|
THORACOSCOPY
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32656
|
| Hospital Charge Code |
76101219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$600.00 |
| 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 |
$1,600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,740.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,380.00
|
| Rate for Payer: PHCS Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Payer |
$1,760.00
|
|
|
THORACOSCOPY BILOBECTOMY
|
Facility
|
OP
|
$1,835.00
|
|
|
Service Code
|
HCPCS 32670
|
| Hospital Charge Code |
76101228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$550.50 |
| 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 |
$1,468.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,596.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,266.15
|
| Rate for Payer: PHCS Commercial |
$1,761.60
|
| Rate for Payer: United Healthcare All Payer |
$1,614.80
|
|
|
THORACOSCOPY BILOBECTOMY
|
Facility
|
IP
|
$1,835.00
|
|
|
Service Code
|
HCPCS 32670
|
| Hospital Charge Code |
76101228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$550.50 |
| 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 |
$1,468.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,596.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,266.15
|
| Rate for Payer: PHCS Commercial |
$1,761.60
|
| Rate for Payer: United Healthcare All Payer |
$1,614.80
|
|
|
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: Ambetter Exchange |
$1,505.39
|
| Rate for Payer: Anthem Medicaid |
$1,304.16
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,505.39
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,505.39
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,806.47
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,505.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,505.39
|
| 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 |
$1,957.01
|
| Rate for Payer: UHCCP Medicaid |
$642.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,317.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,505.39
|
|
|
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: Ambetter Exchange |
$1,505.39
|
| Rate for Payer: Anthem Medicaid |
$1,304.16
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,505.39
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,505.39
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,806.47
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,505.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,505.39
|
| 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 |
$1,957.01
|
| Rate for Payer: UHCCP Medicaid |
$642.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,317.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,505.39
|
|
|
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 |
$1,877.39 |
| Rate for Payer: Aetna Commercial |
$1,877.39
|
| Rate for Payer: Ambetter Exchange |
$1,128.38
|
| Rate for Payer: Anthem Medicaid |
$702.64
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,128.38
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,128.38
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,354.06
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,128.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,128.38
|
| 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 |
$1,466.89
|
| Rate for Payer: UHCCP Medicaid |
$700.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$709.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,128.38
|
|
|
THORACOSCOPY CONTRL BLEEDING
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32654
|
| Hospital Charge Code |
76101217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$600.00 |
| 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 |
$1,600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,740.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,380.00
|
| 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 |
$600.00 |
| 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 |
$1,600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,740.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,380.00
|
| Rate for Payer: PHCS Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Payer |
$1,760.00
|
|
|
THORACOSCOPY CONTRL BLEEDIN(P
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32654
|
| Hospital Charge Code |
761P1217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$1,877.39 |
| Rate for Payer: Aetna Commercial |
$1,877.39
|
| Rate for Payer: Ambetter Exchange |
$1,128.38
|
| Rate for Payer: Anthem Medicaid |
$702.64
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,128.38
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,128.38
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,354.06
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,128.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,128.38
|
| 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 |
$1,466.89
|
| Rate for Payer: UHCCP Medicaid |
$700.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$709.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,128.38
|
|
|
THORACOSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
HCPCS 32601
|
| Hospital Charge Code |
76101207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$351.00 |
| Max. Negotiated Rate |
$1,123.20 |
| Rate for Payer: Aetna Commercial |
$900.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$912.60
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cigna Commercial |
$971.10
|
| Rate for Payer: First Health Commercial |
$1,111.50
|
| Rate for Payer: Humana Commercial |
$994.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$959.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$863.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$351.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,029.60
|
| Rate for Payer: Ohio Health Group HMO |
