|
SYNOVECTOMY CARPOMETACRPL JNT
|
Facility
|
OP
|
$3,921.00
|
|
|
Service Code
|
HCPCS 26130
|
| Hospital Charge Code |
45000136
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,348.43 |
| Max. Negotiated Rate |
$4,197.13 |
| Rate for Payer: Aetna Commercial |
$3,019.17
|
| Rate for Payer: Anthem Medicaid |
$1,348.43
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,997.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,058.38
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,197.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,047.23
|
| Rate for Payer: Cash Price |
$1,960.50
|
| Rate for Payer: Cash Price |
$1,960.50
|
| Rate for Payer: Cigna Commercial |
$3,254.43
|
| Rate for Payer: First Health Commercial |
$3,724.95
|
| Rate for Payer: Humana Commercial |
$3,332.85
|
| Rate for Payer: Humana KY Medicaid |
$1,348.43
|
| Rate for Payer: Humana Medicare Advantage |
$2,997.95
|
| Rate for Payer: Kentucky WC Medicaid |
$1,362.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,215.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,893.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,597.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,375.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,450.48
|
| Rate for Payer: Ohio Health Group HMO |
$2,940.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,136.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,411.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,705.49
|
| Rate for Payer: PHCS Commercial |
$3,764.16
|
| Rate for Payer: United Healthcare All Payer |
$3,450.48
|
|
|
SYNOVECTOMY CARPOMETACRPL JNT
|
Facility
|
OP
|
$3,921.00
|
|
|
Service Code
|
HCPCS 26130
|
| Hospital Charge Code |
76100675
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,348.43 |
| Max. Negotiated Rate |
$4,197.13 |
| Rate for Payer: Aetna Commercial |
$3,019.17
|
| Rate for Payer: Anthem Medicaid |
$1,348.43
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,997.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,058.38
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,197.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,047.23
|
| Rate for Payer: Cash Price |
$1,960.50
|
| Rate for Payer: Cash Price |
$1,960.50
|
| Rate for Payer: Cigna Commercial |
$3,254.43
|
| Rate for Payer: First Health Commercial |
$3,724.95
|
| Rate for Payer: Humana Commercial |
$3,332.85
|
| Rate for Payer: Humana KY Medicaid |
$1,348.43
|
| Rate for Payer: Humana Medicare Advantage |
$2,997.95
|
| Rate for Payer: Kentucky WC Medicaid |
$1,362.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,215.22
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,893.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,597.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,375.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,450.48
|
| Rate for Payer: Ohio Health Group HMO |
$2,940.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,136.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,411.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,705.49
|
| Rate for Payer: PHCS Commercial |
$3,764.16
|
| Rate for Payer: United Healthcare All Payer |
$3,450.48
|
|
|
SYNOVIAL FL CELL CT/DIFF
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
30001543
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.10 |
| Max. Negotiated Rate |
$93.12 |
| Rate for Payer: Aetna Commercial |
$74.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$77.89
|
| Rate for Payer: Cash Price |
$48.50
|
| Rate for Payer: Cigna Commercial |
$80.51
|
| Rate for Payer: First Health Commercial |
$92.15
|
| Rate for Payer: Humana Commercial |
$82.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$79.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$71.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$29.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$85.36
|
| Rate for Payer: Ohio Health Group HMO |
$72.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$77.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$84.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$66.93
|
| Rate for Payer: PHCS Commercial |
$93.12
|
| Rate for Payer: United Healthcare All Payer |
$85.36
|
|
|
SYNOVIAL FL CELL CT/DIFF
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
30001543
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$93.12 |
| Rate for Payer: Aetna Commercial |
$74.69
|
| Rate for Payer: Anthem Medicaid |
$5.60
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$77.89
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7.84
|
| Rate for Payer: CareSource Just4Me Medicare |
$5.60
|
| Rate for Payer: Cash Price |
$48.50
|
| Rate for Payer: Cash Price |
$48.50
|
| Rate for Payer: Cigna Commercial |
$80.51
|
| Rate for Payer: First Health Commercial |
$92.15
|
| Rate for Payer: Humana Commercial |
$82.45
|
| Rate for Payer: Humana KY Medicaid |
$5.60
|
| Rate for Payer: Humana Medicare Advantage |
$5.60
|
| Rate for Payer: Kentucky WC Medicaid |
$5.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$79.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$71.59
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$5.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$85.36
|
| Rate for Payer: Ohio Health Group HMO |
$72.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$77.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$84.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$66.93
|
| Rate for Payer: PHCS Commercial |
$93.12
|
| Rate for Payer: United Healthcare All Payer |
$85.36
|
|
|
SYNOVIAL FL CELL CT/DIFF
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
30001543
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$58.20 |
| Rate for Payer: Aetna Commercial |
$4.11
|
| Rate for Payer: Ambetter Exchange |
$5.60
|
| Rate for Payer: Buckeye Individual/Medicaid |
$5.60
|
| Rate for Payer: Buckeye Medicare Advantage |
$5.60
|
| Rate for Payer: CareSource Just4Me Medicare |
$6.72
|
| Rate for Payer: Cash Price |
$48.50
|
| Rate for Payer: Cash Price |
$48.50
|
| Rate for Payer: Cigna Commercial |
$4.80
|
| Rate for Payer: Healthspan PPO |
$5.77
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$5.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5.60
|
| Rate for Payer: Multiplan PHCS |
$58.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$7.28
|
| Rate for Payer: UHCCP Medicaid |
$33.95
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$3.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.60
|
|
|
SYN POR FEM COMP SZ 10
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 10
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 11
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 11
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 12
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 12
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 13
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 13
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 14
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 14
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 15
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 15
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 16
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 16
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 17
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 17
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 18
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 18
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 8
|
Facility
|
IP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
|
SYN POR FEM COMP SZ 8
|
Facility
|
OP
|
$24,746.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,423.97 |
| Max. Negotiated Rate |
$23,756.70 |
| Rate for Payer: Aetna Commercial |
$19,054.85
|
| Rate for Payer: Anthem Medicaid |
$8,510.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,302.32
|
| Rate for Payer: Cash Price |
$12,373.28
|
| Rate for Payer: Cigna Commercial |
$20,539.64
|
| Rate for Payer: First Health Commercial |
$23,509.23
|
| Rate for Payer: Humana Commercial |
$21,034.58
|
| Rate for Payer: Humana KY Medicaid |
$8,510.34
|
| Rate for Payer: Kentucky WC Medicaid |
$8,596.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,292.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,262.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,423.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,681.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,776.97
|
| Rate for Payer: Ohio Health Group HMO |
$18,559.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,797.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,529.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$17,075.13
|
| Rate for Payer: PHCS Commercial |
$23,756.70
|
| Rate for Payer: United Healthcare All Payer |
$21,776.97
|
|
