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Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $2.99
Max. Negotiated Rate $9,415.68
Rate for Payer: Aetna Commercial $611.13
Rate for Payer: Anthem Medicaid $272.94
Rate for Payer: Anthem POS/PPO/Traditional $619.06
Rate for Payer: Cash Price $396.84
Rate for Payer: Cigna Commercial $658.75
Rate for Payer: First Health Commercial $753.99
Rate for Payer: Humana Commercial $674.62
Rate for Payer: Humana KY Medicaid $272.94
Rate for Payer: Kentucky WC Medicaid $275.72
Rate for Payer: Medical Mutual Of Ohio HMO $650.81
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $585.73
Rate for Payer: Molina Healthcare Benefit Exchange $238.10
Rate for Payer: Molina Healthcare Medicaid $278.42
Rate for Payer: Ohio Health Choice Commercial $698.43
Rate for Payer: Ohio Health Group HMO $595.25
Rate for Payer: Ohio Health Group PPO Differential $158.73
Rate for Payer: Ohio Health Group PPO No Differential $103.18
Rate for Payer: Ohio Health Group PPO SOMC Employees $246.04
Rate for Payer: PHCS Commercial $761.92
Rate for Payer: United Healthcare All Payer $698.43
Service Code HCPCS C1769
Hospital Charge Code 27000056
Hospital Revenue Code 272
Min. Negotiated Rate $2.99
Max. Negotiated Rate $9,415.68
Rate for Payer: Aetna Commercial $611.13
Rate for Payer: Anthem POS/PPO/Traditional $619.06
Rate for Payer: Cash Price $396.84
Rate for Payer: Cigna Commercial $658.75
Rate for Payer: First Health Commercial $753.99
Rate for Payer: Humana Commercial $674.62
Rate for Payer: Medical Mutual Of Ohio HMO $650.81
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $585.73
Rate for Payer: Molina Healthcare Benefit Exchange $238.10
Rate for Payer: Ohio Health Choice Commercial $698.43
Rate for Payer: Ohio Health Group HMO $595.25
Rate for Payer: Ohio Health Group PPO Differential $158.73
Rate for Payer: Ohio Health Group PPO No Differential $103.18
Rate for Payer: Ohio Health Group PPO SOMC Employees $246.04
Rate for Payer: PHCS Commercial $761.92
Service Code HCPCS Q5118
Hospital Charge Code 25003978
Hospital Revenue Code 636
Min. Negotiated Rate $418.65
Max. Negotiated Rate $3,091.54
Rate for Payer: Aetna Commercial $2,479.67
Rate for Payer: Anthem POS/PPO/Traditional $2,511.87
Rate for Payer: Cash Price $1,610.17
Rate for Payer: Cigna Commercial $2,672.89
Rate for Payer: First Health Commercial $3,059.33
Rate for Payer: Humana Commercial $2,737.30
Rate for Payer: Medical Mutual Of Ohio HMO $2,640.69
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,376.62
Rate for Payer: Molina Healthcare Benefit Exchange $966.10
Rate for Payer: Ohio Health Choice Commercial $2,833.91
Rate for Payer: Ohio Health Group HMO $2,415.26
Rate for Payer: Ohio Health Group PPO Differential $644.07
Rate for Payer: Ohio Health Group PPO No Differential $418.65
Rate for Payer: Ohio Health Group PPO SOMC Employees $998.31
Rate for Payer: PHCS Commercial $3,091.54
Service Code HCPCS Q5118
Hospital Charge Code 25003978
Hospital Revenue Code 636
Min. Negotiated Rate $21.51
Max. Negotiated Rate $3,091.54
Rate for Payer: Aetna Commercial $2,479.67
Rate for Payer: Anthem Medicaid $1,107.48
Rate for Payer: Anthem Medicare Advantage/PPO $21.51
Rate for Payer: Anthem POS/PPO/Traditional $2,511.87
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $30.12
Rate for Payer: CareSource Just4Me Medicare $29.04
Rate for Payer: Cash Price $1,610.17
Rate for Payer: Cash Price $1,610.17
Rate for Payer: Cigna Commercial $2,672.89