$877.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$936.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,017.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$807.30
|
| Rate for Payer: PHCS Commercial |
$1,123.20
|
| Rate for Payer: United Healthcare All Payer |
$1,029.60
|
|
|
THORACOSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
HCPCS 32601
|
| Hospital Charge Code |
76101207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$402.36 |
| Max. Negotiated Rate |
$7,547.16 |
| Rate for Payer: Aetna Commercial |
$900.90
|
| Rate for Payer: Anthem Medicaid |
$402.36
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,390.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$912.60
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7,547.16
|
| Rate for Payer: CareSource Just4Me Medicare |
$7,277.62
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cigna Commercial |
$971.10
|
| Rate for Payer: First Health Commercial |
$1,111.50
|
| Rate for Payer: Humana Commercial |
$994.50
|
| Rate for Payer: Humana KY Medicaid |
$402.36
|
| Rate for Payer: Humana Medicare Advantage |
$5,390.83
|
| Rate for Payer: Kentucky WC Medicaid |
$406.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$959.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$863.46
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,469.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$410.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,029.60
|
| Rate for Payer: Ohio Health Group HMO |
$877.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$936.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,017.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$807.30
|
| Rate for Payer: PHCS Commercial |
$1,123.20
|
| Rate for Payer: United Healthcare All Payer |
$1,029.60
|
|
|
THORACOSCOPY DIAGNOSTIC
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 32601
|
| Hospital Charge Code |
76101207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.14 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Aetna Commercial |
$531.41
|
| Rate for Payer: Ambetter Exchange |
$290.00
|
| Rate for Payer: Anthem Medicaid |
$267.14
|
| Rate for Payer: Buckeye Individual/Medicaid |
$290.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$290.00
|
| Rate for Payer: CareSource Just4Me Medicare |
$348.00
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cigna Commercial |
$501.00
|
| Rate for Payer: Healthspan PPO |
$414.91
|
| Rate for Payer: Humana Medicaid |
$267.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$430.04
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$290.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$290.00
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$272.48
|
| Rate for Payer: Molina Healthcare Passport |
$267.14
|
| Rate for Payer: Multiplan PHCS |
$702.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$377.00
|
| Rate for Payer: UHCCP Medicaid |
$409.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$269.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$290.00
|
|
|
THORACOSCOPY DIAGNOSTIC(P
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 32601
|
| Hospital Charge Code |
761P1207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.14 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Aetna Commercial |
$531.41
|
| Rate for Payer: Ambetter Exchange |
$290.00
|
| Rate for Payer: Anthem Medicaid |
$267.14
|
| Rate for Payer: Buckeye Individual/Medicaid |
$290.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$290.00
|
| Rate for Payer: CareSource Just4Me Medicare |
$348.00
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cigna Commercial |
$501.00
|
| Rate for Payer: Healthspan PPO |
$414.91
|
| Rate for Payer: Humana Medicaid |
$267.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$430.04
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$290.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$290.00
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$272.48
|
| Rate for Payer: Molina Healthcare Passport |
$267.14
|
| Rate for Payer: Multiplan PHCS |
$702.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$377.00
|
| Rate for Payer: UHCCP Medicaid |
$409.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$269.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$290.00
|
|
|
THORACOSCOPY LYMPH NODE EXC
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
HCPCS 32674
|
| Hospital Charge Code |
76101230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$624.00 |
| Rate for Payer: Aetna Commercial |
$500.50
|
| Rate for Payer: Anthem Medicaid |
$223.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$507.00
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Cigna Commercial |
$539.50
|
| Rate for Payer: First Health Commercial |
$617.50
|
| Rate for Payer: Humana Commercial |
$552.50
|
| Rate for Payer: Humana KY Medicaid |
$223.53
|
| Rate for Payer: Kentucky WC Medicaid |
$225.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$533.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$479.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$195.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$228.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$572.00
|
| Rate for Payer: Ohio Health Group HMO |
$487.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$520.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$565.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$448.50
|
| Rate for Payer: PHCS Commercial |
$624.00
|
| Rate for Payer: United Healthcare All Payer |
$572.00
|
|
|
THORACOSCOPY LYMPH NODE EXC
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 32674
|
| Hospital Charge Code |
76101230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$176.04 |
| Max. Negotiated Rate |
$408.39 |
| Rate for Payer: Ambetter Exchange |
$201.79
|
| Rate for Payer: Anthem Medicaid |
$176.04
|
| Rate for Payer: Buckeye Individual/Medicaid |
$201.79
|
| Rate for Payer: Buckeye Medicare Advantage |
$201.79
|
| Rate for Payer: CareSource Just4Me Medicare |
