|
THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD
|
Facility
|
OP
|
$8.41
|
|
|
Service Code
|
CPT 85730
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6.01 |
| Max. Negotiated Rate |
$8.41 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$6.01
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$8.41
|
| Rate for Payer: CareSource Just4Me Medicare |
$8.11
|
| Rate for Payer: Humana Medicare Advantage |
$6.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7.21
|
|
|
THRUWAY STRAIGHT 190CM .018
|
Facility
|
IP
|
$1,504.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$451.20 |
| Max. Negotiated Rate |
$1,443.84 |
| Rate for Payer: Aetna Commercial |
$1,158.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,173.12
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cigna Commercial |
$1,248.32
|
| Rate for Payer: First Health Commercial |
$1,428.80
|
| Rate for Payer: Humana Commercial |
$1,278.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,233.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,109.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$451.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,323.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,128.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,203.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,308.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,037.76
|
| Rate for Payer: PHCS Commercial |
$1,443.84
|
| Rate for Payer: United Healthcare All Payer |
$1,323.52
|
|
|
THRUWAY STRAIGHT 190CM .018
|
Facility
|
OP
|
$1,504.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$451.20 |
| Max. Negotiated Rate |
$1,443.84 |
| Rate for Payer: Aetna Commercial |
$1,158.08
|
| Rate for Payer: Anthem Medicaid |
$517.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,173.12
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cigna Commercial |
$1,248.32
|
| Rate for Payer: First Health Commercial |
$1,428.80
|
| Rate for Payer: Humana Commercial |
$1,278.40
|
| Rate for Payer: Humana KY Medicaid |
$517.23
|
| Rate for Payer: Kentucky WC Medicaid |
$522.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,233.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,109.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$451.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$527.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,323.52
|
| Rate for Payer: Ohio Health Group HMO |
$1,128.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,203.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,308.48
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,037.76
|
| Rate for Payer: PHCS Commercial |
$1,443.84
|
| Rate for Payer: United Healthcare All Payer |
$1,323.52
|
|
|
THRUWAY WIRE .018 300CM ST
|
Facility
|
IP
|
$1,699.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$509.70 |
| Max. Negotiated Rate |
$1,631.04 |
| Rate for Payer: Aetna Commercial |
$1,308.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,325.22
|
| Rate for Payer: Cash Price |
$849.50
|
| Rate for Payer: Cigna Commercial |
$1,410.17
|
| Rate for Payer: First Health Commercial |
$1,614.05
|
| Rate for Payer: Humana Commercial |
$1,444.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,393.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,253.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$509.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,495.12
|
| Rate for Payer: Ohio Health Group HMO |
$1,274.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,359.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,478.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,172.31
|
| Rate for Payer: PHCS Commercial |
$1,631.04
|
| Rate for Payer: United Healthcare All Payer |
$1,495.12
|
|
|
THRUWAY WIRE .018 300CM ST
|
Facility
|
OP
|
$1,699.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27000056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$509.70 |
| Max. Negotiated Rate |
$1,631.04 |
| Rate for Payer: Aetna Commercial |
$1,308.23
|
| Rate for Payer: Anthem Medicaid |
$584.29
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,325.22
|
| Rate for Payer: Cash Price |
$849.50
|
| Rate for Payer: Cigna Commercial |
$1,410.17
|
| Rate for Payer: First Health Commercial |
$1,614.05
|
| Rate for Payer: Humana Commercial |
$1,444.15
|
| Rate for Payer: Humana KY Medicaid |
$584.29
|
| Rate for Payer: Kentucky WC Medicaid |
$590.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,393.18
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,253.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$509.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$596.01
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,495.12
|
| Rate for Payer: Ohio Health Group HMO |
$1,274.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,359.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,478.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,172.31
