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Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem Medicaid $3,071.71
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Humana KY Medicaid $3,071.71
Rate for Payer: Kentucky WC Medicaid $3,102.98
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Molina Healthcare Medicaid $3,133.35
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem Medicaid $3,071.71
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Humana KY Medicaid $3,071.71
Rate for Payer: Kentucky WC Medicaid $3,102.98
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Molina Healthcare Medicaid $3,133.35
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $1,161.16
Max. Negotiated Rate $8,574.72
Rate for Payer: Aetna Commercial $6,877.64
Rate for Payer: Anthem POS/PPO/Traditional $6,966.96
Rate for Payer: Cash Price $4,466.00
Rate for Payer: Cigna Commercial $7,413.56
Rate for Payer: First Health Commercial $8,485.40
Rate for Payer: Humana Commercial $7,592.20
Rate for Payer: Medical Mutual Of Ohio HMO $7,324.24
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,591.82
Rate for Payer: Molina Healthcare Benefit Exchange $2,679.60
Rate for Payer: Ohio Health Choice Commercial $7,860.16
Rate for Payer: Ohio Health Group HMO $6,699.00
Rate for Payer: Ohio Health Group PPO Differential $1,786.40
Rate for Payer: Ohio Health Group PPO No Differential $1,161.16
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,768.92
Rate for Payer: PHCS Commercial $8,574.72
Rate for Payer: United Healthcare All Payer $7,860.16
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Service Code HCPCS J3490
Hospital Charge Code 25003557
Hospital Revenue Code 636
Min. Negotiated Rate $238.33
Max. Negotiated Rate $1,759.99
Rate for Payer: Aetna Commercial $1,411.66
Rate for Payer: Anthem POS/PPO/Traditional $1,429.99
Rate for Payer: Cash Price $916.66
Rate for Payer: Cigna Commercial $1,521.66
Rate for Payer: First Health Commercial $1,741.65
Rate for Payer: Humana Commercial $1,558.32
Rate for Payer: Medical Mutual Of Ohio HMO $1,503.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,352.99
Rate for Payer: Molina Healthcare Benefit Exchange $550.00
Rate for Payer: Ohio Health Choice Commercial $1,613.32
Rate for Payer: Ohio Health Group HMO $1,374.99
Rate for Payer: Ohio Health Group PPO Differential $366.66
Rate for Payer: Ohio Health Group PPO No Differential $238.33
Rate for Payer: Ohio Health Group PPO SOMC Employees $568.33
Rate for Payer: PHCS Commercial $1,759.99
Rate for Payer: United Healthcare All Payer $1,613.32
Service Code HCPCS J3490
Hospital Charge Code 25003557
Hospital Revenue Code 636
Min. Negotiated Rate $238.33
Max. Negotiated Rate $1,759.99
Rate for Payer: Aetna Commercial $1,411.66
Rate for Payer: Anthem Medicaid $630.48
Rate for Payer: Anthem POS/PPO/Traditional $1,429.99
Rate for Payer: Cash Price $916.66
Rate for Payer: Cigna Commercial $1,521.66
Rate for Payer: First Health Commercial $1,741.65
Rate for Payer: Humana Commercial $1,558.32
Rate for Payer: Humana KY Medicaid $630.48
Rate for Payer: Kentucky WC Medicaid $636.90
Rate for Payer: Medical Mutual Of Ohio HMO $1,503.32
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,352.99
Rate for Payer: Molina Healthcare Benefit Exchange $550.00
Rate for Payer: Molina Healthcare Medicaid $643.13
Rate for Payer: Ohio Health Choice Commercial $1,613.32
Rate for Payer: Ohio Health Group HMO $1,374.99
Rate for Payer: Ohio Health Group PPO Differential $366.66
Rate for Payer: Ohio Health Group PPO No Differential $238.33
Rate for Payer: Ohio Health Group PPO SOMC Employees $568.33
Rate for Payer: PHCS Commercial $1,759.99
Rate for Payer: United Healthcare All Payer $1,613.32
Service Code HCPCS 90632
Hospital Charge Code 25000011
Hospital Revenue Code 636
Min. Negotiated Rate $45.44
Max. Negotiated Rate $335.59
Rate for Payer: Aetna Commercial $269.17
Rate for Payer: Anthem POS/PPO/Traditional $272.66
Rate for Payer: Cash Price $174.78
Rate for Payer: Cigna Commercial $290.14
Rate for Payer: First Health Commercial $332.09
Rate for Payer: Humana Commercial $297.13
Rate for Payer: Medical Mutual Of Ohio HMO $286.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $257.98
Rate for Payer: Molina Healthcare Benefit Exchange $104.87
Rate for Payer: Ohio Health Choice Commercial $307.62
Rate for Payer: Ohio Health Group HMO $262.18
Rate for Payer: Ohio Health Group PPO Differential $69.91
