|
THORACOSCOPY WBX SAC(P
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 32604
|
| Hospital Charge Code |
761P1208
|
|
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; WITH BIOPSY(IES) OF PLEURA
|
Facility
|
OP
|
$6,985.45
|
|
|
Service Code
|
CPT 32609
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,989.61 |
| Max. Negotiated Rate |
$6,985.45 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$4,989.61
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$6,985.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$6,735.97
|
| Rate for Payer: Humana Medicare Advantage |
$4,989.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,987.53
|
|
|
THORACOSCOPY W/LOBECTOMY
|
Facility
|
IP
|
$3,350.00
|
|
|
Service Code
|
HCPCS 32663
|
| Hospital Charge Code |
76101222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$435.50 |
| Max. Negotiated Rate |
$3,216.00 |
| Rate for Payer: Aetna Commercial |
$2,579.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,613.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna Commercial |
$2,780.50
|
| Rate for Payer: First Health Commercial |
$3,182.50
|
| Rate for Payer: Humana Commercial |
$2,847.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,747.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,472.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,005.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,948.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,512.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$670.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$435.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,038.50
|
| Rate for Payer: PHCS Commercial |
$3,216.00
|
| Rate for Payer: United Healthcare All Payer |
$2,948.00
|
|
|
THORACOSCOPY W/LOBECTOMY
|
Facility
|
OP
|
$3,350.00
|
|
|
Service Code
|
HCPCS 32663
|
| Hospital Charge Code |
76101222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$435.50 |
| Max. Negotiated Rate |
$3,216.00 |
| Rate for Payer: Aetna Commercial |
$2,579.50
|
| Rate for Payer: Anthem Medicaid |
$1,152.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,613.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna Commercial |
$2,780.50
|
| Rate for Payer: First Health Commercial |
$3,182.50
|
| Rate for Payer: Humana Commercial |
$2,847.50
|
| Rate for Payer: Humana KY Medicaid |
$1,152.06
|
| Rate for Payer: Kentucky WC Medicaid |
$1,163.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,747.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,472.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,005.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,175.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,948.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,512.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$670.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$435.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,038.50
|
| Rate for Payer: PHCS Commercial |
$3,216.00
|
| Rate for Payer: United Healthcare All Payer |
$2,948.00
|
|
|
THORACOSCOPY W/LOBECTOMY
|
Professional
|
Both
|
$3,350.00
|
|
|
Service Code
|
HCPCS 32663
|
| Hospital Charge Code |
76101222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,049.94 |
| Max. Negotiated Rate |
$3,350.00 |
| Rate for Payer: Aetna Commercial |
$2,332.72
|
| Rate for Payer: Anthem Medicaid |
$1,049.94
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,350.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna Commercial |
$2,211.52
|
| Rate for Payer: Healthspan PPO |
$1,821.33
|
| Rate for Payer: Humana Medicaid |
$1,049.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,947.52
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,070.94
|
| Rate for Payer: Molina Healthcare Passport |
$1,049.94
|
| Rate for Payer: Multiplan PHCS |
$2,010.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,345.00
|
| Rate for Payer: UHCCP Medicaid |
$1,172.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,060.44
|
|
|
THORACOSCOPY W/LOBECTOMY(P
|
Professional
|
Both
|
$3,350.00
|
|
|
Service Code
|
HCPCS 32663
|
| Hospital Charge Code |
761P1222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,049.94 |
| Max. Negotiated Rate |
$3,350.00 |
| Rate for Payer: Aetna Commercial |
$2,332.72
|
| Rate for Payer: Anthem Medicaid |
$1,049.94
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,350.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna Commercial |
$2,211.52
|
| Rate for Payer: Healthspan PPO |
$1,821.33
|
| Rate for Payer: Humana Medicaid |
$1,049.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,947.52
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,070.94
|
| Rate for Payer: Molina Healthcare Passport |
$1,049.94
|
| Rate for Payer: Multiplan PHCS |
$2,010.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,345.00
|
| Rate for Payer: UHCCP Medicaid |
$1,172.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,060.44
|
|
|
THORACOSCOPY W/MEDIAST EXC
|
Facility
|
IP
|
$1,155.00
|
|
|
Service Code
|
HCPCS 32662
|
| Hospital Charge Code |
76101221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.15 |
| Max. Negotiated Rate |
$1,108.80 |
| Rate for Payer: Aetna Commercial |
$889.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$900.90
|
| Rate for Payer: Cash Price |
$577.50
|
| Rate for Payer: Cigna Commercial |
$958.65
|
| Rate for Payer: First Health Commercial |
$1,097.25
|
| Rate for Payer: Humana Commercial |
$981.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$947.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$852.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$346.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,016.40
