|
VANGRD DISTFEM AUG67.5X10 LL/R
|
Facility
|
IP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DISTFEM AUG67.5X10 RL/L
|
Facility
|
OP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem Medicaid |
$2,949.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Humana KY Medicaid |
$2,949.71
|
| Rate for Payer: Kentucky WC Medicaid |
$2,979.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,008.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DISTFEM AUG67.5X10 RL/L
|
Facility
|
IP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG70X10 LL/RM
|
Facility
|
IP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG70X10 LL/RM
|
Facility
|
OP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem Medicaid |
$2,949.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Humana KY Medicaid |
$2,949.71
|
| Rate for Payer: Kentucky WC Medicaid |
$2,979.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,008.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG70X10 RL/LM
|
Facility
|
IP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG70X10 RL/LM
|
Facility
|
OP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem Medicaid |
$2,949.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Humana KY Medicaid |
$2,949.71
|
| Rate for Payer: Kentucky WC Medicaid |
$2,979.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,008.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG75X10 LL/RM
|
Facility
|
OP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem Medicaid |
$2,949.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Humana KY Medicaid |
$2,949.71
|
| Rate for Payer: Kentucky WC Medicaid |
$2,979.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,008.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG75X10 LL/RM
|
Facility
|
IP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG75X10 RL/LM
|
Facility
|
OP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem Medicaid |
$2,949.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Humana KY Medicaid |
$2,949.71
|
| Rate for Payer: Kentucky WC Medicaid |
$2,979.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,008.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG75X10 RL/LM
|
Facility
|
IP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG80X10 LL/RM
|
Facility
|
IP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG80X10 LL/RM
|
Facility
|
OP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem Medicaid |
$2,949.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Humana KY Medicaid |
$2,949.71
|
| Rate for Payer: Kentucky WC Medicaid |
$2,979.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,008.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG80X10 RL/LM
|
Facility
|
IP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD DIST FEM AUG80X10 RL/LM
|
Facility
|
OP
|
$8,577.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,115.04 |
| Max. Negotiated Rate |
$8,234.13 |
| Rate for Payer: Aetna Commercial |
$6,604.46
|
| Rate for Payer: Anthem Medicaid |
$2,949.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,690.23
|
| Rate for Payer: Cash Price |
$4,288.61
|
| Rate for Payer: Cigna Commercial |
$7,119.09
|
| Rate for Payer: First Health Commercial |
$8,148.36
|
| Rate for Payer: Humana Commercial |
$7,290.64
|
| Rate for Payer: Humana KY Medicaid |
$2,949.71
|
| Rate for Payer: Kentucky WC Medicaid |
$2,979.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,033.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,329.99
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,573.17
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,008.89
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,547.95
|
| Rate for Payer: Ohio Health Group HMO |
$6,432.92
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,715.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,115.04
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,658.94
|
| Rate for Payer: PHCS Commercial |
$8,234.13
|
| Rate for Payer: United Healthcare All Payer |
$7,547.95
|
|
|
VANGRD SSK PSCTIB BRG 22X63/67
|
Facility
|
OP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem Medicaid |
$5,268.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Humana KY Medicaid |
$5,268.44
|
| Rate for Payer: Kentucky WC Medicaid |
$5,322.06
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,374.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGRD SSK PSCTIB BRG 22X63/67
|
Facility
|
IP
|
$15,319.68
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,991.56 |
| Max. Negotiated Rate |
$14,706.89 |
| Rate for Payer: Aetna Commercial |
$11,796.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,949.35
|
| Rate for Payer: Cash Price |
$7,659.84
|
| Rate for Payer: Cigna Commercial |
$12,715.33
|
| Rate for Payer: First Health Commercial |
$14,553.70
|
| Rate for Payer: Humana Commercial |
$13,021.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,562.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,305.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,595.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,481.32
|
| Rate for Payer: Ohio Health Group HMO |
$11,489.76
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,063.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,991.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,749.10
|
| Rate for Payer: PHCS Commercial |
$14,706.89
|
| Rate for Payer: United Healthcare All Payer |
$13,481.32
|
|
|
VANGUARD AUGMENT BOLT
|
Facility
|
IP
|
$3,317.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$431.24 |
| Max. Negotiated Rate |
$3,184.51 |
| Rate for Payer: Aetna Commercial |
$2,554.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,587.42
|
| Rate for Payer: Cash Price |
$1,658.60
|
| Rate for Payer: Cigna Commercial |
$2,753.28
|
| Rate for Payer: First Health Commercial |
$3,151.34
|
| Rate for Payer: Humana Commercial |
$2,819.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,720.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,448.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$995.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,919.14
|
| Rate for Payer: Ohio Health Group HMO |
$2,487.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$663.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$431.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,028.33
|
| Rate for Payer: PHCS Commercial |
$3,184.51
|
| Rate for Payer: United Healthcare All Payer |
$2,919.14
|
|
|
VANGUARD AUGMENT BOLT
|
Facility
|
OP
|
$3,317.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$431.24 |
| Max. Negotiated Rate |
$3,184.51 |
| Rate for Payer: Aetna Commercial |
$2,554.24
|
| Rate for Payer: Anthem Medicaid |
$1,140.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,587.42
|
| Rate for Payer: Cash Price |
$1,658.60
|