Rate for Payer: First Health Commercial $3,059.33
Rate for Payer: Humana Commercial $2,737.30
Rate for Payer: Humana KY Medicaid $1,107.48
Rate for Payer: Humana Medicare Advantage $21.51
Rate for Payer: Kentucky WC Medicaid $1,118.75
Rate for Payer: Medical Mutual Of Ohio HMO $2,640.69
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,376.62
Rate for Payer: Molina Healthcare Benefit Exchange $25.81
Rate for Payer: Molina Healthcare Medicaid $1,129.70
Rate for Payer: Ohio Health Choice Commercial $2,833.91
Rate for Payer: Ohio Health Group HMO $2,415.26
Rate for Payer: Ohio Health Group PPO Differential $644.07
Rate for Payer: Ohio Health Group PPO No Differential $418.65
Rate for Payer: Ohio Health Group PPO SOMC Employees $998.31
Rate for Payer: PHCS Commercial $3,091.54
Rate for Payer: United Healthcare All Payer $2,833.91
Service Code HCPCS Q5118
Hospital Charge Code 25003977
Hospital Revenue Code 636
Min. Negotiated Rate $21.51
Max. Negotiated Rate $12,366.14
Rate for Payer: Aetna Commercial $9,918.68
Rate for Payer: Anthem Medicaid $4,429.91
Rate for Payer: Anthem Medicare Advantage/PPO $21.51
Rate for Payer: Anthem POS/PPO/Traditional $10,047.49
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $30.12
Rate for Payer: CareSource Just4Me Medicare $29.04
Rate for Payer: Cash Price $6,440.70
Rate for Payer: Cash Price $6,440.70
Rate for Payer: Cigna Commercial $10,691.56
Rate for Payer: First Health Commercial $12,237.33
Rate for Payer: Humana Commercial $10,949.19
Rate for Payer: Humana KY Medicaid $4,429.91
Rate for Payer: Humana Medicare Advantage $21.51
Rate for Payer: Kentucky WC Medicaid $4,475.00
Rate for Payer: Medical Mutual Of Ohio HMO $10,562.75
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $9,506.47
Rate for Payer: Molina Healthcare Benefit Exchange $25.81
Rate for Payer: Molina Healthcare Medicaid $4,518.80
Rate for Payer: Ohio Health Choice Commercial $11,335.63
Rate for Payer: Ohio Health Group HMO $9,661.05
Rate for Payer: Ohio Health Group PPO Differential $2,576.28
Rate for Payer: Ohio Health Group PPO No Differential $1,674.58
Rate for Payer: Ohio Health Group PPO SOMC Employees $3,993.23
Rate for Payer: PHCS Commercial $12,366.14
Rate for Payer: United Healthcare All Payer $11,335.63
Service Code HCPCS Q5118
Hospital Charge Code 25003977
Hospital Revenue Code 636
Min. Negotiated Rate $1,674.58
Max. Negotiated Rate $12,366.14
Rate for Payer: Aetna Commercial $9,918.68
Rate for Payer: Anthem POS/PPO/Traditional $10,047.49
Rate for Payer: Cash Price $6,440.70
Rate for Payer: Cigna Commercial $10,691.56
Rate for Payer: First Health Commercial $12,237.33
Rate for Payer: Humana Commercial $10,949.19
Rate for Payer: Medical Mutual Of Ohio HMO $10,562.75
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $9,506.47
Rate for Payer: Molina Healthcare Benefit Exchange $3,864.42
Rate for Payer: Ohio Health Choice Commercial $11,335.63
Rate for Payer: Ohio Health Group HMO $9,661.05
Rate for Payer: Ohio Health Group PPO Differential $2,576.28
Rate for Payer: Ohio Health Group PPO No Differential $1,674.58
Rate for Payer: Ohio Health Group PPO SOMC Employees $3,993.23
Rate for Payer: PHCS Commercial $12,366.14
Service Code HCPCS J0456
Hospital Charge Code 25001876
Hospital Revenue Code 636
Min. Negotiated Rate $14.59
Max. Negotiated Rate $107.76
Rate for Payer: Aetna Commercial $86.43
Rate for Payer: Anthem POS/PPO/Traditional $87.56
Rate for Payer: Cash Price $56.12
