|
UNI-FUSE CATH 4FR 45CM*2CM
|
Facility
|
IP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 4FR 45CM*5CM
|
Facility
|
IP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 4FR 45CM*5CM
|
Facility
|
OP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem Medicaid |
$1,115.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Humana KY Medicaid |
$1,115.96
|
| Rate for Payer: Kentucky WC Medicaid |
$1,127.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,138.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*135CM*10CM
|
Facility
|
OP
|
$1,800.99
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$540.30 |
| Max. Negotiated Rate |
$1,728.95 |
| Rate for Payer: Aetna Commercial |
$1,386.76
|
| Rate for Payer: Anthem Medicaid |
$619.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,404.77
|
| Rate for Payer: Cash Price |
$900.50
|
| Rate for Payer: Cigna Commercial |
$1,494.82
|
| Rate for Payer: First Health Commercial |
$1,710.94
|
| Rate for Payer: Humana Commercial |
$1,530.84
|
| Rate for Payer: Humana KY Medicaid |
$619.36
|
| Rate for Payer: Kentucky WC Medicaid |
$625.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,476.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,329.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$540.30
|
| Rate for Payer: Molina Healthcare Medicaid |
$631.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,584.87
|
| Rate for Payer: Ohio Health Group HMO |
$1,350.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,440.79
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,566.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,242.68
|
| Rate for Payer: PHCS Commercial |
$1,728.95
|
| Rate for Payer: United Healthcare All Payer |
$1,584.87
|
|
|
UNI-FUSE CATH 5FR*135CM*10CM
|
Facility
|
IP
|
$1,800.99
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$540.30 |
| Max. Negotiated Rate |
$1,728.95 |
| Rate for Payer: Aetna Commercial |
$1,386.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,404.77
|
| Rate for Payer: Cash Price |
$900.50
|
| Rate for Payer: Cigna Commercial |
$1,494.82
|
| Rate for Payer: First Health Commercial |
$1,710.94
|
| Rate for Payer: Humana Commercial |
$1,530.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,476.81
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,329.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$540.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,584.87
|
| Rate for Payer: Ohio Health Group HMO |
$1,350.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,440.79
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,566.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,242.68
|
| Rate for Payer: PHCS Commercial |
$1,728.95
|
| Rate for Payer: United Healthcare All Payer |
$1,584.87
|
|
|
UNI-FUSE CATH 5FR*135CM*20CM
|
Facility
|
IP
|
$1,786.40
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$535.92 |
| Max. Negotiated Rate |
$1,714.94 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,393.39
|
| Rate for Payer: Cash Price |
$893.20
|
| Rate for Payer: Cigna Commercial |
$1,482.71
|
| Rate for Payer: First Health Commercial |
$1,697.08
|
| Rate for Payer: Humana Commercial |
$1,518.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,464.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,318.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$535.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,572.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,339.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,429.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,554.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,232.62
|
| Rate for Payer: PHCS Commercial |
$1,714.94
|
| Rate for Payer: United Healthcare All Payer |
$1,572.03
|
|
|
UNI-FUSE CATH 5FR*135CM*20CM
|
Facility
|
OP
|
$1,786.40
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$535.92 |
| Max. Negotiated Rate |
$1,714.94 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Anthem Medicaid |
$614.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,393.39
|
| Rate for Payer: Cash Price |
$893.20
|
| Rate for Payer: Cigna Commercial |
$1,482.71
|
| Rate for Payer: First Health Commercial |
$1,697.08
|
| Rate for Payer: Humana Commercial |
$1,518.44
|
| Rate for Payer: Humana KY Medicaid |
$614.34
|
| Rate for Payer: Kentucky WC Medicaid |
$620.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,464.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,318.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$535.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$626.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,572.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,339.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,429.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,554.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,232.62
|
| Rate for Payer: PHCS Commercial |
$1,714.94
|
| Rate for Payer: United Healthcare All Payer |
$1,572.03
|
|
|
UNI-FUSE CATH 5FR*135CM*30CM
|
Facility
|
OP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem Medicaid |
$1,115.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Humana KY Medicaid |
$1,115.96
|
| Rate for Payer: Kentucky WC Medicaid |
$1,127.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,138.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*135CM*30CM
|
Facility
|
IP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*135CM*40CM
|
Facility
|
OP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem Medicaid |
$1,115.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Humana KY Medicaid |
$1,115.96
|
| Rate for Payer: Kentucky WC Medicaid |
