|
TITAL CHP 130 LEGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAL CHP 135 LEGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAL CHP 135 LEGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAL CHP 90 LEGTH 16 THRD
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
TITAL CHP 90 LEGTH 16 THRD
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20.01
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15.87
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
TITAL CHP 95 LEGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAL CHP 95 LEGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 30 LNGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 30 LNGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 35 LNGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 35 LNGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 40 LNGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 40 LNGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 45 LNGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 45 LNGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 50 LNGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 50 LNGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 55 LNGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 55 LNGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 60 LNGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 60 LNGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 65 LNGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 65 LNGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 70 LNGTH 16 THRD
|
Facility
|
OP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem Medicaid |
$1,149.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Humana KY Medicaid |
$1,149.16
|
| Rate for Payer: Kentucky WC Medicaid |
$1,160.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,172.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
|
TITAN CHP 70 LNGTH 16 THRD
|
Facility
|
IP
|
$3,341.56
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,002.47 |
| Max. Negotiated Rate |
$3,207.90 |
| Rate for Payer: Aetna Commercial |
$2,573.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,606.42
|
| Rate for Payer: Cash Price |
$1,670.78
|
| Rate for Payer: Cigna Commercial |
$2,773.49
|
| Rate for Payer: First Health Commercial |
$3,174.48
|
| Rate for Payer: Humana Commercial |
$2,840.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,740.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,466.07
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,002.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,940.57
|
| Rate for Payer: Ohio Health Group HMO |
$2,506.17
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,673.25
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,907.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,305.68
|
| Rate for Payer: PHCS Commercial |
$3,207.90
|
| Rate for Payer: United Healthcare All Payer |
$2,940.57
|
|