Rate for Payer: Cigna Commercial $93.17
Rate for Payer: First Health Commercial $106.64
Rate for Payer: Humana Commercial $95.41
Rate for Payer: Medical Mutual Of Ohio HMO $92.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $82.84
Rate for Payer: Molina Healthcare Benefit Exchange $33.68
Rate for Payer: Ohio Health Choice Commercial $98.78
Rate for Payer: Ohio Health Group HMO $84.19
Rate for Payer: Ohio Health Group PPO Differential $22.45
Rate for Payer: Ohio Health Group PPO No Differential $14.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $34.80
Rate for Payer: PHCS Commercial $107.76
Service Code HCPCS J0456
Hospital Charge Code 25001876
Hospital Revenue Code 636
Min. Negotiated Rate $14.59
Max. Negotiated Rate $107.76
Rate for Payer: Aetna Commercial $86.43
Rate for Payer: Anthem Medicaid $38.60
Rate for Payer: Anthem POS/PPO/Traditional $87.56
Rate for Payer: Cash Price $56.12
Rate for Payer: Cigna Commercial $93.17
Rate for Payer: First Health Commercial $106.64
Rate for Payer: Humana Commercial $95.41
Rate for Payer: Humana KY Medicaid $38.60
Rate for Payer: Kentucky WC Medicaid $39.00
Rate for Payer: Medical Mutual Of Ohio HMO $92.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $82.84
Rate for Payer: Molina Healthcare Benefit Exchange $33.68
Rate for Payer: Molina Healthcare Medicaid $39.38
Rate for Payer: Ohio Health Choice Commercial $98.78
Rate for Payer: Ohio Health Group HMO $84.19
Rate for Payer: Ohio Health Group PPO Differential $22.45
Rate for Payer: Ohio Health Group PPO No Differential $14.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $34.80
Rate for Payer: PHCS Commercial $107.76
Rate for Payer: United Healthcare All Payer $98.78
Service Code HCPCS J0456
Hospital Charge Code 25001877
Hospital Revenue Code 636
Min. Negotiated Rate $13.91
Max. Negotiated Rate $102.72
Rate for Payer: Aetna Commercial $82.39
Rate for Payer: Anthem Medicaid $36.80
Rate for Payer: Anthem POS/PPO/Traditional $83.46
Rate for Payer: Cash Price $53.50
Rate for Payer: Cigna Commercial $88.81
Rate for Payer: First Health Commercial $101.65
Rate for Payer: Humana Commercial $90.95
Rate for Payer: Humana KY Medicaid $36.80
Rate for Payer: Kentucky WC Medicaid $37.17
Rate for Payer: Medical Mutual Of Ohio HMO $87.74
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $78.97
Rate for Payer: Molina Healthcare Benefit Exchange $32.10
Rate for Payer: Molina Healthcare Medicaid $37.54
Rate for Payer: Ohio Health Choice Commercial $94.16
Rate for Payer: Ohio Health Group HMO $80.25
Rate for Payer: Ohio Health Group PPO Differential $21.40
Rate for Payer: Ohio Health Group PPO No Differential $13.91
Rate for Payer: Ohio Health Group PPO SOMC Employees $33.17
Rate for Payer: PHCS Commercial $102.72
Rate for Payer: United Healthcare All Payer $94.16
Service Code HCPCS J0456
Hospital Charge Code 25001877
Hospital Revenue Code 636
Min. Negotiated Rate $13.91
Max. Negotiated Rate $102.72
Rate for Payer: Aetna Commercial $82.39
Rate for Payer: Anthem POS/PPO/Traditional $83.46
Rate for Payer: Cash Price $53.50
Rate for Payer: Cigna Commercial $88.81
Rate for Payer: First Health Commercial $101.65
Rate for Payer: Humana Commercial $90.95
Rate for Payer: Medical Mutual Of Ohio HMO $87.74
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $78.97
Rate for Payer: Molina Healthcare Benefit Exchange $32.10
Rate for Payer: Ohio Health Choice Commercial $94.16
Rate for Payer: Ohio Health Group HMO $80.25
Rate for Payer: Ohio Health Group PPO Differential $21.40