$1,127.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,138.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*135CM*40CM
|
Facility
|
IP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*135CM*50CM
|
Facility
|
OP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem Medicaid |
$1,115.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Humana KY Medicaid |
$1,115.96
|
| Rate for Payer: Kentucky WC Medicaid |
$1,127.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,138.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*135CM*50CM
|
Facility
|
IP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*40CM*20CM
|
Facility
|
IP
|
$1,786.40
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$535.92 |
| Max. Negotiated Rate |
$1,714.94 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,393.39
|
| Rate for Payer: Cash Price |
$893.20
|
| Rate for Payer: Cigna Commercial |
$1,482.71
|
| Rate for Payer: First Health Commercial |
$1,697.08
|
| Rate for Payer: Humana Commercial |
$1,518.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,464.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,318.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$535.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,572.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,339.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,429.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,554.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,232.62
|
| Rate for Payer: PHCS Commercial |
$1,714.94
|
| Rate for Payer: United Healthcare All Payer |
$1,572.03
|
|
|
UNI-FUSE CATH 5FR*40CM*20CM
|
Facility
|
OP
|
$1,786.40
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$535.92 |
| Max. Negotiated Rate |
$1,714.94 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Anthem Medicaid |
$614.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,393.39
|
| Rate for Payer: Cash Price |
$893.20
|
| Rate for Payer: Cigna Commercial |
$1,482.71
|
| Rate for Payer: First Health Commercial |
$1,697.08
|
| Rate for Payer: Humana Commercial |
$1,518.44
|
| Rate for Payer: Humana KY Medicaid |
$614.34
|
| Rate for Payer: Kentucky WC Medicaid |
$620.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,464.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,318.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$535.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$626.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,572.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,339.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,429.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,554.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,232.62
|
| Rate for Payer: PHCS Commercial |
$1,714.94
|
| Rate for Payer: United Healthcare All Payer |
$1,572.03
|
|
|
UNI-FUSE CATH 5FR*45CM*10CM
|
Facility
|
IP
|
$1,786.40
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$535.92 |
| Max. Negotiated Rate |
$1,714.94 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,393.39
|
| Rate for Payer: Cash Price |
$893.20
|
| Rate for Payer: Cigna Commercial |
$1,482.71
|
| Rate for Payer: First Health Commercial |
$1,697.08
|
| Rate for Payer: Humana Commercial |
$1,518.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,464.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,318.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$535.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,572.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,339.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,429.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,554.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,232.62
|
| Rate for Payer: PHCS Commercial |
$1,714.94
|
| Rate for Payer: United Healthcare All Payer |
$1,572.03
|
|
|
UNI-FUSE CATH 5FR*45CM*10CM
|
Facility
|
OP
|
$1,786.40
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$535.92 |
| Max. Negotiated Rate |
$1,714.94 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Anthem Medicaid |
$614.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,393.39
|
| Rate for Payer: Cash Price |
$893.20
|
| Rate for Payer: Cigna Commercial |
$1,482.71
|
| Rate for Payer: First Health Commercial |
$1,697.08
|
| Rate for Payer: Humana Commercial |
$1,518.44
|
| Rate for Payer: Humana KY Medicaid |
$614.34
|
| Rate for Payer: Kentucky WC Medicaid |
$620.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,464.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,318.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$535.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$626.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,572.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,339.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,429.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,554.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,232.62
|
| Rate for Payer: PHCS Commercial |
$1,714.94
|
| Rate for Payer: United Healthcare All Payer |
$1,572.03
|
|
|
UNI-FUSE CATH 5FR*45CM*20CM
|
Facility
|
OP
|
$1,786.40
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$535.92 |
| Max. Negotiated Rate |
$1,714.94 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Anthem Medicaid |
$614.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,393.39
|
| Rate for Payer: Cash Price |
$893.20
|
| Rate for Payer: Cigna Commercial |
$1,482.71
|
| Rate for Payer: First Health Commercial |
$1,697.08
|
| Rate for Payer: Humana Commercial |
$1,518.44
|
| Rate for Payer: Humana KY Medicaid |
$614.34
|
| Rate for Payer: Kentucky WC Medicaid |
