|
TREAT KNUCKLE DISLOCATION
|
Facility
|
OP
|
$925.00
|
|
|
Service Code
|
HCPCS 26715
|
| Hospital Charge Code |
76100735
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.11 |
| Max. Negotiated Rate |
$4,197.13 |
| Rate for Payer: Aetna Commercial |
$712.25
|
| Rate for Payer: Anthem Medicaid |
$318.11
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,997.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$721.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,197.13
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,047.23
|
| Rate for Payer: Cash Price |
$462.50
|
| Rate for Payer: Cash Price |
$462.50
|
| Rate for Payer: Cigna Commercial |
$767.75
|
| Rate for Payer: First Health Commercial |
$878.75
|
| Rate for Payer: Humana Commercial |
$786.25
|
| Rate for Payer: Humana KY Medicaid |
$318.11
|
| Rate for Payer: Humana Medicare Advantage |
$2,997.95
|
| Rate for Payer: Kentucky WC Medicaid |
$321.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$758.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$682.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,597.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$324.49
|
| Rate for Payer: Ohio Health Choice Commercial |
$814.00
|
| Rate for Payer: Ohio Health Group HMO |
$693.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$740.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$804.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$638.25
|
| Rate for Payer: PHCS Commercial |
$888.00
|
| Rate for Payer: United Healthcare All Payer |
$814.00
|
|
|
TREAT KNUCKLE DISLOCATION
|
Professional
|
Both
|
$925.00
|
|
|
Service Code
|
HCPCS 26715
|
| Hospital Charge Code |
76100735
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$287.61 |
| Max. Negotiated Rate |
$780.37 |
| Rate for Payer: Aetna Commercial |
$780.37
|
| Rate for Payer: Ambetter Exchange |
$548.95
|
| Rate for Payer: Anthem Medicaid |
$287.61
|
| Rate for Payer: Buckeye Individual/Medicaid |
$548.95
|
| Rate for Payer: Buckeye Medicare Advantage |
$548.95
|
| Rate for Payer: CareSource Just4Me Medicare |
$658.74
|
| Rate for Payer: Cash Price |
$462.50
|
| Rate for Payer: Cash Price |
$462.50
|
| Rate for Payer: Cigna Commercial |
$740.77
|
| Rate for Payer: Healthspan PPO |
$706.85
|
| Rate for Payer: Humana Medicaid |
$287.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$690.31
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$548.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$548.95
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$293.36
|
| Rate for Payer: Molina Healthcare Passport |
$287.61
|
| Rate for Payer: Multiplan PHCS |
$555.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$713.63
|
| Rate for Payer: UHCCP Medicaid |
$323.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$290.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$548.95
|
|
|
TREAT KNUCKLE DISLOCATION(P
|
Professional
|
Both
|
$925.00
|
|
|
Service Code
|
HCPCS 26715
|
| Hospital Charge Code |
761P0735
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$287.61 |
| Max. Negotiated Rate |
$780.37 |
| Rate for Payer: Aetna Commercial |
$780.37
|
| Rate for Payer: Ambetter Exchange |
$548.95
|
| Rate for Payer: Anthem Medicaid |
$287.61
|
| Rate for Payer: Buckeye Individual/Medicaid |
$548.95
|
| Rate for Payer: Buckeye Medicare Advantage |
$548.95
|
| Rate for Payer: CareSource Just4Me Medicare |
$658.74
|
| Rate for Payer: Cash Price |
$462.50
|
| Rate for Payer: Cash Price |
$462.50
|
| Rate for Payer: Cigna Commercial |
$740.77
|
| Rate for Payer: Healthspan PPO |
$706.85
|
| Rate for Payer: Humana Medicaid |
$287.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$690.31
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$548.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$548.95
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$293.36
|
| Rate for Payer: Molina Healthcare Passport |
$287.61
|
| Rate for Payer: Multiplan PHCS |
$555.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$713.63
|
| Rate for Payer: UHCCP Medicaid |
$323.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$290.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$548.95
|
|
|
TREAT LOWER LEG JOINT
|
Facility
|
OP
|
$1,330.00
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
76100951
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$457.39 |
| Max. Negotiated Rate |
$9,240.92 |
| Rate for Payer: Aetna Commercial |
$1,024.10
|
| Rate for Payer: Anthem Medicaid |
$457.39
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$6,600.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,037.40
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$9,240.92
|
| Rate for Payer: CareSource Just4Me Medicare |
$8,910.89
|
| Rate for Payer: Cash Price |
