|
UNI EIUS TIB XSMALL 8MM RM/LL
|
Facility
|
IP
|
$8,015.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.97 |
| Max. Negotiated Rate |
$7,694.52 |
| Rate for Payer: Aetna Commercial |
$6,171.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,251.79
|
| Rate for Payer: Cash Price |
$4,007.56
|
| Rate for Payer: Cigna Commercial |
$6,652.55
|
| Rate for Payer: First Health Commercial |
$7,614.36
|
| Rate for Payer: Humana Commercial |
$6,812.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,572.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,915.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,404.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,053.31
|
| Rate for Payer: Ohio Health Group HMO |
$6,011.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,603.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,041.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,484.69
|
| Rate for Payer: PHCS Commercial |
$7,694.52
|
| Rate for Payer: United Healthcare All Payer |
$7,053.31
|
|
|
UNI EIUS TIB XSMALL 9MM LM/RL
|
Facility
|
OP
|
$8,015.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.97 |
| Max. Negotiated Rate |
$7,694.52 |
| Rate for Payer: Aetna Commercial |
$6,171.64
|
| Rate for Payer: Anthem Medicaid |
$2,756.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,251.79
|
| Rate for Payer: Cash Price |
$4,007.56
|
| Rate for Payer: Cigna Commercial |
$6,652.55
|
| Rate for Payer: First Health Commercial |
$7,614.36
|
| Rate for Payer: Humana Commercial |
$6,812.85
|
| Rate for Payer: Humana KY Medicaid |
$2,756.40
|
| Rate for Payer: Kentucky WC Medicaid |
$2,784.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,572.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,915.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,404.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,811.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,053.31
|
| Rate for Payer: Ohio Health Group HMO |
$6,011.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,603.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,041.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,484.69
|
| Rate for Payer: PHCS Commercial |
$7,694.52
|
| Rate for Payer: United Healthcare All Payer |
$7,053.31
|
|
|
UNI EIUS TIB XSMALL 9MM LM/RL
|
Facility
|
IP
|
$8,015.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.97 |
| Max. Negotiated Rate |
$7,694.52 |
| Rate for Payer: Aetna Commercial |
$6,171.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,251.79
|
| Rate for Payer: Cash Price |
$4,007.56
|
| Rate for Payer: Cigna Commercial |
$6,652.55
|
| Rate for Payer: First Health Commercial |
$7,614.36
|
| Rate for Payer: Humana Commercial |
$6,812.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,572.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,915.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,404.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,053.31
|
| Rate for Payer: Ohio Health Group HMO |
$6,011.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,603.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,041.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,484.69
|
| Rate for Payer: PHCS Commercial |
$7,694.52
|
| Rate for Payer: United Healthcare All Payer |
$7,053.31
|
|
|
UNI EIUS TIB XSMALL 9MM RM/LL
|
Facility
|
IP
|
$8,015.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.97 |
| Max. Negotiated Rate |
$7,694.52 |
| Rate for Payer: Aetna Commercial |
$6,171.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,251.79
|
| Rate for Payer: Cash Price |
$4,007.56
|
| Rate for Payer: Cigna Commercial |
$6,652.55
|
| Rate for Payer: First Health Commercial |
$7,614.36
|
| Rate for Payer: Humana Commercial |
$6,812.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,572.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,915.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,404.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,053.31
|
| Rate for Payer: Ohio Health Group HMO |
$6,011.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,603.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,041.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,484.69
|
| Rate for Payer: PHCS Commercial |
$7,694.52
|
| Rate for Payer: United Healthcare All Payer |
$7,053.31
|
|
|
UNI EIUS TIB XSMALL 9MM RM/LL
|
Facility
|
OP
|
$8,015.12
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.97 |
| Max. Negotiated Rate |
$7,694.52 |
| Rate for Payer: Aetna Commercial |
$6,171.64
|
| Rate for Payer: Anthem Medicaid |
$2,756.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,251.79
|
| Rate for Payer: Cash Price |
$4,007.56
|
| Rate for Payer: Cigna Commercial |
$6,652.55
|
| Rate for Payer: First Health Commercial |
$7,614.36
|
| Rate for Payer: Humana Commercial |
$6,812.85
|
| Rate for Payer: Humana KY Medicaid |
$2,756.40
|
| Rate for Payer: Kentucky WC Medicaid |
