|
THORACOSCOPY SURG W/PART PULMO
|
Facility
|
OP
|
$2,400.00
|
|
|
Service Code
|
HCPCS 32651
|
| Hospital Charge Code |
76101214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.00 |
| Max. Negotiated Rate |
$2,304.00 |
| Rate for Payer: Aetna Commercial |
$1,848.00
|
| Rate for Payer: Anthem Medicaid |
$825.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cigna Commercial |
$1,992.00
|
| Rate for Payer: First Health Commercial |
$2,280.00
|
| Rate for Payer: Humana Commercial |
$2,040.00
|
| Rate for Payer: Humana KY Medicaid |
$825.36
|
| Rate for Payer: Kentucky WC Medicaid |
$833.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,968.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,771.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$720.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$841.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,112.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,800.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$480.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$312.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$744.00
|
| Rate for Payer: PHCS Commercial |
$2,304.00
|
| Rate for Payer: United Healthcare All Payer |
$2,112.00
|
|
|
THORACOSCOPY SURG W/PART PULMO
|
Professional
|
Both
|
$2,400.00
|
|
|
Service Code
|
HCPCS 32651
|
| Hospital Charge Code |
761P1214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$728.03 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$1,764.78
|
| Rate for Payer: Anthem Medicaid |
$728.03
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,400.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cigna Commercial |
$1,635.74
|
| Rate for Payer: Healthspan PPO |
$1,377.89
|
| Rate for Payer: Humana Medicaid |
$728.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,503.20
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$742.59
|
| Rate for Payer: Molina Healthcare Passport |
$728.03
|
| Rate for Payer: Multiplan PHCS |
$1,440.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,680.00
|
| Rate for Payer: UHCCP Medicaid |
$840.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$735.31
|
|
|
THORACOSCOPY SURG W/PART PULMO
|
Professional
|
Both
|
$2,400.00
|
|
|
Service Code
|
HCPCS 32651
|
| Hospital Charge Code |
76101214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$728.03 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$1,764.78
|
| Rate for Payer: Anthem Medicaid |
$728.03
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,400.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cigna Commercial |
$1,635.74
|
| Rate for Payer: Healthspan PPO |
$1,377.89
|
| Rate for Payer: Humana Medicaid |
$728.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,503.20
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$742.59
|
| Rate for Payer: Molina Healthcare Passport |
$728.03
|
| Rate for Payer: Multiplan PHCS |
$1,440.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,680.00
|
| Rate for Payer: UHCCP Medicaid |
$840.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$735.31
|
|
|
THORACOSCOPY SURG W/PLEURODESI
|
Professional
|
Both
|
$1,800.00
|
|
|
Service Code
|
HCPCS 32650
|
| Hospital Charge Code |
76101213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$530.98 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna Commercial |
$1,128.88
|
| Rate for Payer: Anthem Medicaid |
$530.98
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,800.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cigna Commercial |
$1,102.18
|
| Rate for Payer: Healthspan PPO |
$881.40
|
| Rate for Payer: Humana Medicaid |
$530.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$920.81
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$541.60
|
| Rate for Payer: Molina Healthcare Passport |
$530.98
|
| Rate for Payer: Multiplan PHCS |
$1,080.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,260.00
|
| Rate for Payer: UHCCP Medicaid |
$630.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$536.29
|
|
|
THORACOSCOPY SURG W/PLEURODESI
|
Facility
|
OP
|
$1,800.00
|
|
|
Service Code
|
HCPCS 32650
|
| Hospital Charge Code |
76101213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$1,728.00 |
| Rate for Payer: Aetna Commercial |
$1,386.00
|
| Rate for Payer: Anthem Medicaid |
$619.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,404.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cigna Commercial |
$1,494.00
|
| Rate for Payer: First Health Commercial |
$1,710.00
|
| Rate for Payer: Humana Commercial |
$1,530.00
|
| Rate for Payer: Humana KY Medicaid |
$619.02
|
| Rate for Payer: Kentucky WC Medicaid |
$625.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,476.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,328.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$540.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$631.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,584.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,350.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$360.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$234.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$558.00