|
| Rate for Payer: PHCS Commercial |
$1,631.04
|
| Rate for Payer: United Healthcare All Payer |
$1,495.12
|
|
|
TH SMOKING CESSATION
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 99407
|
| Hospital Charge Code |
51000300
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.95 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Aetna Commercial |
$37.60
|
| Rate for Payer: Ambetter Exchange |
$23.40
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$29.48
|
| Rate for Payer: Anthem Medicaid |
$21.95
|
| Rate for Payer: Buckeye Individual/Medicaid |
$23.40
|
| Rate for Payer: Buckeye Medicare Advantage |
$23.40
|
| Rate for Payer: CareSource Just4Me Medicare |
$28.08
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cash Price |
$43.50
|
| Rate for Payer: Cigna Commercial |
$36.48
|
| Rate for Payer: Healthspan PPO |
$30.62
|
| Rate for Payer: Humana Medicaid |
$21.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$33.92
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$23.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$23.40
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$22.39
|
| Rate for Payer: Molina Healthcare Passport |
$21.95
|
| Rate for Payer: Multiplan PHCS |
$52.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$30.42
|
| Rate for Payer: UHCCP Medicaid |
$30.95
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$22.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$23.40
|
|
|
TH TRANS CARE MGMT 14 DAY DISC
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 99495
|
| Hospital Charge Code |
51000299
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$130.96 |
| Max. Negotiated Rate |
$273.49 |
| Rate for Payer: Ambetter Exchange |
$130.96
|
| Rate for Payer: Anthem Medicaid |
$167.42
|
| Rate for Payer: Buckeye Individual/Medicaid |
$130.96
|
| Rate for Payer: Buckeye Medicare Advantage |
$130.96
|
| Rate for Payer: CareSource Just4Me Medicare |
$157.15
|
| Rate for Payer: Cash Price |
$191.50
|
| Rate for Payer: Cash Price |
$191.50
|
| Rate for Payer: Cigna Commercial |
$273.49
|
| Rate for Payer: Healthspan PPO |
$138.69
|
| Rate for Payer: Humana Medicaid |
$167.42
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$180.50
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$130.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$130.96
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$170.77
|
| Rate for Payer: Molina Healthcare Passport |
$167.42
|
| Rate for Payer: Multiplan PHCS |
$229.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$170.25
|
| Rate for Payer: UHCCP Medicaid |
$134.05
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$169.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$130.96
|
|
|
TH TRANS CARE MGMT 7 DAY DISCH
|
Professional
|
Both
|
$487.23
|
|
|
Service Code
|
HCPCS 99496
|
| Hospital Charge Code |
51000189
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$170.53 |
| Max. Negotiated Rate |
$386.11 |
| Rate for Payer: Ambetter Exchange |
$178.06
|
| Rate for Payer: Anthem Medicaid |
$226.91
|
| Rate for Payer: Buckeye Individual/Medicaid |
$178.06
|
| Rate for Payer: Buckeye Medicare Advantage |
$178.06
|
| Rate for Payer: CareSource Just4Me Medicare |
$213.67
|
| Rate for Payer: Cash Price |
$243.62
|
| Rate for Payer: Cash Price |
$243.62
|
| Rate for Payer: Cigna Commercial |
$386.11
|
| Rate for Payer: Healthspan PPO |
$195.56
|
| Rate for Payer: Humana Medicaid |
$226.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$264.61
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$178.06
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$178.06
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$231.45
|
| Rate for Payer: Molina Healthcare Passport |
$226.91
|
| Rate for Payer: Multiplan PHCS |
$292.34
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$231.48
|
| Rate for Payer: UHCCP Medicaid |
$170.53
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$229.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$178.06
|
|
|
THYROGLOBULIN ANTIBODY
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
HCPCS 86800
|
| Hospital Charge Code |
30001221
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$140.16 |
| Rate for Payer: Aetna Commercial |
$112.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$117.24
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cigna Commercial |
$121.18
|
| Rate for Payer: First Health Commercial |
$138.70
|
| Rate for Payer: Humana Commercial |
$124.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$119.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$107.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$43.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$128.48
|
| Rate for Payer: Ohio Health Group HMO |