$2,784.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,572.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,915.16
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,404.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,811.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,053.31
|
| Rate for Payer: Ohio Health Group HMO |
$6,011.34
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,603.02
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,041.97
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,484.69
|
| Rate for Payer: PHCS Commercial |
$7,694.52
|
| Rate for Payer: United Healthcare All Payer |
$7,053.31
|
|
|
UNI-FUSE CATH 4FR 135CM*2CM
|
Facility
|
OP
|
$3,176.50
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$412.94 |
| Max. Negotiated Rate |
$3,049.44 |
| Rate for Payer: Aetna Commercial |
$2,445.90
|
| Rate for Payer: Anthem Medicaid |
$1,092.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,477.67
|
| Rate for Payer: Cash Price |
$1,588.25
|
| Rate for Payer: Cigna Commercial |
$2,636.50
|
| Rate for Payer: First Health Commercial |
$3,017.68
|
| Rate for Payer: Humana Commercial |
$2,700.02
|
| Rate for Payer: Humana KY Medicaid |
$1,092.40
|
| Rate for Payer: Kentucky WC Medicaid |
$1,103.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,604.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,344.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$952.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,114.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,795.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,382.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$635.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$412.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$984.72
|
| Rate for Payer: PHCS Commercial |
$3,049.44
|
| Rate for Payer: United Healthcare All Payer |
$2,795.32
|
|
|
UNI-FUSE CATH 4FR 135CM*2CM
|
Facility
|
IP
|
$3,176.50
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$412.94 |
| Max. Negotiated Rate |
$3,049.44 |
| Rate for Payer: Aetna Commercial |
$2,445.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,477.67
|
| Rate for Payer: Cash Price |
$1,588.25
|
| Rate for Payer: Cigna Commercial |
$2,636.50
|
| Rate for Payer: First Health Commercial |
$3,017.68
|
| Rate for Payer: Humana Commercial |
$2,700.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,604.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,344.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$952.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,795.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,382.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$635.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$412.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$984.72
|
| Rate for Payer: PHCS Commercial |
$3,049.44
|
| Rate for Payer: United Healthcare All Payer |
$2,795.32
|
|
|
UNI-FUSE CATH 4FR 135CM*5CM
|
Facility
|
OP
|
$1,910.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$248.30 |
| Max. Negotiated Rate |
$1,833.60 |
| Rate for Payer: Aetna Commercial |
$1,470.70
|
| Rate for Payer: Anthem Medicaid |
$656.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,489.80
|
| Rate for Payer: Cash Price |
$955.00
|
| Rate for Payer: Cigna Commercial |
$1,585.30
|
| Rate for Payer: First Health Commercial |
$1,814.50
|
| Rate for Payer: Humana Commercial |
$1,623.50
|
| Rate for Payer: Humana KY Medicaid |
$656.85
|
| Rate for Payer: Kentucky WC Medicaid |
$663.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,566.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,409.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$573.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$670.03
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,680.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,432.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$382.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$248.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$592.10
|
| Rate for Payer: PHCS Commercial |
$1,833.60
|
| Rate for Payer: United Healthcare All Payer |
$1,680.80
|
|
|
UNI-FUSE CATH 4FR 135CM*5CM
|
Facility
|
IP
|
$1,910.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$248.30 |
| Max. Negotiated Rate |
$1,833.60 |
| Rate for Payer: Aetna Commercial |
$1,470.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,489.80
|
| Rate for Payer: Cash Price |
$955.00
|
| Rate for Payer: Cigna Commercial |
$1,585.30
|
| Rate for Payer: First Health Commercial |
$1,814.50
|
| Rate for Payer: Humana Commercial |
$1,623.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,566.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,409.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$573.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,680.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,432.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$382.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$248.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$592.10