Rate for Payer: Ohio Health Group PPO No Differential $13.91
Rate for Payer: Ohio Health Group PPO SOMC Employees $33.17
Rate for Payer: PHCS Commercial $102.72
Hospital Charge Code 25003638
Hospital Revenue Code 250
Min. Negotiated Rate $2.82
Max. Negotiated Rate $20.80
Rate for Payer: Aetna Commercial $16.69
Rate for Payer: Anthem POS/PPO/Traditional $16.90
Rate for Payer: Cash Price $10.84
Rate for Payer: Cigna Commercial $17.99
Rate for Payer: First Health Commercial $20.59
Rate for Payer: Humana Commercial $18.42
Rate for Payer: Medical Mutual Of Ohio HMO $17.77
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $15.99
Rate for Payer: Molina Healthcare Benefit Exchange $6.50
Rate for Payer: Ohio Health Choice Commercial $19.07
Rate for Payer: Ohio Health Group HMO $16.25
Rate for Payer: Ohio Health Group PPO Differential $4.33
Rate for Payer: Ohio Health Group PPO No Differential $2.82
Rate for Payer: Ohio Health Group PPO SOMC Employees $6.72
Rate for Payer: PHCS Commercial $20.80
Hospital Charge Code 25003638
Hospital Revenue Code 250
Min. Negotiated Rate $2.82
Max. Negotiated Rate $20.80
Rate for Payer: Aetna Commercial $16.69
Rate for Payer: Anthem Medicaid $7.45
Rate for Payer: Anthem POS/PPO/Traditional $16.90
Rate for Payer: Cash Price $10.84
Rate for Payer: Cigna Commercial $17.99
Rate for Payer: First Health Commercial $20.59
Rate for Payer: Humana Commercial $18.42
Rate for Payer: Humana KY Medicaid $7.45
Rate for Payer: Kentucky WC Medicaid $7.53
Rate for Payer: Medical Mutual Of Ohio HMO $17.77
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $15.99
Rate for Payer: Molina Healthcare Benefit Exchange $6.50
Rate for Payer: Molina Healthcare Medicaid $7.60
Rate for Payer: Ohio Health Choice Commercial $19.07
Rate for Payer: Ohio Health Group HMO $16.25
Rate for Payer: Ohio Health Group PPO Differential $4.33
Rate for Payer: Ohio Health Group PPO No Differential $2.82
Rate for Payer: Ohio Health Group PPO SOMC Employees $6.72
Rate for Payer: PHCS Commercial $20.80
Rate for Payer: United Healthcare All Payer $19.07
Hospital Charge Code 25003636
Hospital Revenue Code 250
Min. Negotiated Rate $1.43
Max. Negotiated Rate $10.59
Rate for Payer: Aetna Commercial $8.49
Rate for Payer: Anthem POS/PPO/Traditional $8.60
Rate for Payer: Cash Price $5.52
Rate for Payer: Cigna Commercial $9.15
Rate for Payer: First Health Commercial $10.48
Rate for Payer: Humana Commercial $9.38
Rate for Payer: Medical Mutual Of Ohio HMO $9.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $8.14
Rate for Payer: Molina Healthcare Benefit Exchange $3.31
Rate for Payer: Ohio Health Choice Commercial $9.71
Rate for Payer: Ohio Health Group HMO $8.27
Rate for Payer: Ohio Health Group PPO Differential $2.21
Rate for Payer: Ohio Health Group PPO No Differential $1.43
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.42
Rate for Payer: PHCS Commercial $10.59
Hospital Charge Code 25003636
Hospital Revenue Code 250
Min. Negotiated Rate $1.43
Max. Negotiated Rate $10.59
Rate for Payer: Aetna Commercial $8.49
Rate for Payer: Anthem Medicaid $3.79
Rate for Payer: Anthem POS/PPO/Traditional $8.60
Rate for Payer: Cash Price $5.52
Rate for Payer: Cigna Commercial $9.15
Rate for Payer: First Health Commercial $10.48
Rate for Payer: Humana Commercial $9.38
Rate for Payer: Humana KY Medicaid $3.79
Rate for Payer: Kentucky WC Medicaid $3.83
Rate for Payer: Medical Mutual Of Ohio HMO $9.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $8.14