$242.15
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Cigna Commercial |
$408.39
|
| Rate for Payer: Healthspan PPO |
$219.51
|
| Rate for Payer: Humana Medicaid |
$176.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$296.21
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$201.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$201.79
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$179.56
|
| Rate for Payer: Molina Healthcare Passport |
$176.04
|
| Rate for Payer: Multiplan PHCS |
$390.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$262.33
|
| Rate for Payer: UHCCP Medicaid |
$227.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$177.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$201.79
|
|
|
THORACOSCOPY LYMPH NODE EXC
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
HCPCS 32674
|
| Hospital Charge Code |
76101230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$624.00 |
| Rate for Payer: Aetna Commercial |
$500.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$507.00
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Cigna Commercial |
$539.50
|
| Rate for Payer: First Health Commercial |
$617.50
|
| Rate for Payer: Humana Commercial |
$552.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$533.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$479.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$195.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$572.00
|
| Rate for Payer: Ohio Health Group HMO |
$487.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$520.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$565.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$448.50
|
| Rate for Payer: PHCS Commercial |
$624.00
|
| Rate for Payer: United Healthcare All Payer |
$572.00
|
|
|
THORACOSCOPY LYMPH NODE EXC(P
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 32674
|
| Hospital Charge Code |
761P1230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$176.04 |
| Max. Negotiated Rate |
$408.39 |
| Rate for Payer: Ambetter Exchange |
$201.79
|
| Rate for Payer: Anthem Medicaid |
$176.04
|
| Rate for Payer: Buckeye Individual/Medicaid |
$201.79
|
| Rate for Payer: Buckeye Medicare Advantage |
$201.79
|
| Rate for Payer: CareSource Just4Me Medicare |
$242.15
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Cash Price |
$325.00
|
| Rate for Payer: Cigna Commercial |
$408.39
|
| Rate for Payer: Healthspan PPO |
$219.51
|
| Rate for Payer: Humana Medicaid |
$176.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$296.21
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$201.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$201.79
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$179.56
|
| Rate for Payer: Molina Healthcare Passport |
$176.04
|
| Rate for Payer: Multiplan PHCS |
$390.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$262.33
|
| Rate for Payer: UHCCP Medicaid |
$227.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$177.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$201.79
|
|
|
THORACOSCOPY(P
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32656
|
| Hospital Charge Code |
761P1219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$1,352.90 |
| Rate for Payer: Aetna Commercial |
$1,352.90
|
| Rate for Payer: Ambetter Exchange |
$758.36
|
| Rate for Payer: Anthem Medicaid |
$770.74
|
| Rate for Payer: Buckeye Individual/Medicaid |
$758.36
|
| Rate for Payer: Buckeye Medicare Advantage |
$758.36
|
| Rate for Payer: CareSource Just4Me Medicare |
$910.03
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$758.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$758.36
|
| 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 |
$985.87
|
| Rate for Payer: UHCCP Medicaid |
$700.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$778.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$758.36
|
|
|
THORACOSCOPY(P
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 32659
|
| Hospital Charge Code |
761P1220
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$692.30 |
| Max. Negotiated Rate |
$1,320.00 |
| Rate for Payer: Aetna Commercial |
$1,234.04
|
| Rate for Payer: Ambetter Exchange |
$692.30
|
| Rate for Payer: Anthem Medicaid |
$757.99
|
| Rate for Payer: Buckeye Individual/Medicaid |
$692.30
|
| Rate for Payer: Buckeye Medicare Advantage |
$692.30
|
| Rate for Payer: CareSource Just4Me Medicare |
$830.76
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$692.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$692.30
|
| 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 |
$899.99
|
| Rate for Payer: UHCCP Medicaid |
$770.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$765.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$692.30
|
|
|
THORACOSCOPY(P
|
Professional
|
Both
|
$3,000.00
|
|
|
Service Code
|
HCPCS 32652
|
| Hospital Charge Code |
761P1215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,014.23 |
| Max. Negotiated Rate |
$2,677.82 |
| Rate for Payer: Aetna Commercial |
$2,677.82
|
| Rate for Payer: Ambetter Exchange |
$1,564.36
|
| Rate for Payer: Anthem Medicaid |
$1,014.23
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,564.36
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,564.36
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,877.23
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,564.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,564.36
|
| 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 |
$2,033.67
|
| Rate for Payer: UHCCP Medicaid |
$1,050.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,024.37
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,564.36
|
|
|
THORACOSCOPY PNEUMONECTOMY
|
Facility
|
OP
|
$3,050.00
|
|
|
Service Code
|
HCPCS 32671
|
| Hospital Charge Code |
76101229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$915.00 |
| Max. Negotiated Rate |
$2,928.00 |
| Rate for Payer: Aetna Commercial |