Rate for Payer: Ohio Health Group PPO No Differential $45.44
Rate for Payer: Ohio Health Group PPO SOMC Employees $108.37
Rate for Payer: PHCS Commercial $335.59
Rate for Payer: United Healthcare All Payer $307.62
Service Code HCPCS 90632
Hospital Charge Code 25000011
Hospital Revenue Code 636
Min. Negotiated Rate $45.44
Max. Negotiated Rate $335.59
Rate for Payer: Aetna Commercial $269.17
Rate for Payer: Anthem Medicaid $120.22
Rate for Payer: Anthem POS/PPO/Traditional $272.66
Rate for Payer: Cash Price $174.78
Rate for Payer: Cigna Commercial $290.14
Rate for Payer: First Health Commercial $332.09
Rate for Payer: Humana Commercial $297.13
Rate for Payer: Humana KY Medicaid $120.22
Rate for Payer: Kentucky WC Medicaid $121.44
Rate for Payer: Medical Mutual Of Ohio HMO $286.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $257.98
Rate for Payer: Molina Healthcare Benefit Exchange $104.87
Rate for Payer: Molina Healthcare Medicaid $122.63
Rate for Payer: Ohio Health Choice Commercial $307.62
Rate for Payer: Ohio Health Group HMO $262.18
Rate for Payer: Ohio Health Group PPO Differential $69.91
Rate for Payer: Ohio Health Group PPO No Differential $45.44
Rate for Payer: Ohio Health Group PPO SOMC Employees $108.37
Rate for Payer: PHCS Commercial $335.59
Rate for Payer: United Healthcare All Payer $307.62
Service Code HCPCS C1713
Hospital Charge Code 27000005
Hospital Revenue Code 278
Min. Negotiated Rate $646.36
Max. Negotiated Rate $4,773.12
Rate for Payer: Aetna Commercial $3,828.44
Rate for Payer: Anthem POS/PPO/Traditional $3,878.16
Rate for Payer: Cash Price $2,486.00
Rate for Payer: Cigna Commercial $4,126.76
Rate for Payer: First Health Commercial $4,723.40
Rate for Payer: Humana Commercial $4,226.20
Rate for Payer: Medical Mutual Of Ohio HMO $4,077.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,669.34
Rate for Payer: Molina Healthcare Benefit Exchange $1,491.60
Rate for Payer: Ohio Health Choice Commercial $4,375.36
Rate for Payer: Ohio Health Group HMO $3,729.00
Rate for Payer: Ohio Health Group PPO Differential $994.40
Rate for Payer: Ohio Health Group PPO No Differential $646.36
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,541.32
Rate for Payer: PHCS Commercial $4,773.12
Rate for Payer: United Healthcare All Payer $4,375.36
Service Code HCPCS C1713
Hospital Charge Code 27000005
Hospital Revenue Code 278
Min. Negotiated Rate $646.36
Max. Negotiated Rate $4,773.12
Rate for Payer: Aetna Commercial $3,828.44
Rate for Payer: Anthem Medicaid $1,709.87
Rate for Payer: Anthem POS/PPO/Traditional $3,878.16
Rate for Payer: Cash Price $2,486.00
Rate for Payer: Cigna Commercial $4,126.76
Rate for Payer: First Health Commercial $4,723.40
Rate for Payer: Humana Commercial $4,226.20
Rate for Payer: Humana KY Medicaid $1,709.87
Rate for Payer: Kentucky WC Medicaid $1,727.27
Rate for Payer: Medical Mutual Of Ohio HMO $4,077.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,669.34
Rate for Payer: Molina Healthcare Benefit Exchange $1,491.60
Rate for Payer: Molina Healthcare Medicaid $1,744.18
Rate for Payer: Ohio Health Choice Commercial $4,375.36
Rate for Payer: Ohio Health Group HMO $3,729.00
Rate for Payer: Ohio Health Group PPO Differential $994.40
Rate for Payer: Ohio Health Group PPO No Differential $646.36
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,541.32
Rate for Payer: PHCS Commercial $4,773.12
Rate for Payer: United Healthcare All Payer $4,375.36
Service Code HCPCS C1713
Hospital Charge Code 27000005
Hospital Revenue Code 278
Min. Negotiated Rate $646.36
Max. Negotiated Rate $4,773.12
Rate for Payer: Aetna Commercial $3,828.44
Rate for Payer: Anthem POS/PPO/Traditional $3,878.16
Rate for Payer: Cash Price $2,486.00
Rate for Payer: Cigna Commercial $4,126.76
Rate for Payer: First Health Commercial $4,723.40
Rate for Payer: Humana Commercial $4,226.20
Rate for Payer: Medical Mutual Of Ohio HMO $4,077.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,669.34
Rate for Payer: Molina Healthcare Benefit Exchange $1,491.60
Rate for Payer: Ohio Health Choice Commercial $4,375.36
Rate for Payer: Ohio Health Group HMO $3,729.00
Rate for Payer: Ohio Health Group PPO Differential $994.40
Rate for Payer: Ohio Health Group PPO No Differential $646.36
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,541.32
Rate for Payer: PHCS Commercial $4,773.12
Rate for Payer: United Healthcare All Payer $4,375.36