$665.00
|
| Rate for Payer: Cash Price |
$665.00
|
| Rate for Payer: Cigna Commercial |
$1,103.90
|
| Rate for Payer: First Health Commercial |
$1,263.50
|
| Rate for Payer: Humana Commercial |
$1,130.50
|
| Rate for Payer: Humana KY Medicaid |
$457.39
|
| Rate for Payer: Humana Medicare Advantage |
$6,600.66
|
| Rate for Payer: Kentucky WC Medicaid |
$462.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,090.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$981.54
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,920.79
|
| Rate for Payer: Molina Healthcare Medicaid |
$466.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,170.40
|
| Rate for Payer: Ohio Health Group HMO |
$997.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,064.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,157.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$917.70
|
| Rate for Payer: PHCS Commercial |
$1,276.80
|
| Rate for Payer: United Healthcare All Payer |
$1,170.40
|
|
|
TREAT LOWER LEG JOINT
|
Professional
|
Both
|
$1,330.00
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
76100951
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$343.29 |
| Max. Negotiated Rate |
$943.20 |
| Rate for Payer: Aetna Commercial |
$943.20
|
| Rate for Payer: Ambetter Exchange |
$665.24
|
| Rate for Payer: Anthem Medicaid |
$343.29
|
| Rate for Payer: Buckeye Individual/Medicaid |
$665.24
|
| Rate for Payer: Buckeye Medicare Advantage |
$665.24
|
| Rate for Payer: CareSource Just4Me Medicare |
$798.29
|
| Rate for Payer: Cash Price |
$665.00
|
| Rate for Payer: Cash Price |
$665.00
|
| Rate for Payer: Cigna Commercial |
$805.21
|
| Rate for Payer: Healthspan PPO |
$854.34
|
| Rate for Payer: Humana Medicaid |
$343.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$837.75
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$665.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$665.24
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$350.16
|
| Rate for Payer: Molina Healthcare Passport |
$343.29
|
| Rate for Payer: Multiplan PHCS |
$798.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$864.81
|
| Rate for Payer: UHCCP Medicaid |
$465.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$346.72
|
| Rate for Payer: Wellcare Medicare Advantage |
$665.24
|
|
|
TREAT LOWER LEG JOINT
|
Facility
|
IP
|
$1,330.00
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
76100951
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$399.00 |
| Max. Negotiated Rate |
$1,276.80 |
| Rate for Payer: Aetna Commercial |
$1,024.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,037.40
|
| Rate for Payer: Cash Price |
$665.00
|
| Rate for Payer: Cigna Commercial |
$1,103.90
|
| Rate for Payer: First Health Commercial |
$1,263.50
|
| Rate for Payer: Humana Commercial |
$1,130.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,090.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$981.54
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$399.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,170.40
|
| Rate for Payer: Ohio Health Group HMO |
$997.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,064.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,157.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$917.70
|
| Rate for Payer: PHCS Commercial |
$1,276.80
|
| Rate for Payer: United Healthcare All Payer |
$1,170.40
|
|
|
TREAT LOWER LEG JOINT(P
|
Professional
|
Both
|
$1,330.00
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
761P0951
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$343.29 |
| Max. Negotiated Rate |
$943.20 |
| Rate for Payer: Aetna Commercial |
$943.20
|
| Rate for Payer: Ambetter Exchange |
$665.24
|
| Rate for Payer: Anthem Medicaid |
$343.29
|
| Rate for Payer: Buckeye Individual/Medicaid |
$665.24
|
| Rate for Payer: Buckeye Medicare Advantage |
$665.24
|
| Rate for Payer: CareSource Just4Me Medicare |
$798.29
|
| Rate for Payer: Cash Price |
$665.00
|
| Rate for Payer: Cash Price |
$665.00
|
| Rate for Payer: Cigna Commercial |
$805.21
|
| Rate for Payer: Healthspan PPO |
$854.34
|
| Rate for Payer: Humana Medicaid |
$343.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$837.75
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$665.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$665.24
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$350.16
|
| Rate for Payer: Molina Healthcare Passport |
$343.29
|
| Rate for Payer: Multiplan PHCS |
$798.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$864.81
|
| Rate for Payer: UHCCP Medicaid |
$465.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$346.72
|
| Rate for Payer: Wellcare Medicare Advantage |
$665.24
|
|
|
TREATMENT KNEE CAP DISLOCATION
|
Facility
|
IP
|
$467.00
|
|
|
Service Code
