|
THORACOSCOPY W/BX NODULE
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 32608
|
| Hospital Charge Code |
76101211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$718.23 |
| Rate for Payer: Ambetter Exchange |
$356.61
|
| Rate for Payer: Anthem Medicaid |
$309.51
|
| Rate for Payer: Buckeye Individual/Medicaid |
$356.61
|
| Rate for Payer: Buckeye Medicare Advantage |
$356.61
|
| Rate for Payer: CareSource Just4Me Medicare |
$427.93
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$718.23
|
| Rate for Payer: Healthspan PPO |
$385.14
|
| Rate for Payer: Humana Medicaid |
$309.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$519.69
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$356.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$356.61
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$315.70
|
| Rate for Payer: Molina Healthcare Passport |
$309.51
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$463.59
|
| Rate for Payer: UHCCP Medicaid |
$280.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$312.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$356.61
|
|
|
THORACOSCOPY W/BX NODULE(P
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 32608
|
| Hospital Charge Code |
761P1211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$718.23 |
| Rate for Payer: Ambetter Exchange |
$356.61
|
| Rate for Payer: Anthem Medicaid |
$309.51
|
| Rate for Payer: Buckeye Individual/Medicaid |
$356.61
|
| Rate for Payer: Buckeye Medicare Advantage |
$356.61
|
| Rate for Payer: CareSource Just4Me Medicare |
$427.93
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$718.23
|
| Rate for Payer: Healthspan PPO |
$385.14
|
| Rate for Payer: Humana Medicaid |
$309.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$519.69
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$356.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$356.61
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$315.70
|
| Rate for Payer: Molina Healthcare Passport |
$309.51
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$463.59
|
| Rate for Payer: UHCCP Medicaid |
$280.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$312.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$356.61
|
|
|
THORACOSCOPY W/BX PLEURA
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 32609
|
| Hospital Charge Code |
76101212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$652.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$517.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
THORACOSCOPY W/BX PLEURA
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 32609
|
| Hospital Charge Code |
76101212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.93 |
| Max. Negotiated Rate |
$7,547.16 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem Medicaid |
$257.93
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,390.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| 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 |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Humana KY Medicaid |
$257.93
|
| Rate for Payer: Humana Medicare Advantage |
$5,390.83
|
| Rate for Payer: Kentucky WC Medicaid |
$260.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,469.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$263.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$652.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$517.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
THORACOSCOPY W/BX PLEURA
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 32609
|
| Hospital Charge Code |
76101212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.57 |
| Max. Negotiated Rate |
$496.03 |
| Rate for Payer: Ambetter Exchange |
$239.41
|
| Rate for Payer: Anthem Medicaid |
$213.57
|
| Rate for Payer: Buckeye Individual/Medicaid |
$239.41
|
| Rate for Payer: Buckeye Medicare Advantage |
$239.41
|
| Rate for Payer: CareSource Just4Me Medicare |
$287.29
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$496.03
|
| Rate for Payer: Healthspan PPO |
$266.00
|
| Rate for Payer: Humana Medicaid |
$213.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$358.92
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$239.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$239.41
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$217.84
|
| Rate for Payer: Molina Healthcare Passport |
$213.57
|
| Rate for Payer: Multiplan PHCS |
$450.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$311.23
|
| Rate for Payer: UHCCP Medicaid |
$262.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$215.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$239.41
|
|
|
THORACOSCOPY W/BX PLEURA(P
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 32609
|
| Hospital Charge Code |
761P1212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.57 |
| Max. Negotiated Rate |
$496.03 |
| Rate for Payer: Ambetter Exchange |
$239.41
|
| Rate for Payer: Anthem Medicaid |
$213.57
|
| Rate for Payer: Buckeye Individual/Medicaid |
$239.41
|
| Rate for Payer: Buckeye Medicare Advantage |
$239.41
|
| Rate for Payer: CareSource Just4Me Medicare |
$287.29
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$496.03
|
| Rate for Payer: Healthspan PPO |
$266.00
|
| Rate for Payer: Humana Medicaid |
$213.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$358.92
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$239.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$239.41
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$217.84
|
| Rate for Payer: Molina Healthcare Passport |
$213.57
|
| Rate for Payer: Multiplan PHCS |
$450.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$311.23
|
| Rate for Payer: UHCCP Medicaid |
$262.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$215.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$239.41
|
|
|
THORACOSCOPY WBX SAC
|
Facility
|
OP
|
$1,275.00
|
|
|
Service Code
|
HCPCS 32604
|
| Hospital Charge Code |
76101208
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$438.47 |
