|
TRIATHLON CR FEM COMP #6 LT
|
Facility
|
IP
|
$11,356.74
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,407.02 |
| Max. Negotiated Rate |
$10,902.47 |
| Rate for Payer: Aetna Commercial |
$8,744.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,858.26
|
| Rate for Payer: Cash Price |
$5,678.37
|
| Rate for Payer: Cigna Commercial |
$9,426.09
|
| Rate for Payer: First Health Commercial |
$10,788.90
|
| Rate for Payer: Humana Commercial |
$9,653.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,312.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,381.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,407.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,993.93
|
| Rate for Payer: Ohio Health Group HMO |
$8,517.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,085.39
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,880.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,836.15
|
| Rate for Payer: PHCS Commercial |
$10,902.47
|
| Rate for Payer: United Healthcare All Payer |
$9,993.93
|
|
|
TRIATHLON CR FEM COMP #6 RT
|
Facility
|
IP
|
$11,356.74
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,407.02 |
| Max. Negotiated Rate |
$10,902.47 |
| Rate for Payer: Aetna Commercial |
$8,744.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,858.26
|
| Rate for Payer: Cash Price |
$5,678.37
|
| Rate for Payer: Cigna Commercial |
$9,426.09
|
| Rate for Payer: First Health Commercial |
$10,788.90
|
| Rate for Payer: Humana Commercial |
$9,653.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,312.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,381.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,407.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,993.93
|
| Rate for Payer: Ohio Health Group HMO |
$8,517.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,085.39
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,880.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,836.15
|
| Rate for Payer: PHCS Commercial |
$10,902.47
|
| Rate for Payer: United Healthcare All Payer |
$9,993.93
|
|
|
TRIATHLON CR FEM COMP #6 RT
|
Facility
|
OP
|
$11,356.74
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,407.02 |
| Max. Negotiated Rate |
$10,902.47 |
| Rate for Payer: Aetna Commercial |
$8,744.69
|
| Rate for Payer: Anthem Medicaid |
$3,905.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,858.26
|
| Rate for Payer: Cash Price |
$5,678.37
|
| Rate for Payer: Cigna Commercial |
$9,426.09
|
| Rate for Payer: First Health Commercial |
$10,788.90
|
| Rate for Payer: Humana Commercial |
$9,653.23
|
| Rate for Payer: Humana KY Medicaid |
$3,905.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,945.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,312.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,381.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,407.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,983.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,993.93
|
| Rate for Payer: Ohio Health Group HMO |
$8,517.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,085.39
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,880.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,836.15
|
| Rate for Payer: PHCS Commercial |
$10,902.47
|
| Rate for Payer: United Healthcare All Payer |
$9,993.93
|
|
|
TRIATHLON CR FEM COMP #7 LT
|
Facility
|
IP
|
$13,409.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,022.70 |
| Max. Negotiated Rate |
$12,872.64 |
| Rate for Payer: Aetna Commercial |
$10,324.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,459.02
|
| Rate for Payer: Cash Price |
$6,704.50
|
| Rate for Payer: Cigna Commercial |
$11,129.47
|
| Rate for Payer: First Health Commercial |
$12,738.55
|
| Rate for Payer: Humana Commercial |
$11,397.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,995.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,895.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,022.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,799.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,056.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,727.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,665.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,252.21
|
| Rate for Payer: PHCS Commercial |
$12,872.64
|
| Rate for Payer: United Healthcare All Payer |
$11,799.92
|
|
|
TRIATHLON CR FEM COMP #7 LT
|
Facility
|
OP
|
$13,409.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,022.70 |
| Max. Negotiated Rate |
$12,872.64 |
| Rate for Payer: Aetna Commercial |
$10,324.93
|
| Rate for Payer: Anthem Medicaid |
$4,611.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,459.02
|
| Rate for Payer: Cash Price |
$6,704.50
|
| Rate for Payer: Cigna Commercial |
$11,129.47
|
| Rate for Payer: First Health Commercial |
$12,738.55
|
| Rate for Payer: Humana Commercial |
$11,397.65
|
| Rate for Payer: Humana KY Medicaid |
$4,611.36
|
| Rate for Payer: Kentucky WC Medicaid |