|
HCPCS 27550
|
| Hospital Charge Code |
45000160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.10 |
| Max. Negotiated Rate |
$448.32 |
| Rate for Payer: Aetna Commercial |
$359.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$364.26
|
| Rate for Payer: Cash Price |
$233.50
|
| Rate for Payer: Cigna Commercial |
$387.61
|
| Rate for Payer: First Health Commercial |
$443.65
|
| Rate for Payer: Humana Commercial |
$396.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$382.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$344.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$140.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$410.96
|
| Rate for Payer: Ohio Health Group HMO |
$350.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$373.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$406.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$322.23
|
| Rate for Payer: PHCS Commercial |
$448.32
|
| Rate for Payer: United Healthcare All Payer |
$410.96
|
|
|
TREATMENT KNEE CAP DISLOCATION
|
Facility
|
OP
|
$451.00
|
|
|
Service Code
|
HCPCS 27550
|
| Hospital Charge Code |
76100874
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.10 |
| Max. Negotiated Rate |
$432.96 |
| Rate for Payer: Aetna Commercial |
$347.27
|
| Rate for Payer: Anthem Medicaid |
$155.10
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$221.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$351.78
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$310.30
|
| Rate for Payer: CareSource Just4Me Medicare |
$299.21
|
| Rate for Payer: Cash Price |
$225.50
|
| Rate for Payer: Cash Price |
$225.50
|
| Rate for Payer: Cigna Commercial |
$374.33
|
| Rate for Payer: First Health Commercial |
$428.45
|
| Rate for Payer: Humana Commercial |
$383.35
|
| Rate for Payer: Humana KY Medicaid |
$155.10
|
| Rate for Payer: Humana Medicare Advantage |
$221.64
|
| Rate for Payer: Kentucky WC Medicaid |
$156.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$369.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$332.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$265.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$158.21
|
| Rate for Payer: Ohio Health Choice Commercial |
$396.88
|
| Rate for Payer: Ohio Health Group HMO |
$338.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$360.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$392.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$311.19
|
| Rate for Payer: PHCS Commercial |
$432.96
|
| Rate for Payer: United Healthcare All Payer |
$396.88
|
|
|
TREATMENT KNEE CAP DISLOCATION
|
Facility
|
IP
|
$451.00
|
|
|
Service Code
|
HCPCS 27550
|
| Hospital Charge Code |
76100874
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$135.30 |
| Max. Negotiated Rate |
$432.96 |
| Rate for Payer: Aetna Commercial |
$347.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$351.78
|
| Rate for Payer: Cash Price |
$225.50
|
| Rate for Payer: Cigna Commercial |
$374.33
|
| Rate for Payer: First Health Commercial |
$428.45
|
| Rate for Payer: Humana Commercial |
$383.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$369.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$332.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$135.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$396.88
|
| Rate for Payer: Ohio Health Group HMO |
$338.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$360.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$392.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$311.19
|
| Rate for Payer: PHCS Commercial |
$432.96
|
| Rate for Payer: United Healthcare All Payer |
$396.88
|
|
|
TREATMENT KNEE CAP DISLOCATION
|
Facility
|
OP
|
$467.00
|
|
|
Service Code
|
HCPCS 27550
|
| Hospital Charge Code |
45000160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$448.32 |
| Rate for Payer: Aetna Commercial |
$359.59
|
| Rate for Payer: Anthem Medicaid |
$160.60
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$221.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$364.26
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$310.30
|
| Rate for Payer: CareSource Just4Me Medicare |
$299.21
|
| Rate for Payer: Cash Price |
$233.50
|
| Rate for Payer: Cash Price |
$233.50
|
| Rate for Payer: Cigna Commercial |
$387.61
|
| Rate for Payer: First Health Commercial |
$443.65
|
| Rate for Payer: Humana Commercial |
$396.95
|
| Rate for Payer: Humana KY Medicaid |
$160.60
|
| Rate for Payer: Humana Medicare Advantage |
$221.64
|
| Rate for Payer: Kentucky WC Medicaid |
$162.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$382.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$344.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$265.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$163.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$410.96