$109.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$116.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$127.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$100.74
|
| Rate for Payer: PHCS Commercial |
$140.16
|
| Rate for Payer: United Healthcare All Payer |
$128.48
|
|
|
THYROGLOBULIN ANTIBODY
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
HCPCS 86800
|
| Hospital Charge Code |
30001221
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$140.16 |
| Rate for Payer: Aetna Commercial |
$112.42
|
| Rate for Payer: Anthem Medicaid |
$15.91
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$15.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$117.24
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$22.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$15.91
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cigna Commercial |
$121.18
|
| Rate for Payer: First Health Commercial |
$138.70
|
| Rate for Payer: Humana Commercial |
$124.10
|
| Rate for Payer: Humana KY Medicaid |
$15.91
|
| Rate for Payer: Humana Medicare Advantage |
$15.91
|
| Rate for Payer: Kentucky WC Medicaid |
$16.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$119.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$107.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$19.09
|
| Rate for Payer: Molina Healthcare Medicaid |
$16.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$128.48
|
| Rate for Payer: Ohio Health Group HMO |
$109.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$116.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$127.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$100.74
|
| Rate for Payer: PHCS Commercial |
$140.16
|
| Rate for Payer: United Healthcare All Payer |
$128.48
|
|
|
THYROGLOBULIN ANTIBODY
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 86800
|
| Hospital Charge Code |
30001221
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.87 |
| Max. Negotiated Rate |
$87.60 |
| Rate for Payer: Aetna Commercial |
$10.87
|
| Rate for Payer: Ambetter Exchange |
$15.91
|
| Rate for Payer: Buckeye Individual/Medicaid |
$15.91
|
| Rate for Payer: Buckeye Medicare Advantage |
$15.91
|
| Rate for Payer: CareSource Just4Me Medicare |
$19.09
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cigna Commercial |
$14.16
|
| Rate for Payer: Healthspan PPO |
$16.66
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$15.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$15.91
|
| Rate for Payer: Multiplan PHCS |
$87.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$20.68
|
| Rate for Payer: UHCCP Medicaid |
$51.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.91
|
|
|
THYROID 60 MG TABLET 60MG/1TAB
|
Facility
|
OP
|
$4.96
|
|
|
Service Code
|
NDC 42192033001
|
| Hospital Charge Code |
25001544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$4.76 |
| Rate for Payer: Aetna Commercial |
$3.82
|
| Rate for Payer: Anthem Medicaid |
$1.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3.87
|
| Rate for Payer: Cash Price |
$2.48
|
| Rate for Payer: Cigna Commercial |
$4.12
|
| Rate for Payer: First Health Commercial |
$4.71
|
| Rate for Payer: Humana Commercial |
$4.22
|
| Rate for Payer: Humana KY Medicaid |
$1.71
|
| Rate for Payer: Kentucky WC Medicaid |
$1.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1.49
|
| Rate for Payer: Molina Healthcare Medicaid |
$1.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$4.36
|
| Rate for Payer: Ohio Health Group HMO |
$3.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3.97
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3.42
|
| Rate for Payer: PHCS Commercial |
$4.76
|
| Rate for Payer: United Healthcare All Payer |
$4.36
|
|
|
THYROID 60 MG TABLET 60MG/1TAB
|
Facility
|
IP
|
$4.96
|
|
|
Service Code
|
NDC 42192033001
|
| Hospital Charge Code |
25001544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$4.76 |
| Rate for Payer: Aetna Commercial |
$3.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3.87
|
| Rate for Payer: Cash Price |
$2.48
|
| Rate for Payer: Cigna Commercial |
$4.12
|
| Rate for Payer: First Health Commercial |
$4.71
|
| Rate for Payer: Humana Commercial |
$4.22
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$4.36
|
| Rate for Payer: Ohio Health Group HMO |
$3.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3.97
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4.32
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3.42
|
| Rate for Payer: PHCS Commercial |
$4.76
|
| Rate for Payer: United Healthcare All Payer |
$4.36
|
|
|
THYROID CANCE METASTIC IMAG (P
|
Professional
|
Both
|
$790.00
|
|
|
Service Code
|
HCPCS 78018
|
| Hospital Charge Code |
340P0003
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$47.26 |
| Max. Negotiated Rate |
$474.00 |
| Rate for Payer: Aetna Commercial |
$468.11
|
| Rate for Payer: Ambetter Exchange |
$249.69
|
| Rate for Payer: Anthem Medicaid |
$187.55
|