Rate for Payer: Molina Healthcare Benefit Exchange $3.31
Rate for Payer: Molina Healthcare Medicaid $3.87
Rate for Payer: Ohio Health Choice Commercial $9.71
Rate for Payer: Ohio Health Group HMO $8.27
Rate for Payer: Ohio Health Group PPO Differential $2.21
Rate for Payer: Ohio Health Group PPO No Differential $1.43
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.42
Rate for Payer: PHCS Commercial $10.59
Rate for Payer: United Healthcare All Payer $9.71
Service Code HCPCS J8499
Hospital Charge Code 25002525
Hospital Revenue Code 637
Min. Negotiated Rate $1.20
Max. Negotiated Rate $8.89
Rate for Payer: Aetna Commercial $7.13
Rate for Payer: Anthem Medicaid $3.18
Rate for Payer: Anthem POS/PPO/Traditional $7.22
Rate for Payer: Cash Price $4.63
Rate for Payer: Cigna Commercial $7.69
Rate for Payer: First Health Commercial $8.80
Rate for Payer: Humana Commercial $7.87
Rate for Payer: Humana KY Medicaid $3.18
Rate for Payer: Kentucky WC Medicaid $3.22
Rate for Payer: Medical Mutual Of Ohio HMO $7.59
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6.83
Rate for Payer: Molina Healthcare Benefit Exchange $2.78
Rate for Payer: Molina Healthcare Medicaid $3.25
Rate for Payer: Ohio Health Choice Commercial $8.15
Rate for Payer: Ohio Health Group HMO $6.94
Rate for Payer: Ohio Health Group PPO Differential $1.85
Rate for Payer: Ohio Health Group PPO No Differential $1.20
Rate for Payer: Ohio Health Group PPO SOMC Employees $2.87
Rate for Payer: PHCS Commercial $8.89
Rate for Payer: United Healthcare All Payer $8.15
Service Code HCPCS J8499
Hospital Charge Code 25002525
Hospital Revenue Code 637
Min. Negotiated Rate $1.20
Max. Negotiated Rate $8.89
Rate for Payer: Aetna Commercial $7.13
Rate for Payer: Anthem POS/PPO/Traditional $7.22
Rate for Payer: Cash Price $4.63
Rate for Payer: Cigna Commercial $7.69
Rate for Payer: First Health Commercial $8.80
Rate for Payer: Humana Commercial $7.87
Rate for Payer: Medical Mutual Of Ohio HMO $7.59
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6.83
Rate for Payer: Molina Healthcare Benefit Exchange $2.78
Rate for Payer: Ohio Health Choice Commercial $8.15
Rate for Payer: Ohio Health Group HMO $6.94
Rate for Payer: Ohio Health Group PPO Differential $1.85
Rate for Payer: Ohio Health Group PPO No Differential $1.20
Rate for Payer: Ohio Health Group PPO SOMC Employees $2.87
Rate for Payer: PHCS Commercial $8.89
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $2.99
Max. Negotiated Rate $195,234.43
Rate for Payer: Aetna Commercial $17,002.03
Rate for Payer: Anthem Medicaid $7,593.50
Rate for Payer: Anthem POS/PPO/Traditional $17,222.84
Rate for Payer: Cash Price $11,040.28
Rate for Payer: Cigna Commercial $18,326.86
Rate for Payer: First Health Commercial $20,976.53
Rate for Payer: Humana Commercial $18,768.48
Rate for Payer: Humana KY Medicaid $7,593.50
Rate for Payer: Kentucky WC Medicaid $7,670.79
Rate for Payer: Medical Mutual Of Ohio HMO $18,106.06
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $16,295.45
Rate for Payer: Molina Healthcare Benefit Exchange $6,624.17
Rate for Payer: Molina Healthcare Medicaid $7,745.86
Rate for Payer: Ohio Health Choice Commercial $19,430.89
Rate for Payer: Ohio Health Group HMO $16,560.42
Rate for Payer: Ohio Health Group PPO Differential $4,416.11
Rate for Payer: Ohio Health Group PPO No Differential $2,870.47
Rate for Payer: Ohio Health Group PPO SOMC Employees $6,844.97
Rate for Payer: PHCS Commercial $21,197.34