|
| Rate for Payer: Ohio Health Group HMO |
$350.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$373.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$406.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$322.23
|
| Rate for Payer: PHCS Commercial |
$448.32
|
| Rate for Payer: United Healthcare All Payer |
$410.96
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$1,056.00
|
|
|
Service Code
|
HCPCS 27810
|
| Hospital Charge Code |
76100940
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$274.22 |
| Max. Negotiated Rate |
$677.82 |
| Rate for Payer: Aetna Commercial |
$612.25
|
| Rate for Payer: Ambetter Exchange |
$413.23
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$274.22
|
| Rate for Payer: Anthem Medicaid |
$296.33
|
| Rate for Payer: Buckeye Individual/Medicaid |
$413.23
|
| Rate for Payer: Buckeye Medicare Advantage |
$413.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$495.88
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cigna Commercial |
$677.82
|
| Rate for Payer: Healthspan PPO |
$597.70
|
| Rate for Payer: Humana Medicaid |
$296.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$524.34
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$413.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$413.23
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$302.26
|
| Rate for Payer: Molina Healthcare Passport |
$296.33
|
| Rate for Payer: Multiplan PHCS |
$633.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$537.20
|
| Rate for Payer: UHCCP Medicaid |
$287.93
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$299.29
|
| Rate for Payer: Wellcare Medicare Advantage |
$413.23
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$1,291.00
|
|
|
Service Code
|
HCPCS 27808
|
| Hospital Charge Code |
76100939
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.36 |
| Max. Negotiated Rate |
$774.60 |
| Rate for Payer: Aetna Commercial |
$398.76
|
| Rate for Payer: Ambetter Exchange |
$295.96
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$159.36
|
| Rate for Payer: Anthem Medicaid |
$161.48
|
| Rate for Payer: Buckeye Individual/Medicaid |
$295.96
|
| Rate for Payer: Buckeye Medicare Advantage |
$295.96
|
| Rate for Payer: CareSource Just4Me Medicare |
$355.15
|
| Rate for Payer: Cash Price |
$645.50
|
| Rate for Payer: Cash Price |
$645.50
|
| Rate for Payer: Cigna Commercial |
$497.32
|
| Rate for Payer: Healthspan PPO |
$399.01
|
| Rate for Payer: Humana Medicaid |
$161.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$354.48
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$295.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$295.96
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$164.71
|
| Rate for Payer: Molina Healthcare Passport |
$161.48
|
| Rate for Payer: Multiplan PHCS |
$774.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$384.75
|
| Rate for Payer: UHCCP Medicaid |
$167.33
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$163.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$295.96
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$1,201.00
|
|
|
Service Code
|
HCPCS 28430
|
| Hospital Charge Code |
76101014
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.73 |
| Max. Negotiated Rate |
$720.60 |
| Rate for Payer: Aetna Commercial |
$281.01
|
| Rate for Payer: Ambetter Exchange |
$202.89
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$131.80
|
| Rate for Payer: Anthem Medicaid |
$131.73
|
| Rate for Payer: Buckeye Individual/Medicaid |
$202.89
|
| Rate for Payer: Buckeye Medicare Advantage |
$202.89
|
| Rate for Payer: CareSource Just4Me Medicare |
$243.47
|
| Rate for Payer: Cash Price |
$600.50
|
| Rate for Payer: Cash Price |
$600.50
|
| Rate for Payer: Cigna Commercial |
$355.57
|
| Rate for Payer: Healthspan PPO |
$283.14
|
| Rate for Payer: Humana Medicaid |
$131.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$247.24
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$202.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$202.89
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$134.36
|
| Rate for Payer: Molina Healthcare Passport |
$131.73
|
| Rate for Payer: Multiplan PHCS |
$720.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$263.76
|
| Rate for Payer: UHCCP Medicaid |
$138.39
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$133.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$202.89
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$2,248.00
|
|
|
Service Code
|
HCPCS 27810
|
| Hospital Charge Code |
45000168
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$674.40 |
| Max. Negotiated Rate |
$2,158.08 |
| Rate for Payer: Aetna Commercial |
$1,730.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,753.44