| Rate for Payer: Cigna Commercial |
$2,753.28
|
| Rate for Payer: First Health Commercial |
$3,151.34
|
| Rate for Payer: Humana Commercial |
$2,819.62
|
| Rate for Payer: Humana KY Medicaid |
$1,140.79
|
| Rate for Payer: Kentucky WC Medicaid |
$1,152.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,720.10
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,448.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$995.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,163.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,919.14
|
| Rate for Payer: Ohio Health Group HMO |
$2,487.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$663.44
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$431.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,028.33
|
| Rate for Payer: PHCS Commercial |
$3,184.51
|
| Rate for Payer: United Healthcare All Payer |
$2,919.14
|
|
|
VANGUARD CR ILOK FEM 55MM L
|
Facility
|
IP
|
$15,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,950.00 |
| Max. Negotiated Rate |
$14,400.00 |
| Rate for Payer: Aetna Commercial |
$11,550.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,700.00
|
| Rate for Payer: Cash Price |
$7,500.00
|
| Rate for Payer: Cigna Commercial |
$12,450.00
|
| Rate for Payer: First Health Commercial |
$14,250.00
|
| Rate for Payer: Humana Commercial |
$12,750.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,300.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,070.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,500.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$11,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,650.00
|
| Rate for Payer: PHCS Commercial |
$14,400.00
|
| Rate for Payer: United Healthcare All Payer |
$13,200.00
|
|
|
VANGUARD CR ILOK FEM 55MM L
|
Facility
|
OP
|
$15,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,950.00 |
| Max. Negotiated Rate |
$14,400.00 |
| Rate for Payer: Aetna Commercial |
$11,550.00
|
| Rate for Payer: Anthem Medicaid |
$5,158.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,700.00
|
| Rate for Payer: Cash Price |
$7,500.00
|
| Rate for Payer: Cigna Commercial |
$12,450.00
|
| Rate for Payer: First Health Commercial |
$14,250.00
|
| Rate for Payer: Humana Commercial |
$12,750.00
|
| Rate for Payer: Humana KY Medicaid |
$5,158.50
|
| Rate for Payer: Kentucky WC Medicaid |
$5,211.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,300.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,070.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,500.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,262.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$11,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,650.00
|
| Rate for Payer: PHCS Commercial |
$14,400.00
|
| Rate for Payer: United Healthcare All Payer |
$13,200.00
|
|
|
VANGUARD CR ILOK FEM 55MM R
|
Facility
|
OP
|
$15,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,950.00 |
| Max. Negotiated Rate |
$14,400.00 |
| Rate for Payer: Aetna Commercial |
$11,550.00
|
| Rate for Payer: Anthem Medicaid |
$5,158.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,700.00
|
| Rate for Payer: Cash Price |
$7,500.00
|
| Rate for Payer: Cigna Commercial |
$12,450.00
|
| Rate for Payer: First Health Commercial |
$14,250.00
|
| Rate for Payer: Humana Commercial |
$12,750.00
|
| Rate for Payer: Humana KY Medicaid |
$5,158.50
|
| Rate for Payer: Kentucky WC Medicaid |
$5,211.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,300.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,070.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,500.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,262.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$11,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,650.00
|
| Rate for Payer: PHCS Commercial |
$14,400.00
|
| Rate for Payer: United Healthcare All Payer |
$13,200.00
|
|
|
VANGUARD CR ILOK FEM 55MM R
|
Facility
|
IP
|
$15,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,950.00 |
| Max. Negotiated Rate |
$14,400.00 |
| Rate for Payer: Aetna Commercial |
$11,550.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,700.00
|
| Rate for Payer: Cash Price |
$7,500.00
|
| Rate for Payer: Cigna Commercial |
$12,450.00
|
| Rate for Payer: First Health Commercial |
$14,250.00
|
| Rate for Payer: Humana Commercial |
$12,750.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,300.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,070.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,500.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$11,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,650.00
|
| Rate for Payer: PHCS Commercial |
$14,400.00
|
| Rate for Payer: United Healthcare All Payer |
$13,200.00
|
|
|
VANGUARD CR ILOK FEM 57.5MM L
|
Facility
|
IP
|
$15,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,950.00 |
| Max. Negotiated Rate |
$14,400.00 |
| Rate for Payer: Aetna Commercial |
$11,550.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,700.00
|
| Rate for Payer: Cash Price |
$7,500.00
|
| Rate for Payer: Cigna Commercial |
$12,450.00
|
| Rate for Payer: First Health Commercial |
$14,250.00
|
| Rate for Payer: Humana Commercial |
$12,750.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,300.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,070.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,500.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$11,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,650.00
|
| Rate for Payer: PHCS Commercial |
$14,400.00
|
| Rate for Payer: United Healthcare All Payer |
$13,200.00
|
|
|
VANGUARD CR ILOK FEM 57.5MM L
|
Facility
|
OP
|
$15,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,950.00 |
| Max. Negotiated Rate |
$14,400.00 |
| Rate for Payer: Aetna Commercial |
$11,550.00
|
| Rate for Payer: Anthem Medicaid |
$5,158.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,700.00
|
| Rate for Payer: Cash Price |
$7,500.00
|
| Rate for Payer: Cigna Commercial |
$12,450.00
|
| Rate for Payer: First Health Commercial |
$14,250.00
|
| Rate for Payer: Humana Commercial |
$12,750.00
|
| Rate for Payer: Humana KY Medicaid |
$5,158.50
|
| Rate for Payer: Kentucky WC Medicaid |
$5,211.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,300.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,070.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,500.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,262.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,200.00
|
| Rate for Payer: Ohio Health Group HMO |
$11,250.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,000.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,650.00
|
| Rate for Payer: PHCS Commercial |
$14,400.00
|
| Rate for Payer: United Healthcare All Payer |
$13,200.00
|
|