$4,658.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,995.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,895.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,022.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,703.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,799.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,056.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,727.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,665.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,252.21
|
| Rate for Payer: PHCS Commercial |
$12,872.64
|
| Rate for Payer: United Healthcare All Payer |
$11,799.92
|
|
|
TRIATHLON CR FEM COMP #7 RT
|
Facility
|
OP
|
$13,409.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,022.70 |
| Max. Negotiated Rate |
$12,872.64 |
| Rate for Payer: Aetna Commercial |
$10,324.93
|
| Rate for Payer: Anthem Medicaid |
$4,611.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,459.02
|
| Rate for Payer: Cash Price |
$6,704.50
|
| Rate for Payer: Cigna Commercial |
$11,129.47
|
| Rate for Payer: First Health Commercial |
$12,738.55
|
| Rate for Payer: Humana Commercial |
$11,397.65
|
| Rate for Payer: Humana KY Medicaid |
$4,611.36
|
| Rate for Payer: Kentucky WC Medicaid |
$4,658.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,995.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,895.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,022.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,703.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,799.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,056.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,727.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,665.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,252.21
|
| Rate for Payer: PHCS Commercial |
$12,872.64
|
| Rate for Payer: United Healthcare All Payer |
$11,799.92
|
|
|
TRIATHLON CR FEM COMP #7 RT
|
Facility
|
IP
|
$13,409.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,022.70 |
| Max. Negotiated Rate |
$12,872.64 |
| Rate for Payer: Aetna Commercial |
$10,324.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,459.02
|
| Rate for Payer: Cash Price |
$6,704.50
|
| Rate for Payer: Cigna Commercial |
$11,129.47
|
| Rate for Payer: First Health Commercial |
$12,738.55
|
| Rate for Payer: Humana Commercial |
$11,397.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,995.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,895.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,022.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,799.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,056.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,727.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,665.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,252.21
|
| Rate for Payer: PHCS Commercial |
$12,872.64
|
| Rate for Payer: United Healthcare All Payer |
$11,799.92
|
|
|
TRIATHLON CR FEM COMP #8 LT
|
Facility
|
OP
|
$13,409.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,022.70 |
| Max. Negotiated Rate |
$12,872.64 |
| Rate for Payer: Aetna Commercial |
$10,324.93
|
| Rate for Payer: Anthem Medicaid |
$4,611.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,459.02
|
| Rate for Payer: Cash Price |
$6,704.50
|
| Rate for Payer: Cigna Commercial |
$11,129.47
|
| Rate for Payer: First Health Commercial |
$12,738.55
|
| Rate for Payer: Humana Commercial |
$11,397.65
|
| Rate for Payer: Humana KY Medicaid |
$4,611.36
|
| Rate for Payer: Kentucky WC Medicaid |
$4,658.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,995.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,895.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,022.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$4,703.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,799.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,056.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,727.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,665.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,252.21
|
| Rate for Payer: PHCS Commercial |
$12,872.64
|
| Rate for Payer: United Healthcare All Payer |
$11,799.92
|
|
|
TRIATHLON CR FEM COMP #8 LT
|
Facility
|
IP
|
$13,409.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,022.70 |
| Max. Negotiated Rate |
$12,872.64 |
| Rate for Payer: Aetna Commercial |
$10,324.93
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$10,459.02
|
| Rate for Payer: Cash Price |
$6,704.50
|
| Rate for Payer: Cigna Commercial |
$11,129.47
|
| Rate for Payer: First Health Commercial |
$12,738.55
|
| Rate for Payer: Humana Commercial |
$11,397.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$10,995.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$9,895.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,022.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$11,799.92
|
| Rate for Payer: Ohio Health Group HMO |
$10,056.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10,727.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$11,665.83
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,252.21
|
| Rate for Payer: PHCS Commercial |
$12,872.64
|