|
| Rate for Payer: Cash Price |
$1,124.00
|
| Rate for Payer: Cigna Commercial |
$1,865.84
|
| Rate for Payer: First Health Commercial |
$2,135.60
|
| Rate for Payer: Humana Commercial |
$1,910.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,843.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,659.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$674.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,978.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,686.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,798.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,955.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,551.12
|
| Rate for Payer: PHCS Commercial |
$2,158.08
|
| Rate for Payer: United Healthcare All Payer |
$1,978.24
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1,056.00
|
|
|
Service Code
|
HCPCS 27810
|
| Hospital Charge Code |
76100940
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$363.16 |
| Max. Negotiated Rate |
$2,070.25 |
| Rate for Payer: Aetna Commercial |
$813.12
|
| Rate for Payer: Anthem Medicaid |
$363.16
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,478.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$823.68
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,070.25
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,996.31
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cigna Commercial |
$876.48
|
| Rate for Payer: First Health Commercial |
$1,003.20
|
| Rate for Payer: Humana Commercial |
$897.60
|
| Rate for Payer: Humana KY Medicaid |
$363.16
|
| Rate for Payer: Humana Medicare Advantage |
$1,478.75
|
| Rate for Payer: Kentucky WC Medicaid |
$366.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$865.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$779.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,774.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$370.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$929.28
|
| Rate for Payer: Ohio Health Group HMO |
$792.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$844.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$728.64
|
| Rate for Payer: PHCS Commercial |
$1,013.76
|
| Rate for Payer: United Healthcare All Payer |
$929.28
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1,291.00
|
|
|
Service Code
|
HCPCS 27808
|
| Hospital Charge Code |
76100939
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$221.64 |
| Max. Negotiated Rate |
$1,239.36 |
| Rate for Payer: Aetna Commercial |
$994.07
|
| Rate for Payer: Anthem Medicaid |
$443.97
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$221.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,006.98
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$310.30
|
| Rate for Payer: CareSource Just4Me Medicare |
$299.21
|
| Rate for Payer: Cash Price |
$645.50
|
| Rate for Payer: Cash Price |
$645.50
|
| Rate for Payer: Cigna Commercial |
$1,071.53
|
| Rate for Payer: First Health Commercial |
$1,226.45
|
| Rate for Payer: Humana Commercial |
$1,097.35
|
| Rate for Payer: Humana KY Medicaid |
$443.97
|
| Rate for Payer: Humana Medicare Advantage |
$221.64
|
| Rate for Payer: Kentucky WC Medicaid |
$448.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,058.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$952.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$265.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$452.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,136.08
|
| Rate for Payer: Ohio Health Group HMO |
$968.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,032.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,123.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$890.79
|
| Rate for Payer: PHCS Commercial |
$1,239.36
|
| Rate for Payer: United Healthcare All Payer |
$1,136.08
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1,201.00
|
|
|
Service Code
|
HCPCS 28430
|
| Hospital Charge Code |
76101014
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$360.30 |
| Max. Negotiated Rate |
$1,152.96 |
| Rate for Payer: Aetna Commercial |
$924.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$936.78
|
| Rate for Payer: Cash Price |
$600.50
|
| Rate for Payer: Cigna Commercial |
$996.83
|
| Rate for Payer: First Health Commercial |
$1,140.95
|
| Rate for Payer: Humana Commercial |
$1,020.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$984.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$886.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$360.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,056.88
|
| Rate for Payer: Ohio Health Group HMO |
$900.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$960.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,044.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$828.69