|
| Rate for Payer: Ohio Health Group HMO |
$866.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$231.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$150.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$358.05
|
| Rate for Payer: PHCS Commercial |
$1,108.80
|
| Rate for Payer: United Healthcare All Payer |
$1,016.40
|
|
|
THORACOSCOPY W/MEDIAST EXC
|
Facility
|
OP
|
$1,155.00
|
|
|
Service Code
|
HCPCS 32662
|
| Hospital Charge Code |
76101221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.15 |
| Max. Negotiated Rate |
$1,108.80 |
| Rate for Payer: Aetna Commercial |
$889.35
|
| Rate for Payer: Anthem Medicaid |
$397.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$900.90
|
| Rate for Payer: Cash Price |
$577.50
|
| Rate for Payer: Cigna Commercial |
$958.65
|
| Rate for Payer: First Health Commercial |
$1,097.25
|
| Rate for Payer: Humana Commercial |
$981.75
|
| Rate for Payer: Humana KY Medicaid |
$397.20
|
| Rate for Payer: Kentucky WC Medicaid |
$401.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$947.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$852.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$346.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$405.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,016.40
|
| Rate for Payer: Ohio Health Group HMO |
$866.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$231.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$150.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$358.05
|
| Rate for Payer: PHCS Commercial |
$1,108.80
|
| Rate for Payer: United Healthcare All Payer |
$1,016.40
|
|
|
THORACOSCOPY W/MEDIAST EXC
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 32662
|
| Hospital Charge Code |
76101221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$404.25 |
| Max. Negotiated Rate |
$1,526.81 |
| Rate for Payer: Aetna Commercial |
$1,526.81
|
| Rate for Payer: Anthem Medicaid |
$919.29
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,155.00
|
| Rate for Payer: Cash Price |
$577.50
|
| Rate for Payer: Cash Price |
$577.50
|
| Rate for Payer: Cigna Commercial |
$1,491.75
|
| Rate for Payer: Healthspan PPO |
$1,192.09
|
| Rate for Payer: Humana Medicaid |
$919.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,243.08
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$937.68
|
| Rate for Payer: Molina Healthcare Passport |
$919.29
|
| Rate for Payer: Multiplan PHCS |
$693.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$808.50
|
| Rate for Payer: UHCCP Medicaid |
$404.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$928.48
|
|
|
THORACOSCOPY W/MEDIAST EXC(P
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 32662
|
| Hospital Charge Code |
761P1221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$404.25 |
| Max. Negotiated Rate |
$1,526.81 |
| Rate for Payer: Aetna Commercial |
$1,526.81
|
| Rate for Payer: Anthem Medicaid |
$919.29
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,155.00
|
| Rate for Payer: Cash Price |
$577.50
|
| Rate for Payer: Cash Price |
$577.50
|
| Rate for Payer: Cigna Commercial |
$1,491.75
|
| Rate for Payer: Healthspan PPO |
$1,192.09
|
| Rate for Payer: Humana Medicaid |
$919.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,243.08
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$937.68
|
| Rate for Payer: Molina Healthcare Passport |
$919.29
|
| Rate for Payer: Multiplan PHCS |
$693.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$808.50
|
| Rate for Payer: UHCCP Medicaid |
$404.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$928.48
|
|
|
THORACOSCOPY W/WEDGE RESECT
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32666
|
| Hospital Charge Code |
76101224
|
|
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 W/WEDGE RESECT
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32666
|
| Hospital Charge Code |
76101224
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$2,000.00 |
| Rate for Payer: Anthem Medicaid |
$707.35
|
| 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 |
$1,641.20
|
| Rate for Payer: Healthspan PPO |
$877.62
|
| Rate for Payer: Humana Medicaid |
$707.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,183.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$721.50
|
| Rate for Payer: Molina Healthcare Passport |
$707.35
|
| 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 |
$714.42
|
|
|
THORACOSCOPY W/WEDGE RESECT
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32666
|
| Hospital Charge Code |
76101224
|
|
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 W/WEDGE RESECT(P
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32666
|
| Hospital Charge Code |
761P1224
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$2,000.00 |
| Rate for Payer: Anthem Medicaid |
$707.35
|
| 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 |
$1,641.20
|
| Rate for Payer: Healthspan PPO |
$877.62
|
| Rate for Payer: Humana Medicaid |
$707.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,183.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$721.50
|
| Rate for Payer: Molina Healthcare Passport |
$707.35
|
| 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 |
$714.42
|
|
|
THORACOSCOPY W/W RESECT ADDL
|
Facility
|
IP
|
$570.00
|
|
|
Service Code
|
HCPCS 32667
|
| Hospital Charge Code |
76101225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.10 |
| Max. Negotiated Rate |
$547.20 |
| Rate for Payer: Aetna Commercial |
$438.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$444.60