| Max. Negotiated Rate |
$13,467.66 |
| Rate for Payer: Aetna Commercial |
$981.75
|
| Rate for Payer: Anthem Medicaid |
$438.47
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$9,619.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$994.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$13,467.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$12,986.68
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cigna Commercial |
$1,058.25
|
| Rate for Payer: First Health Commercial |
$1,211.25
|
| Rate for Payer: Humana Commercial |
$1,083.75
|
| Rate for Payer: Humana KY Medicaid |
$438.47
|
| Rate for Payer: Humana Medicare Advantage |
$9,619.76
|
| Rate for Payer: Kentucky WC Medicaid |
$442.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,045.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$940.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$11,543.71
|
| Rate for Payer: Molina Healthcare Medicaid |
$447.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,122.00
|
| Rate for Payer: Ohio Health Group HMO |
$956.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,020.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,109.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$879.75
|
| Rate for Payer: PHCS Commercial |
$1,224.00
|
| Rate for Payer: United Healthcare All Payer |
$1,122.00
|
|
|
THORACOSCOPY WBX SAC
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 32604
|
| Hospital Charge Code |
76101208
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$376.99 |
| Max. Negotiated Rate |
$838.92 |
| Rate for Payer: Aetna Commercial |
$838.92
|
| Rate for Payer: Ambetter Exchange |
$450.66
|
| Rate for Payer: Anthem Medicaid |
$376.99
|
| Rate for Payer: Buckeye Individual/Medicaid |
$450.66
|
| Rate for Payer: Buckeye Medicare Advantage |
$450.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$540.79
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$450.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$450.66
|
| 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 |
$585.86
|
| Rate for Payer: UHCCP Medicaid |
$446.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$380.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$450.66
|
|
|
THORACOSCOPY WBX SAC
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
HCPCS 32604
|
| Hospital Charge Code |
76101208
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$382.50 |
| Max. Negotiated Rate |
$1,224.00 |
| Rate for Payer: Aetna Commercial |
$981.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$994.50
|
| Rate for Payer: Cash Price |
$637.50
|
| Rate for Payer: Cigna Commercial |
$1,058.25
|
| Rate for Payer: First Health Commercial |
$1,211.25
|
| Rate for Payer: Humana Commercial |
$1,083.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,045.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$940.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$382.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,122.00
|
| Rate for Payer: Ohio Health Group HMO |
$956.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,020.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,109.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$879.75
|
| Rate for Payer: PHCS Commercial |
$1,224.00
|
| Rate for Payer: United Healthcare All Payer |
$1,122.00
|
|
|
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 |
$838.92 |
| Rate for Payer: Aetna Commercial |
$838.92
|
| Rate for Payer: Ambetter Exchange |
$450.66
|
| Rate for Payer: Anthem Medicaid |
$376.99
|
| Rate for Payer: Buckeye Individual/Medicaid |
$450.66
|
| Rate for Payer: Buckeye Medicare Advantage |
$450.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$540.79
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$450.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$450.66
|
| 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 |
$585.86
|
| Rate for Payer: UHCCP Medicaid |
$446.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$380.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$450.66
|
|
|
THORACOSCOPY; WITH BIOPSY(IES) OF PLEURA
|
Facility
|
OP
|
$7,547.16
|
|
|
Service Code
|
CPT 32609
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,390.83 |
| Max. Negotiated Rate |
$7,547.16 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,390.83
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7,547.16
|
| Rate for Payer: CareSource Just4Me Medicare |
$7,277.62
|
| Rate for Payer: Humana Medicare Advantage |
$5,390.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,469.00
|
|
|
THORACOSCOPY W/LOBECTOMY
|
Facility
|
OP
|
$3,350.00
|
|
|
Service Code
|
HCPCS 32663
|
| Hospital Charge Code |
76101222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$3,216.00 |
| Rate for Payer: Aetna Commercial |
$2,579.50
|
| Rate for Payer: Anthem Medicaid |
$1,152.07
|
| 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 |
$1,152.07
|
| 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 |
$2,680.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,914.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,311.50
|
| Rate for Payer: PHCS Commercial |
$3,216.00
|
| Rate for Payer: United Healthcare All Payer |
$2,948.00
|
|
|
THORACOSCOPY W/LOBECTOMY
|
Facility
|
IP
|
$3,350.00
|
|
|
Service Code
|
HCPCS 32663
|
| Hospital Charge Code |
76101222
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,005.00 |
| 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 |
$2,680.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,914.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,311.50
|
| 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 |
$2,332.72 |
| Rate for Payer: Aetna Commercial |
$2,332.72
|
| Rate for Payer: Ambetter Exchange |
$1,315.71
|
| Rate for Payer: Anthem Medicaid |
$1,049.94
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,315.71
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,315.71
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,578.85