|
| Rate for Payer: PHCS Commercial |
$1,728.00
|
| Rate for Payer: United Healthcare All Payer |
$1,584.00
|
|
|
THORACOSCOPY SURG W/PLEURODESI
|
Professional
|
Both
|
$1,800.00
|
|
|
Service Code
|
HCPCS 32650
|
| Hospital Charge Code |
761P1213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$530.98 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna Commercial |
$1,128.88
|
| Rate for Payer: Anthem Medicaid |
$530.98
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,800.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cigna Commercial |
$1,102.18
|
| Rate for Payer: Healthspan PPO |
$881.40
|
| Rate for Payer: Humana Medicaid |
$530.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$920.81
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$541.60
|
| Rate for Payer: Molina Healthcare Passport |
$530.98
|
| Rate for Payer: Multiplan PHCS |
$1,080.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,260.00
|
| Rate for Payer: UHCCP Medicaid |
$630.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$536.29
|
|
|
THORACOSCOPY SURG W/PLEURODESI
|
Facility
|
IP
|
$1,800.00
|
|
|
Service Code
|
HCPCS 32650
|
| Hospital Charge Code |
76101213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$1,728.00 |
| Rate for Payer: Aetna Commercial |
$1,386.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,404.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cigna Commercial |
$1,494.00
|
| Rate for Payer: First Health Commercial |
$1,710.00
|
| Rate for Payer: Humana Commercial |
$1,530.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,476.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,328.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$540.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,584.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,350.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$360.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$234.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$558.00
|
| Rate for Payer: PHCS Commercial |
$1,728.00
|
| Rate for Payer: United Healthcare All Payer |
$1,584.00
|
|
|
THORACOSCOPY W/BX INFILTRATE
|
Facility
|
OP
|
$515.00
|
|
|
Service Code
|
HCPCS 32607
|
| Hospital Charge Code |
76101210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.95 |
| Max. Negotiated Rate |
$12,462.13 |
| Rate for Payer: Aetna Commercial |
$396.55
|
| Rate for Payer: Anthem Medicaid |
$177.11
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$8,901.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$401.70
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$12,462.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$12,017.05
|
| Rate for Payer: Cash Price |
$257.50
|
| Rate for Payer: Cash Price |
$257.50
|
| Rate for Payer: Cigna Commercial |
$427.45
|
| Rate for Payer: First Health Commercial |
$489.25
|
| Rate for Payer: Humana Commercial |
$437.75
|
| Rate for Payer: Humana KY Medicaid |
$177.11
|
| Rate for Payer: Humana Medicare Advantage |
$8,901.52
|
| Rate for Payer: Kentucky WC Medicaid |
$178.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$422.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$380.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,681.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$180.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$453.20
|
| Rate for Payer: Ohio Health Group HMO |
$386.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$103.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$66.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$159.65
|
| Rate for Payer: PHCS Commercial |
$494.40
|
| Rate for Payer: United Healthcare All Payer |
$453.20
|
|
|
THORACOSCOPY W/BX INFILTRATE
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 32607
|
| Hospital Charge Code |
76101210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$180.25 |
| Max. Negotiated Rate |
$584.45 |
| Rate for Payer: Anthem Medicaid |
$251.88
|
| Rate for Payer: Buckeye Medicare Advantage |
$515.00
|
| Rate for Payer: Cash Price |
$257.50
|
| Rate for Payer: Cash Price |
$257.50
|
| Rate for Payer: Cigna Commercial |
$584.45
|
| Rate for Payer: Healthspan PPO |
$313.17
|
| Rate for Payer: Humana Medicaid |
$251.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$422.58
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$256.92
|
| Rate for Payer: Molina Healthcare Passport |
$251.88
|
| Rate for Payer: Multiplan PHCS |
$309.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$360.50
|
| Rate for Payer: UHCCP Medicaid |
$180.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$254.40
|
|
|
THORACOSCOPY W/BX INFILTRATE
|
Facility
|
IP
|
$515.00
|
|
|
Service Code
|
HCPCS 32607
|
| Hospital Charge Code |
76101210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.95 |
| Max. Negotiated Rate |
$494.40 |
| Rate for Payer: Aetna Commercial |
$396.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$401.70
|
| Rate for Payer: Cash Price |
$257.50
|
| Rate for Payer: Cigna Commercial |
$427.45
|
| Rate for Payer: First Health Commercial |
$489.25
|
| Rate for Payer: Humana Commercial |