$620.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,464.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,318.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$535.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$626.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,572.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,339.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,429.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,554.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,232.62
|
| Rate for Payer: PHCS Commercial |
$1,714.94
|
| Rate for Payer: United Healthcare All Payer |
$1,572.03
|
|
|
UNI-FUSE CATH 5FR*45CM*20CM
|
Facility
|
IP
|
$1,786.40
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$535.92 |
| Max. Negotiated Rate |
$1,714.94 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,393.39
|
| Rate for Payer: Cash Price |
$893.20
|
| Rate for Payer: Cigna Commercial |
$1,482.71
|
| Rate for Payer: First Health Commercial |
$1,697.08
|
| Rate for Payer: Humana Commercial |
$1,518.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,464.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,318.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$535.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,572.03
|
| Rate for Payer: Ohio Health Group HMO |
$1,339.80
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,429.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,554.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,232.62
|
| Rate for Payer: PHCS Commercial |
$1,714.94
|
| Rate for Payer: United Healthcare All Payer |
$1,572.03
|
|
|
UNI-FUSE CATH 5FR*90CM*10CM
|
Facility
|
OP
|
$3,556.25
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,066.88 |
| Max. Negotiated Rate |
$3,414.00 |
| Rate for Payer: Aetna Commercial |
$2,738.31
|
| Rate for Payer: Anthem Medicaid |
$1,222.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,773.88
|
| Rate for Payer: Cash Price |
$1,778.12
|
| Rate for Payer: Cigna Commercial |
$2,951.69
|
| Rate for Payer: First Health Commercial |
$3,378.44
|
| Rate for Payer: Humana Commercial |
$3,022.81
|
| Rate for Payer: Humana KY Medicaid |
$1,222.99
|
| Rate for Payer: Kentucky WC Medicaid |
$1,235.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,916.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,624.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,066.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,247.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,129.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,667.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,845.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,093.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,453.81
|
| Rate for Payer: PHCS Commercial |
$3,414.00
|
| Rate for Payer: United Healthcare All Payer |
$3,129.50
|
|
|
UNI-FUSE CATH 5FR*90CM*10CM
|
Facility
|
IP
|
$3,556.25
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,066.88 |
| Max. Negotiated Rate |
$3,414.00 |
| Rate for Payer: Aetna Commercial |
$2,738.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,773.88
|
| Rate for Payer: Cash Price |
$1,778.12
|
| Rate for Payer: Cigna Commercial |
$2,951.69
|
| Rate for Payer: First Health Commercial |
$3,378.44
|
| Rate for Payer: Humana Commercial |
$3,022.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,916.12
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,624.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,066.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,129.50
|
| Rate for Payer: Ohio Health Group HMO |
$2,667.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,845.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,093.94
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,453.81
|
| Rate for Payer: PHCS Commercial |
$3,414.00
|
| Rate for Payer: United Healthcare All Payer |
$3,129.50
|
|
|
UNI-FUSE CATH 5FR*90CM*20CM
|
Facility
|
OP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem Medicaid |
$1,115.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Humana KY Medicaid |
$1,115.96
|
| Rate for Payer: Kentucky WC Medicaid |
$1,127.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,138.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*90CM*20CM
|
Facility
|
IP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*90CM*30CM
|
Facility
|
IP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
|
UNI-FUSE CATH 5FR*90CM*30CM
|
Facility
|
OP
|
$3,245.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.50 |
| Max. Negotiated Rate |
$3,115.20 |
| Rate for Payer: Aetna Commercial |
$2,498.65
|
| Rate for Payer: Anthem Medicaid |
$1,115.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,531.10
|
| Rate for Payer: Cash Price |
$1,622.50
|
| Rate for Payer: Cigna Commercial |
$2,693.35
|
| Rate for Payer: First Health Commercial |
$3,082.75
|
| Rate for Payer: Humana Commercial |
$2,758.25
|
| Rate for Payer: Humana KY Medicaid |
$1,115.96
|
| Rate for Payer: Kentucky WC Medicaid |
$1,127.31
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,660.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,394.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$973.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,138.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,855.60
|
| Rate for Payer: Ohio Health Group HMO |
$2,433.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,596.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,823.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,239.05
|
| Rate for Payer: PHCS Commercial |
$3,115.20
|
| Rate for Payer: United Healthcare All Payer |
$2,855.60
|
|