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,315.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,315.71
|
| 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 |
$1,710.42
|
| Rate for Payer: UHCCP Medicaid |
$1,172.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,060.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,315.71
|
|
|
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 |
$2,332.72 |
| Rate for Payer: Aetna Commercial |
$2,332.72
|
| Rate for Payer: Ambetter Exchange |
$1,315.71
|
| Rate for Payer: Anthem Medicaid |
$1,049.94
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,315.71
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,315.71
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,578.85
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$1,315.71
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,315.71
|
| 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 |
$1,710.42
|
| Rate for Payer: UHCCP Medicaid |
$1,172.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,060.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,315.71
|
|
|
THORACOSCOPY W/MEDIAST EXC
|
Facility
|
OP
|
$1,155.00
|
|
|
Service Code
|
HCPCS 32662
|
| Hospital Charge Code |
76101221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$346.50 |
| 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 |
$924.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,004.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$796.95
|
| Rate for Payer: PHCS Commercial |
$1,108.80
|
| Rate for Payer: United Healthcare All Payer |
$1,016.40
|
|
|
THORACOSCOPY W/MEDIAST EXC
|
Facility
|
IP
|
$1,155.00
|
|
|
Service Code
|
HCPCS 32662
|
| Hospital Charge Code |
76101221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$346.50 |
| 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 |
$924.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,004.85
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$796.95
|
| 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: Ambetter Exchange |
$842.87
|
| Rate for Payer: Anthem Medicaid |
$919.29
|
| Rate for Payer: Buckeye Individual/Medicaid |
$842.87
|
| Rate for Payer: Buckeye Medicare Advantage |
$842.87
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,011.44
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$842.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$842.87
|
| 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 |
$1,095.73
|
| Rate for Payer: UHCCP Medicaid |
$404.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$928.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$842.87
|
|
|
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: Ambetter Exchange |
$842.87
|
| Rate for Payer: Anthem Medicaid |
$919.29
|
| Rate for Payer: Buckeye Individual/Medicaid |
$842.87
|
| Rate for Payer: Buckeye Medicare Advantage |
$842.87
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,011.44
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$842.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$842.87
|
| 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 |
$1,095.73
|
| Rate for Payer: UHCCP Medicaid |
$404.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$928.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$842.87
|
|
|
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 |
$1,641.20 |
| Rate for Payer: Ambetter Exchange |
$819.99
|
| Rate for Payer: Anthem Medicaid |
$707.35
|
| Rate for Payer: Buckeye Individual/Medicaid |
$819.99
|
| Rate for Payer: Buckeye Medicare Advantage |
$819.99
|
| Rate for Payer: CareSource Just4Me Medicare |
$983.99
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$819.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$819.99
|
| 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 |
$1,065.99
|
| Rate for Payer: UHCCP Medicaid |
$700.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$714.42
|
| Rate for Payer: Wellcare Medicare Advantage |
$819.99
|
|
|
THORACOSCOPY W/WEDGE RESECT
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32666
|
| Hospital Charge Code |
76101224
|
|
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 W/WEDGE RESECT
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 32666
|
| Hospital Charge Code |
76101224
|
|
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 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 |
$1,641.20 |
| Rate for Payer: Ambetter Exchange |
$819.99
|
| Rate for Payer: Anthem Medicaid |
$707.35
|
| Rate for Payer: Buckeye Individual/Medicaid |
$819.99
|
| Rate for Payer: Buckeye Medicare Advantage |
$819.99
|
| Rate for Payer: CareSource Just4Me Medicare |
$983.99
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$819.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$819.99
|
| 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 |
$1,065.99
|
| Rate for Payer: UHCCP Medicaid |
$700.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$714.42
|
| Rate for Payer: Wellcare Medicare Advantage |
$819.99
|
|
|
THORACOSCOPY W/W RESECT ADDL
|
Facility
|
IP
|
$570.00
|
|
|
Service Code
|
HCPCS 32667
|
| Hospital Charge Code |
76101225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.00 |
| 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 |
$456.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$495.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$393.30
|
| 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 |
$342.00 |
| Rate for Payer: Ambetter Exchange |
$146.44
|
| Rate for Payer: Anthem Medicaid |
$128.37
|
| Rate for Payer: Buckeye Individual/Medicaid |
$146.44
|
| Rate for Payer: Buckeye Medicare Advantage |
$146.44
|
| Rate for Payer: CareSource Just4Me Medicare |
$175.73
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$146.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$146.44
|
| 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 |
$190.37
|
| Rate for Payer: UHCCP Medicaid |
$199.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$129.65
|
| Rate for Payer: Wellcare Medicare Advantage |
$146.44
|
|