$437.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$422.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$380.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$154.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$453.20
|
| Rate for Payer: Ohio Health Group HMO |
$386.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$103.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$66.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$159.65
|
| Rate for Payer: PHCS Commercial |
$494.40
|
| Rate for Payer: United Healthcare All Payer |
$453.20
|
|
|
THORACOSCOPY W/BX INFILTRAT(P
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 32607
|
| Hospital Charge Code |
761P1210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$180.25 |
| Max. Negotiated Rate |
$584.45 |
| Rate for Payer: Anthem Medicaid |
$251.88
|
| Rate for Payer: Buckeye Medicare Advantage |
$515.00
|
| Rate for Payer: Cash Price |
$257.50
|
| Rate for Payer: Cash Price |
$257.50
|
| Rate for Payer: Cigna Commercial |
$584.45
|
| Rate for Payer: Healthspan PPO |
$313.17
|
| Rate for Payer: Humana Medicaid |
$251.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$422.58
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$256.92
|
| Rate for Payer: Molina Healthcare Passport |
$251.88
|
| Rate for Payer: Multiplan PHCS |
$309.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$360.50
|
| Rate for Payer: UHCCP Medicaid |
$180.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$254.40
|
|
|
THORACOSCOPY W/BX MED SPACE
|
Professional
|
Both
|
$2,100.00
|
|
|
Service Code
|
HCPCS 32606
|
| Hospital Charge Code |
76101209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$365.84 |
| Max. Negotiated Rate |
$2,100.00 |
| Rate for Payer: Aetna Commercial |
$802.51
|
| Rate for Payer: Anthem Medicaid |
$365.84
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,100.00
|
| Rate for Payer: Cash Price |
$1,050.00
|
| Rate for Payer: Cash Price |
$1,050.00
|
| Rate for Payer: Cigna Commercial |
$754.47
|
| Rate for Payer: Healthspan PPO |
$626.58
|
| Rate for Payer: Humana Medicaid |
$365.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$646.80
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$373.16
|
| Rate for Payer: Molina Healthcare Passport |
$365.84
|
| Rate for Payer: Multiplan PHCS |
$1,260.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,470.00
|
| Rate for Payer: UHCCP Medicaid |
$735.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$369.50
|
|
|
THORACOSCOPY W/BX MED SPACE
|
Facility
|
OP
|
$2,100.00
|
|
|
Service Code
|
HCPCS 32606
|
| Hospital Charge Code |
76101209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.00 |
| Max. Negotiated Rate |
$6,985.45 |
| Rate for Payer: Aetna Commercial |
$1,617.00
|
| Rate for Payer: Anthem Medicaid |
$722.19
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4,989.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,638.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$6,985.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$6,735.97
|
| Rate for Payer: Cash Price |
$1,050.00
|
| Rate for Payer: Cash Price |
$1,050.00
|
| Rate for Payer: Cigna Commercial |
$1,743.00
|
| Rate for Payer: First Health Commercial |
$1,995.00
|
| Rate for Payer: Humana Commercial |
$1,785.00
|
| Rate for Payer: Humana KY Medicaid |
$722.19
|
| Rate for Payer: Humana Medicare Advantage |
$4,989.61
|
| Rate for Payer: Kentucky WC Medicaid |
$729.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,722.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,549.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,987.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$736.68
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,848.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,575.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.00
|
| Rate for Payer: PHCS Commercial |
$2,016.00
|
| Rate for Payer: United Healthcare All Payer |
$1,848.00
|
|
|
THORACOSCOPY W/BX MED SPACE
|
Facility
|
IP
|
$2,100.00
|
|
|
Service Code
|
HCPCS 32606
|
| Hospital Charge Code |
76101209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.00 |
| Max. Negotiated Rate |
$2,016.00 |
| Rate for Payer: Aetna Commercial |
$1,617.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,638.00
|
| Rate for Payer: Cash Price |
$1,050.00
|
| Rate for Payer: Cigna Commercial |
$1,743.00
|
| Rate for Payer: First Health Commercial |
$1,995.00
|
| Rate for Payer: Humana Commercial |
$1,785.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,722.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,549.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$630.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,848.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,575.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$420.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$273.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$651.00
|
| Rate for Payer: PHCS Commercial |
$2,016.00
|
| Rate for Payer: United Healthcare All Payer |
$1,848.00
|
|
|
THORACOSCOPY W/BX NODULE
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
HCPCS 32608
|
| Hospital Charge Code |
