,085.00 |
| Rate for Payer: Aetna Commercial |
$2,012.31
|
| Rate for Payer: Anthem Medicaid |
$880.74
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,085.00
|
| Rate for Payer: Cash Price |
$1,542.50
|
| Rate for Payer: Cash Price |
$1,542.50
|
| Rate for Payer: Cigna Commercial |
$1,866.06
|
| Rate for Payer: Healthspan PPO |
$1,571.16
|
| Rate for Payer: Humana Medicaid |
$880.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,679.02
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$898.35
|
| Rate for Payer: Molina Healthcare Passport |
$880.74
|
| Rate for Payer: Multiplan PHCS |
$1,851.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,159.50
|
| Rate for Payer: UHCCP Medicaid |
$1,079.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$889.55
|
|
|
THORACOSCOPY
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32656
|
| Hospital Charge Code |
76101219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.00 |
| Max. Negotiated Rate |
$1,920.00 |
| Rate for Payer: Aetna Commercial |
$1,540.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,560.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$1,660.00
|
| Rate for Payer: First Health Commercial |
$1,900.00
|
| Rate for Payer: Humana Commercial |
$1,700.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,640.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,476.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$600.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,760.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,500.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$620.00
|
| Rate for Payer: PHCS Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Payer |
$1,760.00
|
|
|
THORACOSCOPY
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 32659
|
| Hospital Charge Code |
76101220
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$757.99 |
| Max. Negotiated Rate |
$2,200.00 |
| Rate for Payer: Aetna Commercial |
$1,234.04
|
| Rate for Payer: Anthem Medicaid |
$757.99
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,200.00
|
| Rate for Payer: Cash Price |
$1,100.00
|
| Rate for Payer: Cash Price |
$1,100.00
|
| Rate for Payer: Cigna Commercial |
$1,208.30
|
| Rate for Payer: Healthspan PPO |
$963.51
|
| Rate for Payer: Humana Medicaid |
$757.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,015.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$773.15
|
| Rate for Payer: Molina Healthcare Passport |
$757.99
|
| Rate for Payer: Multiplan PHCS |
$1,320.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,540.00
|
| Rate for Payer: UHCCP Medicaid |
$770.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$765.57
|
|
|
THORACOSCOPY
|
Facility
|
IP
|
$2,200.00
|
|
|
Service Code
|
HCPCS 32659
|
| Hospital Charge Code |
76101220
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$2,112.00 |
| Rate for Payer: Aetna Commercial |
$1,694.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,100.00
|
| Rate for Payer: Cigna Commercial |
$1,826.00
|
| Rate for Payer: First Health Commercial |
$2,090.00
|
| Rate for Payer: Humana Commercial |
$1,870.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,804.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,623.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$660.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,936.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,650.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$440.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$286.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$682.00
|
| Rate for Payer: PHCS Commercial |
$2,112.00
|
| Rate for Payer: United Healthcare All Payer |
$1,936.00
|
|
|
THORACOSCOPY
|
Professional
|
Both
|
$3,000.00
|
|
|
Service Code
|
HCPCS 32652
|
| Hospital Charge Code |
76101215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,014.23 |
| Max. Negotiated Rate |
$3,000.00 |
| Rate for Payer: Aetna Commercial |
$2,677.82
|
| Rate for Payer: Anthem Medicaid |
$1,014.23
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,000.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$2,465.77
|
| Rate for Payer: Healthspan PPO |
$2,090.77
|
| Rate for Payer: Humana Medicaid |
$1,014.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,285.83
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,034.51
|
| Rate for Payer: Molina Healthcare Passport |
$1,014.23
|
| Rate for Payer: Multiplan PHCS |
$1,800.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,100.00
|
| Rate for Payer: UHCCP Medicaid |
$1,050.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,024.37
|
|
|
THORACOSCOPY
|
Facility
|
IP
|
$3,000.00
|
|
|
Service Code
|
HCPCS 32652
|
| Hospital Charge Code |
76101215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.00 |
| Max. Negotiated Rate |
$2,880.00 |
| Rate for Payer: Aetna Commercial |
$2,310.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,340.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$2,490.00
|
| Rate for Payer: First Health Commercial |
$2,850.00
|
| Rate for Payer: Humana Commercial |
$2,550.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,460.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,214.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$900.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,640.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$390.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$930.00
|
| Rate for Payer: PHCS Commercial |
$2,880.00
|
| Rate for Payer: United Healthcare All Payer |
$2,640.00
|
|
|
THORACOSCOPY
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32656
|
| Hospital Charge Code |
76101219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.00 |
| Max. Negotiated Rate |