| Rate for Payer: Buckeye Individual/Medicaid |
$249.69
|
| Rate for Payer: Buckeye Medicare Advantage |
$249.69
|
| Rate for Payer: CareSource Just4Me Medicare |
$299.63
|
| Rate for Payer: Cash Price |
$395.00
|
| Rate for Payer: Cash Price |
$395.00
|
| Rate for Payer: Cigna Commercial |
$403.85
|
| Rate for Payer: Healthspan PPO |
$467.87
|
| Rate for Payer: Humana Medicaid |
$187.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$47.26
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$249.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$249.69
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$191.30
|
| Rate for Payer: Molina Healthcare Passport |
$187.55
|
| Rate for Payer: Multiplan PHCS |
$474.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$324.60
|
| Rate for Payer: UHCCP Medicaid |
$276.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$189.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$249.69
|
|
|
THYROID CANCE METASTIC IMAG (T
|
Facility
|
OP
|
$1,033.00
|
|
|
Service Code
|
HCPCS 78018
|
| Hospital Charge Code |
340T0003
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$355.25 |
| Max. Negotiated Rate |
$991.68 |
| Rate for Payer: Aetna Commercial |
$795.41
|
| Rate for Payer: Anthem Medicaid |
$355.25
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$497.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$805.74
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$696.29
|
| Rate for Payer: CareSource Just4Me Medicare |
$671.42
|
| Rate for Payer: Cash Price |
$516.50
|
| Rate for Payer: Cash Price |
$516.50
|
| Rate for Payer: Cigna Commercial |
$857.39
|
| Rate for Payer: First Health Commercial |
$981.35
|
| Rate for Payer: Humana Commercial |
$878.05
|
| Rate for Payer: Humana KY Medicaid |
$355.25
|
| Rate for Payer: Humana Medicare Advantage |
$497.35
|
| Rate for Payer: Kentucky WC Medicaid |
$358.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$847.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$762.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$362.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$909.04
|
| Rate for Payer: Ohio Health Group HMO |
$774.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$826.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$898.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$712.77
|
| Rate for Payer: PHCS Commercial |
$991.68
|
| Rate for Payer: United Healthcare All Payer |
$909.04
|
|
|
THYROID CANCE METASTIC IMAG (T
|
Facility
|
IP
|
$1,033.00
|
|
|
Service Code
|
HCPCS 78018
|
| Hospital Charge Code |
340T0003
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$309.90 |
| Max. Negotiated Rate |
$991.68 |
| Rate for Payer: Aetna Commercial |
$795.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$805.74
|
| Rate for Payer: Cash Price |
$516.50
|
| Rate for Payer: Cigna Commercial |
$857.39
|
| Rate for Payer: First Health Commercial |
$981.35
|
| Rate for Payer: Humana Commercial |
$878.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$847.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$762.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$309.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$909.04
|
| Rate for Payer: Ohio Health Group HMO |
$774.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$826.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$898.71
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$712.77
|
| Rate for Payer: PHCS Commercial |
$991.68
|
| Rate for Payer: United Healthcare All Payer |
$909.04
|
|
|
THYROID CANCE METASTIC IMAG W
|
Facility
|
OP
|
$1,823.00
|
|
|
Service Code
|
HCPCS 78018
|
| Hospital Charge Code |
34000003
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$497.35 |
| Max. Negotiated Rate |
$1,750.08 |
| Rate for Payer: Aetna Commercial |
$1,403.71
|
| Rate for Payer: Anthem Medicaid |
$626.93
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$497.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,421.94
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$696.29
|
| Rate for Payer: CareSource Just4Me Medicare |
$671.42
|
| Rate for Payer: Cash Price |
$911.50
|
| Rate for Payer: Cash Price |
$911.50
|
| Rate for Payer: Cigna Commercial |
$1,513.09
|
| Rate for Payer: First Health Commercial |
$1,731.85
|
| Rate for Payer: Humana Commercial |
$1,549.55
|
| Rate for Payer: Humana KY Medicaid |
$626.93
|
| Rate for Payer: Humana Medicare Advantage |
$497.35
|
| Rate for Payer: Kentucky WC Medicaid |
$633.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,494.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,345.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$596.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$639.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,604.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,367.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,458.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,586.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,257.87