|
| Rate for Payer: PHCS Commercial |
$1,152.96
|
| Rate for Payer: United Healthcare All Payer |
$1,056.88
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1,201.00
|
|
|
Service Code
|
HCPCS 28430
|
| Hospital Charge Code |
76101014
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$221.64 |
| Max. Negotiated Rate |
$1,152.96 |
| Rate for Payer: Aetna Commercial |
$924.77
|
| Rate for Payer: Anthem Medicaid |
$413.02
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$221.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$936.78
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$310.30
|
| Rate for Payer: CareSource Just4Me Medicare |
$299.21
|
| Rate for Payer: Cash Price |
$600.50
|
| Rate for Payer: Cash Price |
$600.50
|
| Rate for Payer: Cigna Commercial |
$996.83
|
| Rate for Payer: First Health Commercial |
$1,140.95
|
| Rate for Payer: Humana Commercial |
$1,020.85
|
| Rate for Payer: Humana KY Medicaid |
$413.02
|
| Rate for Payer: Humana Medicare Advantage |
$221.64
|
| Rate for Payer: Kentucky WC Medicaid |
$417.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$984.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$886.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$265.97
|
| Rate for Payer: Molina Healthcare Medicaid |
$421.31
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,056.88
|
| Rate for Payer: Ohio Health Group HMO |
$900.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$960.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,044.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$828.69
|
| Rate for Payer: PHCS Commercial |
$1,152.96
|
| Rate for Payer: United Healthcare All Payer |
$1,056.88
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1,056.00
|
|
|
Service Code
|
HCPCS 27810
|
| Hospital Charge Code |
76100940
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$316.80 |
| Max. Negotiated Rate |
$1,013.76 |
| Rate for Payer: Aetna Commercial |
$813.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$823.68
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cigna Commercial |
$876.48
|
| Rate for Payer: First Health Commercial |
$1,003.20
|
| Rate for Payer: Humana Commercial |
$897.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$865.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$779.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$316.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$929.28
|
| Rate for Payer: Ohio Health Group HMO |
$792.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$844.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$728.64
|
| Rate for Payer: PHCS Commercial |
$1,013.76
|
| Rate for Payer: United Healthcare All Payer |
$929.28
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$2,248.00
|
|
|
Service Code
|
HCPCS 27810
|
| Hospital Charge Code |
45000168
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$773.09 |
| Max. Negotiated Rate |
$2,158.08 |
| Rate for Payer: Aetna Commercial |
$1,730.96
|
| Rate for Payer: Anthem Medicaid |
$773.09
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,478.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,753.44
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,070.25
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,996.31
|
| Rate for Payer: Cash Price |
$1,124.00
|
| Rate for Payer: Cash Price |
$1,124.00
|
| Rate for Payer: Cigna Commercial |
$1,865.84
|
| Rate for Payer: First Health Commercial |
$2,135.60
|
| Rate for Payer: Humana Commercial |
$1,910.80
|
| Rate for Payer: Humana KY Medicaid |
$773.09
|
| Rate for Payer: Humana Medicare Advantage |
$1,478.75
|
| Rate for Payer: Kentucky WC Medicaid |
$780.96
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,843.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,659.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,774.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$788.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,978.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,686.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,798.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,955.76
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,551.12
|
| Rate for Payer: PHCS Commercial |
$2,158.08
|
| Rate for Payer: United Healthcare All Payer |
$1,978.24
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1,291.00
|
|
|
Service Code
|
HCPCS 27808
|
| Hospital Charge Code |
76100939
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$387.30 |
| Max. Negotiated Rate |
$1,239.36 |
| Rate for Payer: Aetna Commercial |
$994.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,006.98
|
| Rate for Payer: Cash Price |
$645.50
|
| Rate for Payer: Cigna Commercial |
$1,071.53
|