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cigna Commercial |
$473.10
|
| Rate for Payer: First Health Commercial |
$541.50
|
| Rate for Payer: Humana Commercial |
$484.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$467.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$420.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$171.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$501.60
|
| Rate for Payer: Ohio Health Group HMO |
$427.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$114.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$74.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$176.70
|
| Rate for Payer: PHCS Commercial |
$547.20
|
| Rate for Payer: United Healthcare All Payer |
$501.60
|
|
|
THORACOSCOPY W/W RESECT ADDL
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 32667
|
| Hospital Charge Code |
76101225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.37 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Anthem Medicaid |
$128.37
|
| Rate for Payer: Buckeye Medicare Advantage |
$570.00
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cigna Commercial |
$297.92
|
| Rate for Payer: Healthspan PPO |
$160.23
|
| Rate for Payer: Humana Medicaid |
$128.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$216.22
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$130.94
|
| Rate for Payer: Molina Healthcare Passport |
$128.37
|
| Rate for Payer: Multiplan PHCS |
$342.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$399.00
|
| Rate for Payer: UHCCP Medicaid |
$199.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$129.65
|
|
|
THORACOSCOPY W/W RESECT ADDL
|
Facility
|
OP
|
$570.00
|
|
|
Service Code
|
HCPCS 32667
|
| Hospital Charge Code |
76101225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.10 |
| Max. Negotiated Rate |
$547.20 |
| Rate for Payer: Aetna Commercial |
$438.90
|
| Rate for Payer: Anthem Medicaid |
$196.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$444.60
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cigna Commercial |
$473.10
|
| Rate for Payer: First Health Commercial |
$541.50
|
| Rate for Payer: Humana Commercial |
$484.50
|
| Rate for Payer: Humana KY Medicaid |
$196.02
|
| Rate for Payer: Kentucky WC Medicaid |
$198.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$467.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$420.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$171.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$199.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$501.60
|
| Rate for Payer: Ohio Health Group HMO |
$427.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$114.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$74.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$176.70
|
| Rate for Payer: PHCS Commercial |
$547.20
|
| Rate for Payer: United Healthcare All Payer |
$501.60
|
|
|
THORACOSCOPY W/W RESECT ADD(P
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 32667
|
| Hospital Charge Code |
761P1225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.37 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Anthem Medicaid |
$128.37
|
| Rate for Payer: Buckeye Medicare Advantage |
$570.00
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cigna Commercial |
$297.92
|
| Rate for Payer: Healthspan PPO |
$160.23
|
| Rate for Payer: Humana Medicaid |
$128.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$216.22
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$130.94
|
| Rate for Payer: Molina Healthcare Passport |
$128.37
|
| Rate for Payer: Multiplan PHCS |
$342.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$399.00
|
| Rate for Payer: UHCCP Medicaid |
$199.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$129.65
|
|
|
THORACOSCOPY W/W RESECT DIAG
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 32668
|
| Hospital Charge Code |
76101226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Anthem Medicaid |
$129.08
|
| Rate for Payer: Buckeye Medicare Advantage |
$570.00
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cigna Commercial |
$299.76
|
| Rate for Payer: Healthspan PPO |
$161.37
|
| Rate for Payer: Humana Medicaid |
$129.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$217.75
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$131.66
|
| Rate for Payer: Molina Healthcare Passport |
$129.08
|
| Rate for Payer: Multiplan PHCS |
$342.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$399.00
|
| Rate for Payer: UHCCP Medicaid |
$199.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$130.37
|
|
|
THORACOSCOPY W/W RESECT DIAG
|
Facility
|
IP
|
$570.00
|
|
|
Service Code
|
HCPCS 32668
|
| Hospital Charge Code |
76101226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.10 |
| Max. Negotiated Rate |
$547.20 |
| Rate for Payer: Aetna Commercial |
$438.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$444.60
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cigna Commercial |
$473.10
|
| Rate for Payer: First Health Commercial |
$541.50
|
| Rate for Payer: Humana Commercial |
$484.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$467.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$420.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$171.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$501.60
|
| Rate for Payer: Ohio Health Group HMO |
$427.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$114.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$74.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$176.70
|
| Rate for Payer: PHCS Commercial |
$547.20
|
| Rate for Payer: United Healthcare All Payer |