76101211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$12,462.13 |
| Rate for Payer: Aetna Commercial |
$616.00
|
| Rate for Payer: Anthem Medicaid |
$275.12
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$8,901.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$624.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$12,462.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$12,017.05
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$664.00
|
| Rate for Payer: First Health Commercial |
$760.00
|
| Rate for Payer: Humana Commercial |
$680.00
|
| Rate for Payer: Humana KY Medicaid |
$275.12
|
| Rate for Payer: Humana Medicare Advantage |
$8,901.52
|
| Rate for Payer: Kentucky WC Medicaid |
$277.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$656.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$590.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,681.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$280.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$704.00
|
| Rate for Payer: Ohio Health Group HMO |
$600.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$160.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$104.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$248.00
|
| Rate for Payer: PHCS Commercial |
$768.00
|
| Rate for Payer: United Healthcare All Payer |
$704.00
|
|
|
THORACOSCOPY W/BX NODULE
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 32608
|
| Hospital Charge Code |
76101211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Anthem Medicaid |
$309.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$800.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$718.23
|
| Rate for Payer: Healthspan PPO |
$385.14
|
| Rate for Payer: Humana Medicaid |
$309.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$519.69
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$315.70
|
| Rate for Payer: Molina Healthcare Passport |
$309.51
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$560.00
|
| Rate for Payer: UHCCP Medicaid |
$280.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$312.61
|
|
|
THORACOSCOPY W/BX NODULE
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
HCPCS 32608
|
| Hospital Charge Code |
76101211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$768.00 |
| Rate for Payer: Aetna Commercial |
$616.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$624.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$664.00
|
| Rate for Payer: First Health Commercial |
$760.00
|
| Rate for Payer: Humana Commercial |
$680.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$656.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$590.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$240.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$704.00
|
| Rate for Payer: Ohio Health Group HMO |
$600.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$160.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$104.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$248.00
|
| Rate for Payer: PHCS Commercial |
$768.00
|
| Rate for Payer: United Healthcare All Payer |
$704.00
|
|
|
THORACOSCOPY W/BX NODULE(P
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 32608
|
| Hospital Charge Code |
761P1211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Anthem Medicaid |
$309.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$800.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$718.23
|
| Rate for Payer: Healthspan PPO |
$385.14
|
| Rate for Payer: Humana Medicaid |
$309.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$519.69
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$315.70
|
| Rate for Payer: Molina Healthcare Passport |
$309.51
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$560.00
|
| Rate for Payer: UHCCP Medicaid |
$280.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$312.61
|
|
|
THORACOSCOPY W/BX PLEURA
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 32609
|
| Hospital Charge Code |
76101212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$6,985.45 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem Medicaid |
$257.92
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4,989.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$6,985.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$6,735.97
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Humana KY Medicaid |
$257.92
|
| Rate for Payer: Humana Medicare Advantage |
$4,989.61
|
| Rate for Payer: Kentucky WC Medicaid |
$260.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,987.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$263.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$97.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$232.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
THORACOSCOPY W/BX PLEURA
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 32609
|
| Hospital Charge Code |
76101212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.57 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Anthem Medicaid |
$213.57
|
| Rate for Payer: Buckeye Medicare Advantage |
$750.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$496.03