$1,920.00 |
| Rate for Payer: Aetna Commercial |
$1,540.00
|
| Rate for Payer: Anthem Medicaid |
$687.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,560.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$1,660.00
|
| Rate for Payer: First Health Commercial |
$1,900.00
|
| Rate for Payer: Humana Commercial |
$1,700.00
|
| Rate for Payer: Humana KY Medicaid |
$687.80
|
| Rate for Payer: Kentucky WC Medicaid |
$694.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,640.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,476.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$600.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$701.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,760.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,500.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$620.00
|
| Rate for Payer: PHCS Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Payer |
$1,760.00
|
|
|
THORACOSCOPY
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
HCPCS 32652
|
| Hospital Charge Code |
76101215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.00 |
| Max. Negotiated Rate |
$2,880.00 |
| Rate for Payer: Aetna Commercial |
$2,310.00
|
| Rate for Payer: Anthem Medicaid |
$1,031.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,340.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cigna Commercial |
$2,490.00
|
| Rate for Payer: First Health Commercial |
$2,850.00
|
| Rate for Payer: Humana Commercial |
$2,550.00
|
| Rate for Payer: Humana KY Medicaid |
$1,031.70
|
| Rate for Payer: Kentucky WC Medicaid |
$1,042.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,460.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,214.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$900.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,052.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,640.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$390.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$930.00
|
| Rate for Payer: PHCS Commercial |
$2,880.00
|
| Rate for Payer: United Healthcare All Payer |
$2,640.00
|
|
|
THORACOSCOPY
|
Facility
|
OP
|
$2,200.00
|
|
|
Service Code
|
HCPCS 32659
|
| Hospital Charge Code |
76101220
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$2,112.00 |
| Rate for Payer: Aetna Commercial |
$1,694.00
|
| Rate for Payer: Anthem Medicaid |
$756.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,100.00
|
| Rate for Payer: Cigna Commercial |
$1,826.00
|
| Rate for Payer: First Health Commercial |
$2,090.00
|
| Rate for Payer: Humana Commercial |
$1,870.00
|
| Rate for Payer: Humana KY Medicaid |
$756.58
|
| Rate for Payer: Kentucky WC Medicaid |
$764.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,804.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,623.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$660.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$771.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,936.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,650.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$440.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$286.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$682.00
|
| Rate for Payer: PHCS Commercial |
$2,112.00
|
| Rate for Payer: United Healthcare All Payer |
$1,936.00
|
|
|
THORACOSCOPY
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32656
|
| Hospital Charge Code |
76101219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$2,000.00 |
| Rate for Payer: Aetna Commercial |
$1,352.90
|
| Rate for Payer: Anthem Medicaid |
$770.74
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,000.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$1,324.64
|
| Rate for Payer: Healthspan PPO |
$1,056.31
|
| Rate for Payer: Humana Medicaid |
$770.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,103.26
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$786.15
|
| Rate for Payer: Molina Healthcare Passport |
$770.74
|
| Rate for Payer: Multiplan PHCS |
$1,200.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,400.00
|
| Rate for Payer: UHCCP Medicaid |
$700.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$778.45
|
|
|
THORACOSCOPY BILOBECTOMY
|
Professional
|
Both
|
$1,835.00
|
|
|
Service Code
|
HCPCS 32670
|
| Hospital Charge Code |
76101228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$642.25 |
| Max. Negotiated Rate |
$3,025.55 |
| Rate for Payer: Anthem Medicaid |
$1,304.16
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,835.00
|
| Rate for Payer: Cash Price |
$917.50
|
| Rate for Payer: Cash Price |
$917.50
|
| Rate for Payer: Cigna Commercial |
$3,025.55
|
| Rate for Payer: Healthspan PPO |
$1,620.81
|
| Rate for Payer: Humana Medicaid |
$1,304.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,187.05
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,330.24
|
| Rate for Payer: Molina Healthcare Passport |
$1,304.16
|
| Rate for Payer: Multiplan PHCS |
$1,101.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,284.50
|
| Rate for Payer: UHCCP Medicaid |
$642.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,317.20
|
|
|
THORACOSCOPY BILOBECTOMY
|
Facility
|
IP
|
$1,835.00
|
|
|
Service Code
|
HCPCS 32670
|
| Hospital Charge Code |
76101228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.55 |
| Max. Negotiated Rate |
$1,761.60 |
| Rate for Payer: Aetna Commercial |
$1,412.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,431.30
|
| Rate for Payer: Cash Price |
$917.50
|
| Rate for Payer: Cigna Commercial |
$1,523.05
|
| Rate for Payer: First Health Commercial |
$1,743.25
|
| Rate for Payer: Humana Commercial |