$501.60
|
|
|
THORACOSCOPY W/W RESECT DIAG
|
Facility
|
OP
|
$570.00
|
|
|
Service Code
|
HCPCS 32668
|
| Hospital Charge Code |
76101226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.10 |
| Max. Negotiated Rate |
$547.20 |
| Rate for Payer: Aetna Commercial |
$438.90
|
| Rate for Payer: Anthem Medicaid |
$196.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$444.60
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cigna Commercial |
$473.10
|
| Rate for Payer: First Health Commercial |
$541.50
|
| Rate for Payer: Humana Commercial |
$484.50
|
| Rate for Payer: Humana KY Medicaid |
$196.02
|
| Rate for Payer: Kentucky WC Medicaid |
$198.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$467.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$420.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$171.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$199.96
|
| Rate for Payer: Ohio Health Choice Commercial |
$501.60
|
| Rate for Payer: Ohio Health Group HMO |
$427.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$114.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$74.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$176.70
|
| Rate for Payer: PHCS Commercial |
$547.20
|
| Rate for Payer: United Healthcare All Payer |
$501.60
|
|
|
THORACOSCOPY W/W RESECT DIA(P
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 32668
|
| Hospital Charge Code |
761P1226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Anthem Medicaid |
$129.08
|
| Rate for Payer: Buckeye Medicare Advantage |
$570.00
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cash Price |
$285.00
|
| Rate for Payer: Cigna Commercial |
$299.76
|
| Rate for Payer: Healthspan PPO |
$161.37
|
| Rate for Payer: Humana Medicaid |
$129.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$217.75
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$131.66
|
| Rate for Payer: Molina Healthcare Passport |
$129.08
|
| Rate for Payer: Multiplan PHCS |
$342.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$399.00
|
| Rate for Payer: UHCCP Medicaid |
$199.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$130.37
|
|
|
THORACOTOMY
|
Facility
|
OP
|
$6,355.50
|
|
|
Service Code
|
HCPCS 32160
|
| Hospital Charge Code |
76101180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$826.22 |
| Max. Negotiated Rate |
$6,101.28 |
| Rate for Payer: Aetna Commercial |
$4,893.74
|
| Rate for Payer: Anthem Medicaid |
$2,185.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,957.29
|
| Rate for Payer: Cash Price |
$3,177.75
|
| Rate for Payer: Cigna Commercial |
$5,275.06
|
| Rate for Payer: First Health Commercial |
$6,037.72
|
| Rate for Payer: Humana Commercial |
$5,402.18
|
| Rate for Payer: Humana KY Medicaid |
$2,185.66
|
| Rate for Payer: Kentucky WC Medicaid |
$2,207.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,211.51
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,690.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,906.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,229.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,592.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,766.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,271.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$826.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,970.20
|
| Rate for Payer: PHCS Commercial |
$6,101.28
|
| Rate for Payer: United Healthcare All Payer |
$5,592.84
|
|
|
THORACOTOMY
|
Facility
|
OP
|
$1,750.00
|
|
|
Service Code
|
HCPCS 32100
|
| Hospital Charge Code |
76101174
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.50 |
| Max. Negotiated Rate |
$1,680.00 |
| Rate for Payer: Aetna Commercial |
$1,347.50
|
| Rate for Payer: Anthem Medicaid |
$601.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,365.00
|
| Rate for Payer: Cash Price |
$875.00
|
| Rate for Payer: Cigna Commercial |
$1,452.50
|
| Rate for Payer: First Health Commercial |
$1,662.50
|
| Rate for Payer: Humana Commercial |
$1,487.50
|
| Rate for Payer: Humana KY Medicaid |
$601.82
|
| Rate for Payer: Kentucky WC Medicaid |
$607.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,435.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,291.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$525.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$613.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,540.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,312.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$350.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$227.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$542.50
|
| Rate for Payer: PHCS Commercial |
$1,680.00
|
| Rate for Payer: United Healthcare All Payer |
$1,540.00
|
|
|
THORACOTOMY
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 32141
|
| Hospital Charge Code |
76101178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$777.66 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$2,431.74
|
| Rate for Payer: Anthem Medicaid |
$777.66
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,500.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$2,182.21
|
| Rate for Payer: Healthspan PPO |
$1,898.64
|
| Rate for Payer: Humana Medicaid |
$777.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,117.50
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$793.21
|
| Rate for Payer: Molina Healthcare Passport |
$777.66
|
| Rate for Payer: Multiplan PHCS |
$1,500.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,750.00
|
| Rate for Payer: UHCCP Medicaid |
$875.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$785.44
|
|