|
| Rate for Payer: Healthspan PPO |
$266.00
|
| Rate for Payer: Humana Medicaid |
$213.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$358.92
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$217.84
|
| Rate for Payer: Molina Healthcare Passport |
$213.57
|
| Rate for Payer: Multiplan PHCS |
$450.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$525.00
|
| Rate for Payer: UHCCP Medicaid |
$262.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$215.71
|
|
|
THORACOSCOPY W/BX PLEURA
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 32609
|
| Hospital Charge Code |
76101212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$150.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$97.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$232.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
THORACOSCOPY W/BX PLEURA(P
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 32609
|
| Hospital Charge Code |
761P1212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.57 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Anthem Medicaid |
$213.57
|
| Rate for Payer: Buckeye Medicare Advantage |
$750.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$496.03
|
| Rate for Payer: Healthspan PPO |
$266.00
|
| Rate for Payer: Humana Medicaid |
$213.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$358.92
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$217.84
|
| Rate for Payer: Molina Healthcare Passport |
$213.57
|
| Rate for Payer: Multiplan PHCS |
$450.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$525.00
|
| Rate for Payer: UHCCP Medicaid |
$262.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$215.71
|
|
|
THORACOSCOPY WBX SAC
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 32604
|
| Hospital Charge Code |
76101208
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$376.99 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Aetna Commercial |
$838.92
|
| Rate for Payer: Anthem Medicaid |
$376.99
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,275.00
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cigna Commercial |
$784.12
|
| Rate for Payer: Healthspan PPO |
$655.01
|
| Rate for Payer: Humana Medicaid |
$376.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$675.49
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$384.53
|
| Rate for Payer: Molina Healthcare Passport |
$376.99
|
| Rate for Payer: Multiplan PHCS |
$765.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$892.50
|
| Rate for Payer: UHCCP Medicaid |
$446.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$380.76
|
|
|
THORACOSCOPY WBX SAC
|
Facility
|
OP
|
$1,275.00
|
|
|
Service Code
|
HCPCS 32604
|
| Hospital Charge Code |
76101208
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$12,462.13 |
| Rate for Payer: Aetna Commercial |
$981.75
|
| Rate for Payer: Anthem Medicaid |
$438.47
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$8,901.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$994.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$12,462.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$12,017.05
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cigna Commercial |
$1,058.25
|
| Rate for Payer: First Health Commercial |
$1,211.25
|
| Rate for Payer: Humana Commercial |
$1,083.75
|
| Rate for Payer: Humana KY Medicaid |
$438.47
|
| Rate for Payer: Humana Medicare Advantage |
$8,901.52
|
| Rate for Payer: Kentucky WC Medicaid |
$442.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,045.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$940.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,681.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$447.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,122.00
|
| Rate for Payer: Ohio Health Group HMO |
$956.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$255.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$165.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$395.25
|
| Rate for Payer: PHCS Commercial |
$1,224.00
|
| Rate for Payer: United Healthcare All Payer |
$1,122.00
|
|
|
THORACOSCOPY WBX SAC
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
HCPCS 32604
|
| Hospital Charge Code |
76101208
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$1,224.00 |
| Rate for Payer: Aetna Commercial |
$981.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$994.50
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cigna Commercial |
$1,058.25
|
| Rate for Payer: First Health Commercial |
$1,211.25
|
| Rate for Payer: Humana Commercial |
$1,083.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,045.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$940.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$382.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,122.00
|
| Rate for Payer: Ohio Health Group HMO |
$956.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$255.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$165.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$395.25
|
| Rate for Payer: PHCS Commercial |
$1,224.00
|
| Rate for Payer: United Healthcare All Payer |
$1,122.00
|
|