|
| Rate for Payer: PHCS Commercial |
$1,833.60
|
| Rate for Payer: United Healthcare All Payer |
$1,680.80
|
|
|
UNI-FUSE CATH 4FR 45CM*2CM
|
Facility
|
OP
|
$3,274.50
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$425.68 |
| Max. Negotiated Rate |
$3,143.52 |
| Rate for Payer: Aetna Commercial |
$2,521.36
|
| Rate for Payer: Anthem Medicaid |
$1,126.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,554.11
|
| Rate for Payer: Cash Price |
$1,637.25
|
| Rate for Payer: Cigna Commercial |
$2,717.84
|
| Rate for Payer: First Health Commercial |
$3,110.78
|
| Rate for Payer: Humana Commercial |
$2,783.32
|
| Rate for Payer: Humana KY Medicaid |
$1,126.10
|
| Rate for Payer: Kentucky WC Medicaid |
$1,137.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,685.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,416.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$982.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,148.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,881.56
|
| Rate for Payer: Ohio Health Group HMO |
$2,455.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$654.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$425.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,015.10
|
| Rate for Payer: PHCS Commercial |
$3,143.52
|
| Rate for Payer: United Healthcare All Payer |
$2,881.56
|
|
|
UNI-FUSE CATH 4FR 45CM*2CM
|
Facility
|
IP
|
$3,274.50
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$425.68 |
| Max. Negotiated Rate |
$3,143.52 |
| Rate for Payer: Aetna Commercial |
$2,521.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,554.11
|
| Rate for Payer: Cash Price |
$1,637.25
|
| Rate for Payer: Cigna Commercial |
$2,717.84
|
| Rate for Payer: First Health Commercial |
$3,110.78
|
| Rate for Payer: Humana Commercial |
$2,783.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,685.09
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,416.58
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$982.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,881.56
|
| Rate for Payer: Ohio Health Group HMO |
$2,455.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$654.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$425.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,015.10
|
| Rate for Payer: PHCS Commercial |
$3,143.52
|
| Rate for Payer: United Healthcare All Payer |
$2,881.56
|
|
|
UNI-FUSE CATH 4FR 45CM*5CM
|
Facility
|
IP
|
$3,176.50
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$412.94 |
| Max. Negotiated Rate |
$3,049.44 |
| Rate for Payer: Aetna Commercial |
$2,445.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,477.67
|
| Rate for Payer: Cash Price |
$1,588.25
|
| Rate for Payer: Cigna Commercial |
$2,636.50
|
| Rate for Payer: First Health Commercial |
$3,017.68
|
| Rate for Payer: Humana Commercial |
$2,700.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,604.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,344.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$952.95
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,795.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,382.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$635.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$412.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$984.72
|
| Rate for Payer: PHCS Commercial |
$3,049.44
|
| Rate for Payer: United Healthcare All Payer |
$2,795.32
|
|
|
UNI-FUSE CATH 4FR 45CM*5CM
|
Facility
|
OP
|
$3,176.50
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$412.94 |
| Max. Negotiated Rate |
$3,049.44 |
| Rate for Payer: Aetna Commercial |
$2,445.90
|
| Rate for Payer: Anthem Medicaid |
$1,092.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,477.67
|
| Rate for Payer: Cash Price |
$1,588.25
|
| Rate for Payer: Cigna Commercial |
$2,636.50
|
| Rate for Payer: First Health Commercial |
$3,017.68
|
| Rate for Payer: Humana Commercial |
$2,700.02
|
| Rate for Payer: Humana KY Medicaid |
$1,092.40
|
| Rate for Payer: Kentucky WC Medicaid |
$1,103.52
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,604.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,344.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$952.95
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,114.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,795.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,382.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$635.30
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$412.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$984.72
|
| Rate for Payer: PHCS Commercial |
$3,049.44
|
| Rate for Payer: United Healthcare All Payer |
$2,795.32
|
|
|
UNI-FUSE CATH 5FR*135CM*10CM
|
Facility
|
IP
|
$1,811.44
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$235.49 |
| Max. Negotiated Rate |
$1,738.98 |