| Rate for Payer: United Healthcare All Payer |
$11,799.92
|
|
|
TRIATHLON CR FEM COMP #8 RT
|
Facility
|
OP
|
$11,356.74
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,407.02 |
| Max. Negotiated Rate |
$10,902.47 |
| Rate for Payer: Aetna Commercial |
$8,744.69
|
| Rate for Payer: Anthem Medicaid |
$3,905.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,858.26
|
| Rate for Payer: Cash Price |
$5,678.37
|
| Rate for Payer: Cigna Commercial |
$9,426.09
|
| Rate for Payer: First Health Commercial |
$10,788.90
|
| Rate for Payer: Humana Commercial |
$9,653.23
|
| Rate for Payer: Humana KY Medicaid |
$3,905.58
|
| Rate for Payer: Kentucky WC Medicaid |
$3,945.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,312.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,381.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,407.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,983.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,993.93
|
| Rate for Payer: Ohio Health Group HMO |
$8,517.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,085.39
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,880.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,836.15
|
| Rate for Payer: PHCS Commercial |
$10,902.47
|
| Rate for Payer: United Healthcare All Payer |
$9,993.93
|
|
|
TRIATHLON CR FEM COMP #8 RT
|
Facility
|
IP
|
$11,356.74
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,407.02 |
| Max. Negotiated Rate |
$10,902.47 |
| Rate for Payer: Aetna Commercial |
$8,744.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,858.26
|
| Rate for Payer: Cash Price |
$5,678.37
|
| Rate for Payer: Cigna Commercial |
$9,426.09
|
| Rate for Payer: First Health Commercial |
$10,788.90
|
| Rate for Payer: Humana Commercial |
$9,653.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$9,312.53
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$8,381.27
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,407.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,993.93
|
| Rate for Payer: Ohio Health Group HMO |
$8,517.56
|
| Rate for Payer: Ohio Health Group PPO Differential |
$9,085.39
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$9,880.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,836.15
|
| Rate for Payer: PHCS Commercial |
$10,902.47
|
| Rate for Payer: United Healthcare All Payer |
$9,993.93
|
|
|
TRIATHLON CR FEM COMP BEAD 1L
|
Facility
|
OP
|
$18,127.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,438.10 |
| Max. Negotiated Rate |
$17,401.92 |
| Rate for Payer: Aetna Commercial |
$13,957.79
|
| Rate for Payer: Anthem Medicaid |
$6,233.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,139.06
|
| Rate for Payer: Cash Price |
$9,063.50
|
| Rate for Payer: Cigna Commercial |
$15,045.41
|
| Rate for Payer: First Health Commercial |
$17,220.65
|
| Rate for Payer: Humana Commercial |
$15,407.95
|
| Rate for Payer: Humana KY Medicaid |
$6,233.88
|
| Rate for Payer: Kentucky WC Medicaid |
$6,297.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,864.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,377.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,438.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,358.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,951.76
|
| Rate for Payer: Ohio Health Group HMO |
$13,595.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$14,501.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,770.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,507.63
|
| Rate for Payer: PHCS Commercial |
$17,401.92
|
| Rate for Payer: United Healthcare All Payer |
$15,951.76
|
|
|
TRIATHLON CR FEM COMP BEAD 1L
|
Facility
|
IP
|
$18,127.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,438.10 |
| Max. Negotiated Rate |
$17,401.92 |
| Rate for Payer: Aetna Commercial |
$13,957.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,139.06
|
| Rate for Payer: Cash Price |
$9,063.50
|
| Rate for Payer: Cigna Commercial |
$15,045.41
|
| Rate for Payer: First Health Commercial |
$17,220.65
|
| Rate for Payer: Humana Commercial |
$15,407.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,864.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,377.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,438.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,951.76
|
| Rate for Payer: Ohio Health Group HMO |
$13,595.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$14,501.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,770.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,507.63
|
| Rate for Payer: PHCS Commercial |
$17,401.92
|
| Rate for Payer: United Healthcare All Payer |
$15,951.76
|
|
|
TRIATHLON CR FEM COMP BEAD 1R
|
Facility
|
IP
|
$18,127.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,438.10 |
| Max. Negotiated Rate |
$17,401.92 |
| Rate for Payer: Aetna Commercial |
$13,957.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,139.06
|
| Rate for Payer: Cash Price |
$9,063.50
|
| Rate for Payer: Cigna Commercial |
$15,045.41
|
| Rate for Payer: First Health Commercial |
$17,220.65
|
| Rate for Payer: Humana Commercial |