$2,348.50
|
| Rate for Payer: Anthem Medicaid |
$1,048.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,379.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cigna Commercial |
$2,531.50
|
| Rate for Payer: First Health Commercial |
$2,897.50
|
| Rate for Payer: Humana Commercial |
$2,592.50
|
| Rate for Payer: Humana KY Medicaid |
$1,048.89
|
| Rate for Payer: Kentucky WC Medicaid |
$1,059.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,501.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,250.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$915.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,069.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,684.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,287.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,440.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,653.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,104.50
|
| Rate for Payer: PHCS Commercial |
$2,928.00
|
| Rate for Payer: United Healthcare All Payer |
$2,684.00
|
|
|
THORACOSCOPY PNEUMONECTOMY
|
Facility
|
IP
|
$3,050.00
|
|
|
Service Code
|
HCPCS 32671
|
| Hospital Charge Code |
76101229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$915.00 |
| Max. Negotiated Rate |
$2,928.00 |
| Rate for Payer: Aetna Commercial |
$2,348.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,379.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cigna Commercial |
$2,531.50
|
| Rate for Payer: First Health Commercial |
$2,897.50
|
| Rate for Payer: Humana Commercial |
$2,592.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,501.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,250.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$915.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,684.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,287.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,440.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,653.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,104.50
|
| Rate for Payer: PHCS Commercial |
$2,928.00
|
| Rate for Payer: United Healthcare All Payer |
$2,684.00
|
|
|
THORACOSCOPY PNEUMONECTOMY
|
Professional
|
Both
|
$3,050.00
|
|
|
Service Code
|
HCPCS 32671
|
| Hospital Charge Code |
76101229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,067.50 |
| Max. Negotiated Rate |
$3,360.49 |
| Rate for Payer: Ambetter Exchange |
$1,667.07
|
| Rate for Payer: Anthem Medicaid |
$1,448.08
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,667.07
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,667.07
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,000.48
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cigna Commercial |
$3,360.49
|
| Rate for Payer: Healthspan PPO |
$1,802.80
|
| Rate for Payer: Humana Medicaid |
$1,448.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,432.23
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,667.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,667.07
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,477.04
|
| Rate for Payer: Molina Healthcare Passport |
$1,448.08
|
| Rate for Payer: Multiplan PHCS |
$1,830.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,167.19
|
| Rate for Payer: UHCCP Medicaid |
$1,067.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,462.56
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,667.07
|
|
|
THORACOSCOPY PNEUMONECTOMY(P
|
Professional
|
Both
|
$3,050.00
|
|
|
Service Code
|
HCPCS 32671
|
| Hospital Charge Code |
761P1229
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,067.50 |
| Max. Negotiated Rate |
$3,360.49 |
| Rate for Payer: Ambetter Exchange |
$1,667.07
|
| Rate for Payer: Anthem Medicaid |
$1,448.08
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,667.07
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,667.07
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,000.48
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cigna Commercial |
$3,360.49
|
| Rate for Payer: Healthspan PPO |
$1,802.80
|
| Rate for Payer: Humana Medicaid |
$1,448.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,432.23
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,667.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,667.07
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,477.04
|
| Rate for Payer: Molina Healthcare Passport |
$1,448.08
|
| Rate for Payer: Multiplan PHCS |
$1,830.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,167.19
|
| Rate for Payer: UHCCP Medicaid |
$1,067.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,462.56
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,667.07
|
|
|
THORACOSCOPY REMOVE SEGMENT
|
Facility
|
OP
|
$2,350.00
|
|
|
Service Code
|
HCPCS 32669
|
| Hospital Charge Code |
76101227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$705.00 |
| Max. Negotiated Rate |
$2,256.00 |
| Rate for Payer: Aetna Commercial |
$1,809.50
|
| Rate for Payer: Anthem Medicaid |
$808.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,833.00
|
| Rate for Payer: Cash Price |
$1,175.00
|
| Rate for Payer: Cigna Commercial |
$1,950.50
|
| Rate for Payer: First Health Commercial |
$2,232.50
|
| Rate for Payer: Humana Commercial |
$1,997.50
|
| Rate for Payer: Humana KY Medicaid |
$808.16
|
| Rate for Payer: Kentucky WC Medicaid |
$816.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,927.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,734.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$705.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$824.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,068.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,762.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,880.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,044.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,621.50
|
| Rate for Payer: PHCS Commercial |
$2,256.00
|
| Rate for Payer: United Healthcare All Payer |
$2,068.00
|
|