Rate for Payer: United Healthcare All Payer $19,430.89
Service Code HCPCS C1776
Hospital Charge Code 27000011
Hospital Revenue Code 278
Min. Negotiated Rate $2.99
Max. Negotiated Rate $195,234.43
Rate for Payer: Aetna Commercial $17,002.03
Rate for Payer: Anthem POS/PPO/Traditional $17,222.84
Rate for Payer: Cash Price $11,040.28
Rate for Payer: Cigna Commercial $18,326.86
Rate for Payer: First Health Commercial $20,976.53
Rate for Payer: Humana Commercial $18,768.48
Rate for Payer: Medical Mutual Of Ohio HMO $18,106.06
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $16,295.45
Rate for Payer: Molina Healthcare Benefit Exchange $6,624.17
Rate for Payer: Ohio Health Choice Commercial $19,430.89
Rate for Payer: Ohio Health Group HMO $16,560.42
Rate for Payer: Ohio Health Group PPO Differential $4,416.11
Rate for Payer: Ohio Health Group PPO No Differential $2,870.47
Rate for Payer: Ohio Health Group PPO SOMC Employees $6,844.97
Rate for Payer: PHCS Commercial $21,197.34
Hospital Charge Code 25001759
Hospital Revenue Code 637
Min. Negotiated Rate $0.54
Max. Negotiated Rate $4.01
Rate for Payer: Aetna Commercial $3.22
Rate for Payer: Anthem Medicaid $1.44
Rate for Payer: Anthem POS/PPO/Traditional $3.26
Rate for Payer: Cash Price $2.09
Rate for Payer: Cigna Commercial $3.47
Rate for Payer: First Health Commercial $3.97
Rate for Payer: Humana Commercial $3.55
Rate for Payer: Humana KY Medicaid $1.44
Rate for Payer: Kentucky WC Medicaid $1.45
Rate for Payer: Medical Mutual Of Ohio HMO $3.43
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.08
Rate for Payer: Molina Healthcare Benefit Exchange $1.25
Rate for Payer: Molina Healthcare Medicaid $1.47
Rate for Payer: Ohio Health Choice Commercial $3.68
Rate for Payer: Ohio Health Group HMO $3.14
Rate for Payer: Ohio Health Group PPO Differential $0.84
Rate for Payer: Ohio Health Group PPO No Differential $0.54
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.30
Rate for Payer: PHCS Commercial $4.01
Rate for Payer: United Healthcare All Payer $3.68
Hospital Charge Code 25001759
Hospital Revenue Code 637
Min. Negotiated Rate $0.54
Max. Negotiated Rate $4.01
Rate for Payer: Aetna Commercial $3.22
Rate for Payer: Anthem POS/PPO/Traditional $3.26
Rate for Payer: Cash Price $2.09
Rate for Payer: Cigna Commercial $3.47
Rate for Payer: First Health Commercial $3.97
Rate for Payer: Humana Commercial $3.55
Rate for Payer: Medical Mutual Of Ohio HMO $3.43
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.08
Rate for Payer: Molina Healthcare Benefit Exchange $1.25
Rate for Payer: Ohio Health Choice Commercial $3.68
Rate for Payer: Ohio Health Group HMO $3.14
Rate for Payer: Ohio Health Group PPO Differential $0.84
Rate for Payer: Ohio Health Group PPO No Differential $0.54
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.30
Rate for Payer: PHCS Commercial $4.01
Hospital Charge Code 25001760
Hospital Revenue Code 637
Min. Negotiated Rate $0.56
Max. Negotiated Rate $4.10
Rate for Payer: Aetna Commercial $3.29
Rate for Payer: Anthem POS/PPO/Traditional $3.33
Rate for Payer: Cash Price $2.13
Rate for Payer: Cigna Commercial $3.54
Rate for Payer: First Health Commercial $4.06
Rate for Payer: Humana Commercial $3.63
Rate for Payer: Medical Mutual Of Ohio HMO $3.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.15
Rate for Payer: Molina Healthcare Benefit Exchange $1.28
Rate for Payer: Ohio Health Choice Commercial $3.76
Rate for Payer: Ohio Health Group HMO $3.20