$15,407.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,864.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,377.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,438.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,951.76
|
| Rate for Payer: Ohio Health Group HMO |
$13,595.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$14,501.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,770.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,507.63
|
| Rate for Payer: PHCS Commercial |
$17,401.92
|
| Rate for Payer: United Healthcare All Payer |
$15,951.76
|
|
|
TRIATHLON CR FEM COMP BEAD 1R
|
Facility
|
OP
|
$18,127.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,438.10 |
| Max. Negotiated Rate |
$17,401.92 |
| Rate for Payer: Aetna Commercial |
$13,957.79
|
| Rate for Payer: Anthem Medicaid |
$6,233.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$14,139.06
|
| Rate for Payer: Cash Price |
$9,063.50
|
| Rate for Payer: Cigna Commercial |
$15,045.41
|
| Rate for Payer: First Health Commercial |
$17,220.65
|
| Rate for Payer: Humana Commercial |
$15,407.95
|
| Rate for Payer: Humana KY Medicaid |
$6,233.88
|
| Rate for Payer: Kentucky WC Medicaid |
$6,297.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,864.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$13,377.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,438.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,358.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,951.76
|
| Rate for Payer: Ohio Health Group HMO |
$13,595.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$14,501.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,770.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,507.63
|
| Rate for Payer: PHCS Commercial |
$17,401.92
|
| Rate for Payer: United Healthcare All Payer |
$15,951.76
|
|
|
TRIATHLON CR FEM COMP BEAD 2L
|
Facility
|
OP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem Medicaid |
$4,918.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Humana KY Medicaid |
$4,918.81
|
| Rate for Payer: Kentucky WC Medicaid |
$4,968.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,017.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
|
TRIATHLON CR FEM COMP BEAD 2L
|
Facility
|
IP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
|
TRIATHLON CR FEM COMP BEAD 2R
|
Facility
|
IP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
|
TRIATHLON CR FEM COMP BEAD 2R
|
Facility
|
OP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem Medicaid |
$4,918.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Humana KY Medicaid |
$4,918.81
|
| Rate for Payer: Kentucky WC Medicaid |
$4,968.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,017.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
|
TRIATHLON CR FEM COMP BEAD 3L
|
Facility
|
OP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem Medicaid |
$4,918.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Humana KY Medicaid |
$4,918.81
|
| Rate for Payer: Kentucky WC Medicaid |
$4,968.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,017.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
|
TRIATHLON CR FEM COMP BEAD 3L
|
Facility
|
IP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
|
TRIATHLON CR FEM COMP BEAD 3R
|
Facility
|
OP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem Medicaid |
$4,918.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Humana KY Medicaid |
$4,918.81
|
| Rate for Payer: Kentucky WC Medicaid |
$4,968.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,017.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
|
TRIATHLON CR FEM COMP BEAD 3R
|
Facility
|
IP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
|
TRIATHLON CR FEM COMP BEAD 4L
|
Facility
|
IP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
|
TRIATHLON CR FEM COMP BEAD 4L
|
Facility
|
OP
|
$14,303.01
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,290.90 |
| Max. Negotiated Rate |
$13,730.89 |
| Rate for Payer: Aetna Commercial |
$11,013.32
|
| Rate for Payer: Anthem Medicaid |
$4,918.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,156.35
|
| Rate for Payer: Cash Price |
$7,151.51
|
| Rate for Payer: Cigna Commercial |
$11,871.50
|
| Rate for Payer: First Health Commercial |
$13,587.86
|
| Rate for Payer: Humana Commercial |
$12,157.56
|
| Rate for Payer: Humana KY Medicaid |
$4,918.81
|
| Rate for Payer: Kentucky WC Medicaid |
$4,968.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$11,728.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$10,555.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,290.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,017.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$12,586.65
|
| Rate for Payer: Ohio Health Group HMO |
$10,727.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$11,442.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$12,443.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,869.08
|
| Rate for Payer: PHCS Commercial |
$13,730.89
|
| Rate for Payer: United Healthcare All Payer |
$12,586.65
|
|