| Rate for Payer: First Health Commercial |
$1,226.45
|
| Rate for Payer: Humana Commercial |
$1,097.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,058.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$952.76
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$387.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,136.08
|
| Rate for Payer: Ohio Health Group HMO |
$968.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,032.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,123.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$890.79
|
| Rate for Payer: PHCS Commercial |
$1,239.36
|
| Rate for Payer: United Healthcare All Payer |
$1,136.08
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Professional
|
Both
|
$625.00
|
|
|
Service Code
|
HCPCS 27788
|
| Hospital Charge Code |
76102717
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$224.57 |
| Max. Negotiated Rate |
$660.64 |
| Rate for Payer: Aetna Commercial |
$546.95
|
| Rate for Payer: Ambetter Exchange |
$371.66
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$226.79
|
| Rate for Payer: Anthem Medicaid |
$224.57
|
| Rate for Payer: Buckeye Individual/Medicaid |
$371.66
|
| Rate for Payer: Buckeye Medicare Advantage |
$371.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$445.99
|
| Rate for Payer: Cash Price |
$312.50
|
| Rate for Payer: Cash Price |
$312.50
|
| Rate for Payer: Cigna Commercial |
$660.64
|
| Rate for Payer: Healthspan PPO |
$533.24
|
| Rate for Payer: Humana Medicaid |
$224.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$469.12
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$371.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$371.66
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$229.06
|
| Rate for Payer: Molina Healthcare Passport |
$224.57
|
| Rate for Payer: Multiplan PHCS |
$375.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$483.16
|
| Rate for Payer: UHCCP Medicaid |
$238.13
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$226.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$371.66
|
|
|
TREATMENT OF ANKLE FRACTURE(P
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 28430
|
| Hospital Charge Code |
761P1014
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.73 |
| Max. Negotiated Rate |
$355.57 |
| Rate for Payer: Aetna Commercial |
$281.01
|
| Rate for Payer: Ambetter Exchange |
$202.89
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$131.80
|
| Rate for Payer: Anthem Medicaid |
$131.73
|
| Rate for Payer: Buckeye Individual/Medicaid |
$202.89
|
| Rate for Payer: Buckeye Medicare Advantage |
$202.89
|
| Rate for Payer: CareSource Just4Me Medicare |
$243.47
|
| Rate for Payer: Cash Price |
$295.00
|
| Rate for Payer: Cash Price |
$295.00
|
| Rate for Payer: Cigna Commercial |
$355.57
|
| Rate for Payer: Healthspan PPO |
$283.14
|
| Rate for Payer: Humana Medicaid |
$131.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$247.24
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$202.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$202.89
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$134.36
|
| Rate for Payer: Molina Healthcare Passport |
$131.73
|
| Rate for Payer: Multiplan PHCS |
$354.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$263.76
|
| Rate for Payer: UHCCP Medicaid |
$138.39
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$133.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$202.89
|
|
|
TREATMENT OF ANKLE FRACTURE(P
|
Professional
|
Both
|
$1,056.00
|
|
|
Service Code
|
HCPCS 27810
|
| Hospital Charge Code |
761P0940
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$274.22 |
| Max. Negotiated Rate |
$677.82 |
| Rate for Payer: Aetna Commercial |
$612.25
|
| Rate for Payer: Ambetter Exchange |
$413.23
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$274.22
|
| Rate for Payer: Anthem Medicaid |
$296.33
|
| Rate for Payer: Buckeye Individual/Medicaid |
$413.23
|
| Rate for Payer: Buckeye Medicare Advantage |
$413.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$495.88
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cigna Commercial |
$677.82
|
| Rate for Payer: Healthspan PPO |
$597.70
|
| Rate for Payer: Humana Medicaid |
$296.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$524.34
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$413.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$413.23
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$302.26
|
| Rate for Payer: Molina Healthcare Passport |
$296.33
|
| Rate for Payer: Multiplan PHCS |
$633.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$537.20
|
| Rate for Payer: UHCCP Medicaid |
$287.93
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$299.29
|
| Rate for Payer: Wellcare Medicare Advantage |
$413.23
|
|