| Rate for Payer: Aetna Commercial |
$1,394.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,412.92
|
| Rate for Payer: Cash Price |
$905.72
|
| Rate for Payer: Cigna Commercial |
$1,503.50
|
| Rate for Payer: First Health Commercial |
$1,720.87
|
| Rate for Payer: Humana Commercial |
$1,539.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,485.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,336.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$543.43
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,594.07
|
| Rate for Payer: Ohio Health Group HMO |
$1,358.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$362.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$561.55
|
| Rate for Payer: PHCS Commercial |
$1,738.98
|
| Rate for Payer: United Healthcare All Payer |
$1,594.07
|
|
|
UNI-FUSE CATH 5FR*135CM*10CM
|
Facility
|
OP
|
$1,811.44
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$235.49 |
| Max. Negotiated Rate |
$1,738.98 |
| Rate for Payer: Aetna Commercial |
$1,394.81
|
| Rate for Payer: Anthem Medicaid |
$622.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,412.92
|
| Rate for Payer: Cash Price |
$905.72
|
| Rate for Payer: Cigna Commercial |
$1,503.50
|
| Rate for Payer: First Health Commercial |
$1,720.87
|
| Rate for Payer: Humana Commercial |
$1,539.72
|
| Rate for Payer: Humana KY Medicaid |
$622.95
|
| Rate for Payer: Kentucky WC Medicaid |
$629.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,485.38
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,336.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$543.43
|
| Rate for Payer: Molina Healthcare Medicaid |
$635.45
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,594.07
|
| Rate for Payer: Ohio Health Group HMO |
$1,358.58
|
| Rate for Payer: Ohio Health Group PPO Differential |
$362.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$235.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$561.55
|
| Rate for Payer: PHCS Commercial |
$1,738.98
|
| Rate for Payer: United Healthcare All Payer |
$1,594.07
|
|
|
UNI-FUSE CATH 5FR*135CM*20CM
|
Facility
|
IP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
|
UNI-FUSE CATH 5FR*135CM*20CM
|
Facility
|
OP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem Medicaid |
$618.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Humana KY Medicaid |
$618.33
|
| Rate for Payer: Kentucky WC Medicaid |
$624.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
|
UNI-FUSE CATH 5FR*135CM*30CM
|
Facility
|
IP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
|
UNI-FUSE CATH 5FR*135CM*30CM
|
Facility
|
OP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem Medicaid |
$618.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Humana KY Medicaid |
$618.33
|
| Rate for Payer: Kentucky WC Medicaid |
$624.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
|
UNI-FUSE CATH 5FR*40CM*20CM
|
Facility
|
IP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
|
UNI-FUSE CATH 5FR*40CM*20CM
|
Facility
|
OP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem Medicaid |
$618.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Humana KY Medicaid |
$618.33
|
| Rate for Payer: Kentucky WC Medicaid |
$624.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
|
UNI-FUSE CATH 5FR*45CM*10CM
|
Facility
|
IP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
|
UNI-FUSE CATH 5FR*45CM*10CM
|
Facility
|
OP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem Medicaid |
$618.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Humana KY Medicaid |
$618.33
|
| Rate for Payer: Kentucky WC Medicaid |
$624.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
|
UNI-FUSE CATH 5FR*45CM*20CM
|
Facility
|
OP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem Medicaid |
$618.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Humana KY Medicaid |
$618.33
|
| Rate for Payer: Kentucky WC Medicaid |
$624.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$630.74
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
|
UNI-FUSE CATH 5FR*45CM*20CM
|
Facility
|
IP
|
$1,798.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$1,726.08 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,402.44
|
| Rate for Payer: Cash Price |
$899.00
|
| Rate for Payer: Cigna Commercial |
$1,492.34
|
| Rate for Payer: First Health Commercial |
$1,708.10
|
| Rate for Payer: Humana Commercial |
$1,528.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,474.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,326.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$539.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,582.24
|
| Rate for Payer: Ohio Health Group HMO |
$1,348.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$359.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$233.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$557.38
|
| Rate for Payer: PHCS Commercial |
$1,726.08
|
| Rate for Payer: United Healthcare All Payer |
$1,582.24
|
|