|
| Rate for Payer: PHCS Commercial |
$1,750.08
|
| Rate for Payer: United Healthcare All Payer |
$1,604.24
|
|
|
THYROID CANCE METASTIC IMAG W
|
Professional
|
Both
|
$1,823.00
|
|
|
Service Code
|
HCPCS 78018
|
| Hospital Charge Code |
34000003
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$47.26 |
| Max. Negotiated Rate |
$1,093.80 |
| Rate for Payer: Aetna Commercial |
$468.11
|
| Rate for Payer: Ambetter Exchange |
$249.69
|
| Rate for Payer: Anthem Medicaid |
$187.55
|
| Rate for Payer: Buckeye Individual/Medicaid |
$249.69
|
| Rate for Payer: Buckeye Medicare Advantage |
$249.69
|
| Rate for Payer: CareSource Just4Me Medicare |
$299.63
|
| Rate for Payer: Cash Price |
$911.50
|
| Rate for Payer: Cash Price |
$911.50
|
| Rate for Payer: Cigna Commercial |
$403.85
|
| Rate for Payer: Healthspan PPO |
$467.87
|
| Rate for Payer: Humana Medicaid |
$187.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$47.26
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$249.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$249.69
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$191.30
|
| Rate for Payer: Molina Healthcare Passport |
$187.55
|
| Rate for Payer: Multiplan PHCS |
$1,093.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$324.60
|
| Rate for Payer: UHCCP Medicaid |
$638.05
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$189.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$249.69
|
|
|
THYROID CANCE METASTIC IMAG W
|
Facility
|
IP
|
$1,823.00
|
|
|
Service Code
|
HCPCS 78018
|
| Hospital Charge Code |
34000003
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$546.90 |
| Max. Negotiated Rate |
$1,750.08 |
| Rate for Payer: Aetna Commercial |
$1,403.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,421.94
|
| Rate for Payer: Cash Price |
$911.50
|
| Rate for Payer: Cigna Commercial |
$1,513.09
|
| Rate for Payer: First Health Commercial |
$1,731.85
|
| Rate for Payer: Humana Commercial |
$1,549.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,494.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,345.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$546.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,604.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,367.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,458.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,586.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,257.87
|
| Rate for Payer: PHCS Commercial |
$1,750.08
|
| Rate for Payer: United Healthcare All Payer |
$1,604.24
|
|
|
THYROIDECTOMY
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 60240
|
| Hospital Charge Code |
76102275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$790.92 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna Commercial |
$1,437.38
|
| Rate for Payer: Ambetter Exchange |
$871.43
|
| Rate for Payer: Anthem Medicaid |
$790.92
|
| Rate for Payer: Buckeye Individual/Medicaid |
$871.43
|
| Rate for Payer: Buckeye Medicare Advantage |
$871.43
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,045.72
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$1,363.13
|
| Rate for Payer: Healthspan PPO |
$1,212.16
|
| Rate for Payer: Humana Medicaid |
$790.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,252.00
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$871.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$871.43
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$806.74
|
| Rate for Payer: Molina Healthcare Passport |
$790.92
|
| Rate for Payer: Multiplan PHCS |
$1,500.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,132.86
|
| Rate for Payer: UHCCP Medicaid |
$875.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$798.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$871.43
|
|
|
THYROIDECTOMY
|
Facility
|
IP
|
$2,500.00
|
|
|
Service Code
|
HCPCS 60240
|
| Hospital Charge Code |
76102275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$1,925.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,950.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$2,075.00
|
| Rate for Payer: First Health Commercial |
$2,375.00
|
| Rate for Payer: Humana Commercial |
$2,125.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,050.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,845.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$750.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,875.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,175.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,725.00
|
| Rate for Payer: PHCS Commercial |
$2,400.00
|
| Rate for Payer: United Healthcare All Payer |
$2,200.00
|
|
|
THYROIDECTOMY
|
Facility
|
OP
|
$2,500.00
|
|
|
Service Code
|
HCPCS 60240
|
| Hospital Charge Code |