$1,559.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,504.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,354.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$550.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,614.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,376.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$367.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$238.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$568.85
|
| Rate for Payer: PHCS Commercial |
$1,761.60
|
| Rate for Payer: United Healthcare All Payer |
$1,614.80
|
|
|
THORACOSCOPY BILOBECTOMY
|
Facility
|
OP
|
$1,835.00
|
|
|
Service Code
|
HCPCS 32670
|
| Hospital Charge Code |
76101228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.55 |
| Max. Negotiated Rate |
$1,761.60 |
| Rate for Payer: Aetna Commercial |
$1,412.95
|
| Rate for Payer: Anthem Medicaid |
$631.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,431.30
|
| Rate for Payer: Cash Price |
$917.50
|
| Rate for Payer: Cigna Commercial |
$1,523.05
|
| Rate for Payer: First Health Commercial |
$1,743.25
|
| Rate for Payer: Humana Commercial |
$1,559.75
|
| Rate for Payer: Humana KY Medicaid |
$631.06
|
| Rate for Payer: Kentucky WC Medicaid |
$637.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,504.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,354.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$550.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$643.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,614.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,376.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$367.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$238.55
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$568.85
|
| Rate for Payer: PHCS Commercial |
$1,761.60
|
| Rate for Payer: United Healthcare All Payer |
$1,614.80
|
|
|
THORACOSCOPY BILOBECTOMY(P
|
Professional
|
Both
|
$1,835.00
|
|
|
Service Code
|
HCPCS 32670
|
| Hospital Charge Code |
761P1228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$642.25 |
| Max. Negotiated Rate |
$3,025.55 |
| Rate for Payer: Anthem Medicaid |
$1,304.16
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,835.00
|
| Rate for Payer: Cash Price |
$917.50
|
| Rate for Payer: Cash Price |
$917.50
|
| Rate for Payer: Cigna Commercial |
$3,025.55
|
| Rate for Payer: Healthspan PPO |
$1,620.81
|
| Rate for Payer: Humana Medicaid |
$1,304.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,187.05
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,330.24
|
| Rate for Payer: Molina Healthcare Passport |
$1,304.16
|
| Rate for Payer: Multiplan PHCS |
$1,101.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,284.50
|
| Rate for Payer: UHCCP Medicaid |
$642.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,317.20
|
|
|
THORACOSCOPY CONTRL BLEEDING
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32654
|
| Hospital Charge Code |
76101217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$2,000.00 |
| Rate for Payer: Aetna Commercial |
$1,877.39
|
| Rate for Payer: Anthem Medicaid |
$702.64
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,000.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$1,737.85
|
| Rate for Payer: Healthspan PPO |
$1,465.82
|
| Rate for Payer: Humana Medicaid |
$702.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,618.00
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$716.69
|
| Rate for Payer: Molina Healthcare Passport |
$702.64
|
| Rate for Payer: Multiplan PHCS |
$1,200.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,400.00
|
| Rate for Payer: UHCCP Medicaid |
$700.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$709.67
|
|
|
THORACOSCOPY CONTRL BLEEDING
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32654
|
| Hospital Charge Code |
76101217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.00 |
| Max. Negotiated Rate |
$1,920.00 |
| Rate for Payer: Aetna Commercial |
$1,540.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,560.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$1,660.00
|
| Rate for Payer: First Health Commercial |
$1,900.00
|
| Rate for Payer: Humana Commercial |
$1,700.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,640.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,476.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$600.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,760.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,500.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$620.00
|
| Rate for Payer: PHCS Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Payer |
$1,760.00
|
|
|
THORACOSCOPY CONTRL BLEEDING
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32654
|
| Hospital Charge Code |
76101217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.00 |
| Max. Negotiated Rate |
$1,920.00 |
| Rate for Payer: Aetna Commercial |
$1,540.00
|
| Rate for Payer: Anthem Medicaid |
$687.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,560.00
|
| Rate for Payer: Cash Price |
$1,000.00
|
| Rate for Payer: Cigna Commercial |
$1,660.00
|
| Rate for Payer: First Health Commercial |
$1,900.00
|
| Rate for Payer: Humana Commercial |
$1,700.00
|
| Rate for Payer: Humana KY Medicaid |
$687.80
|
| Rate for Payer: Kentucky WC Medicaid |
$694.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,640.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,476.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$600.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$701.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,760.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,500.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$620.00
|
| Rate for Payer: PHCS Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Payer |
$1,760.00
|
|