Rate for Payer: Ohio Health Group PPO Differential $0.85
Rate for Payer: Ohio Health Group PPO No Differential $0.56
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.32
Rate for Payer: PHCS Commercial $4.10
Hospital Charge Code 25001760
Hospital Revenue Code 637
Min. Negotiated Rate $0.56
Max. Negotiated Rate $4.10
Rate for Payer: Aetna Commercial $3.29
Rate for Payer: Anthem Medicaid $1.47
Rate for Payer: Anthem POS/PPO/Traditional $3.33
Rate for Payer: Cash Price $2.13
Rate for Payer: Cigna Commercial $3.54
Rate for Payer: First Health Commercial $4.06
Rate for Payer: Humana Commercial $3.63
Rate for Payer: Humana KY Medicaid $1.47
Rate for Payer: Kentucky WC Medicaid $1.48
Rate for Payer: Medical Mutual Of Ohio HMO $3.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.15
Rate for Payer: Molina Healthcare Benefit Exchange $1.28
Rate for Payer: Molina Healthcare Medicaid $1.50
Rate for Payer: Ohio Health Choice Commercial $3.76
Rate for Payer: Ohio Health Group HMO $3.20
Rate for Payer: Ohio Health Group PPO Differential $0.85
Rate for Payer: Ohio Health Group PPO No Differential $0.56
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.32
Rate for Payer: PHCS Commercial $4.10
Rate for Payer: United Healthcare All Payer $3.76
Hospital Charge Code 25001761
Hospital Revenue Code 637
Min. Negotiated Rate $0.54
Max. Negotiated Rate $3.96
Rate for Payer: Aetna Commercial $3.17
Rate for Payer: Anthem POS/PPO/Traditional $3.21
Rate for Payer: Cash Price $2.06
Rate for Payer: Cigna Commercial $3.42
Rate for Payer: First Health Commercial $3.91
Rate for Payer: Humana Commercial $3.50
Rate for Payer: Medical Mutual Of Ohio HMO $3.38
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.04
Rate for Payer: Molina Healthcare Benefit Exchange $1.24
Rate for Payer: Ohio Health Choice Commercial $3.63
Rate for Payer: Ohio Health Group HMO $3.09
Rate for Payer: Ohio Health Group PPO Differential $0.82
Rate for Payer: Ohio Health Group PPO No Differential $0.54
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.28
Rate for Payer: PHCS Commercial $3.96
Hospital Charge Code 25001761
Hospital Revenue Code 637
Min. Negotiated Rate $0.54
Max. Negotiated Rate $3.96
Rate for Payer: Aetna Commercial $3.17
Rate for Payer: Anthem Medicaid $1.42
Rate for Payer: Anthem POS/PPO/Traditional $3.21
Rate for Payer: Cash Price $2.06
Rate for Payer: Cigna Commercial $3.42
Rate for Payer: First Health Commercial $3.91
Rate for Payer: Humana Commercial $3.50
Rate for Payer: Humana KY Medicaid $1.42
Rate for Payer: Kentucky WC Medicaid $1.43
Rate for Payer: Medical Mutual Of Ohio HMO $3.38
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.04
Rate for Payer: Molina Healthcare Benefit Exchange $1.24
Rate for Payer: Molina Healthcare Medicaid $1.45
Rate for Payer: Ohio Health Choice Commercial $3.63
Rate for Payer: Ohio Health Group HMO $3.09
Rate for Payer: Ohio Health Group PPO Differential $0.82
Rate for Payer: Ohio Health Group PPO No Differential $0.54
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.28
Rate for Payer: PHCS Commercial $3.96
Rate for Payer: United Healthcare All Payer $3.63
Hospital Charge Code 22200201
Hospital Revenue Code 222
Min. Negotiated Rate $25.20
Max. Negotiated Rate $72.00
Rate for Payer: Buckeye Medicare Advantage $72.00
Rate for Payer: Cash Price $36.00
Rate for Payer: Multiplan PHCS $43.20
Rate for Payer: Ohio Health Choice Preferred Health Choice $50.40
Rate for Payer: UHCCP Medicaid $25.20