76102275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$859.75 |
| Max. Negotiated Rate |
$7,547.16 |
| Rate for Payer: Aetna Commercial |
$1,925.00
|
| Rate for Payer: Anthem Medicaid |
$859.75
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,390.83
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,950.00
|
| 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 |
$1,250.00
|
| Rate for Payer: Cash Price |
$1,250.00
|
| Rate for Payer: Cigna Commercial |
$2,075.00
|
| Rate for Payer: First Health Commercial |
$2,375.00
|
| Rate for Payer: Humana Commercial |
$2,125.00
|
| Rate for Payer: Humana KY Medicaid |
$859.75
|
| Rate for Payer: Humana Medicare Advantage |
$5,390.83
|
| Rate for Payer: Kentucky WC Medicaid |
$868.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,050.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,845.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,469.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$877.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,875.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,175.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,725.00
|
| Rate for Payer: PHCS Commercial |
$2,400.00
|
| Rate for Payer: United Healthcare All Payer |
$2,200.00
|
|
|
THYROIDECTOMY
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 60271
|
| Hospital Charge Code |
76102278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$795.80 |
| Max. Negotiated Rate |
$1,560.00 |
| Rate for Payer: Aetna Commercial |
$1,556.24
|
| Rate for Payer: Ambetter Exchange |
$1,002.26
|
| Rate for Payer: Anthem Medicaid |
$795.80
|
| Rate for Payer: Buckeye Individual/Medicaid |
$1,002.26
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,002.26
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,202.71
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cigna Commercial |
$1,479.69
|
| Rate for Payer: Healthspan PPO |
$1,312.40
|
| Rate for Payer: Humana Medicaid |
$795.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,362.16
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$1,002.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.26
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$811.72
|
| Rate for Payer: Molina Healthcare Passport |
$795.80
|
| Rate for Payer: Multiplan PHCS |
$1,560.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,302.94
|
| Rate for Payer: UHCCP Medicaid |
$910.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$803.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,002.26
|
|
|
THYROIDECTOMY
|
Facility
|
OP
|
$2,600.00
|
|
|
Service Code
|
HCPCS 60271
|
| Hospital Charge Code |
76102278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$894.14 |
| Max. Negotiated Rate |
$7,652.33 |
| Rate for Payer: Aetna Commercial |
$2,002.00
|
| Rate for Payer: Anthem Medicaid |
$894.14
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,465.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,028.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7,652.33
|
| Rate for Payer: CareSource Just4Me Medicare |
$7,379.03
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cigna Commercial |
$2,158.00
|
| Rate for Payer: First Health Commercial |
$2,470.00
|
| Rate for Payer: Humana Commercial |
$2,210.00
|
| Rate for Payer: Humana KY Medicaid |
$894.14
|
| Rate for Payer: Humana Medicare Advantage |
$5,465.95
|
| Rate for Payer: Kentucky WC Medicaid |
$903.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,132.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,918.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,559.14
|
| Rate for Payer: Molina Healthcare Medicaid |
$912.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,288.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,080.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,262.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,794.00
|
| Rate for Payer: PHCS Commercial |
$2,496.00
|
| Rate for Payer: United Healthcare All Payer |
$2,288.00
|
|
|
THYROIDECTOMY
|
Facility
|
IP
|
$2,600.00
|
|
|
Service Code
|
HCPCS 60271
|
| Hospital Charge Code |
76102278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$2,496.00 |
| Rate for Payer: Aetna Commercial |
$2,002.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,028.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cigna Commercial |
$2,158.00
|
| Rate for Payer: First Health Commercial |
$2,470.00
|
| Rate for Payer: Humana Commercial |
$2,210.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,132.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,918.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,288.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,080.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,262.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,794.00
|
| Rate for Payer: PHCS Commercial |
$2,496.00
|
| Rate for Payer: United Healthcare All Payer |
$2,288.00
|
|
