|
BIOPSY FOREARM SOFT TISSUES
|
Facility
|
OP
|
$760.00
|
|
|
Service Code
|
HCPCS 25065
|
| Hospital Charge Code |
76100571
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$261.36 |
| Max. Negotiated Rate |
$2,095.90 |
| Rate for Payer: Aetna Commercial |
$585.20
|
| Rate for Payer: Anthem Medicaid |
$261.36
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,497.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$592.80
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,095.90
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,021.04
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cigna Commercial |
$630.80
|
| Rate for Payer: First Health Commercial |
$722.00
|
| Rate for Payer: Humana Commercial |
$646.00
|
| Rate for Payer: Humana KY Medicaid |
$261.36
|
| Rate for Payer: Humana Medicare Advantage |
$1,497.07
|
| Rate for Payer: Kentucky WC Medicaid |
$264.02
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$623.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$560.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,796.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$266.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$668.80
|
| Rate for Payer: Ohio Health Group HMO |
$570.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$608.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$661.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$524.40
|
| Rate for Payer: PHCS Commercial |
$729.60
|
| Rate for Payer: United Healthcare All Payer |
$668.80
|
|
|
BIOPSY FOREARM SOFT TISSUES
|
Facility
|
IP
|
$760.00
|
|
|
Service Code
|
HCPCS 25065
|
| Hospital Charge Code |
76100571
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.00 |
| Max. Negotiated Rate |
$729.60 |
| Rate for Payer: Aetna Commercial |
$585.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$592.80
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cigna Commercial |
$630.80
|
| Rate for Payer: First Health Commercial |
$722.00
|
| Rate for Payer: Humana Commercial |
$646.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$623.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$560.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$228.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$668.80
|
| Rate for Payer: Ohio Health Group HMO |
$570.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$608.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$661.20
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$524.40
|
| Rate for Payer: PHCS Commercial |
$729.60
|
| Rate for Payer: United Healthcare All Payer |
$668.80
|
|
|
BIOPSY FOREARM SOFT TISSUES
|
Facility
|
OP
|
$825.00
|
|
|
Service Code
|
HCPCS 25066
|
| Hospital Charge Code |
76100572
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$283.72 |
| Max. Negotiated Rate |
$3,702.27 |
| Rate for Payer: Aetna Commercial |
$635.25
|
| Rate for Payer: Anthem Medicaid |
$283.72
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,644.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$643.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,702.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,570.05
|
| Rate for Payer: Cash Price |
$412.50
|
| Rate for Payer: Cash Price |
$412.50
|
| Rate for Payer: Cigna Commercial |
$684.75
|
| Rate for Payer: First Health Commercial |
$783.75
|
| Rate for Payer: Humana Commercial |
$701.25
|
| Rate for Payer: Humana KY Medicaid |
$283.72
|
| Rate for Payer: Humana Medicare Advantage |
$2,644.48
|
| Rate for Payer: Kentucky WC Medicaid |
$286.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$676.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$608.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,173.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$289.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$726.00
|
| Rate for Payer: Ohio Health Group HMO |
$618.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$660.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$717.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$569.25
|
| Rate for Payer: PHCS Commercial |
$792.00
|
| Rate for Payer: United Healthcare All Payer |
$726.00
|
|
|
BIOPSY FOREARM SOFT TISSUES
|
Facility
|
IP
|
$825.00
|
|
|
Service Code
|
HCPCS 25066
|
| Hospital Charge Code |
76100572
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$247.50 |
| Max. Negotiated Rate |
$792.00 |
| Rate for Payer: Aetna Commercial |
$635.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$643.50
|
| Rate for Payer: Cash Price |
$412.50
|
| Rate for Payer: Cigna Commercial |
$684.75
|
| Rate for Payer: First Health Commercial |
$783.75
|
| Rate for Payer: Humana Commercial |
$701.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$676.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$608.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$247.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$726.00
|
| Rate for Payer: Ohio Health Group HMO |
$618.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$660.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$717.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$569.25
|
| Rate for Payer: PHCS Commercial |
$792.00
|
| Rate for Payer: United Healthcare All Payer |
$726.00
|
|
|
BIOPSY FOREARM SOFT TISSUES
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 25066
|
| Hospital Charge Code |
76100572
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$160.21 |
| Max. Negotiated Rate |
$707.10 |
| Rate for Payer: Aetna Commercial |
$537.35
|
| Rate for Payer: Ambetter Exchange |
$355.00
|
| Rate for Payer: Anthem Medicaid |
$160.21
|
| Rate for Payer: Buckeye Individual/Medicaid |
$355.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$355.00
|
| Rate for Payer: CareSource Just4Me Medicare |
$426.00
|
| Rate for Payer: Cash Price |
$412.50
|
| Rate for Payer: Cash Price |
$412.50
|
| Rate for Payer: Cigna Commercial |
$707.10
|
| Rate for Payer: Healthspan PPO |
$486.72
|
| Rate for Payer: Humana Medicaid |
$160.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$450.53
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$355.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$355.00
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$163.41
|
| Rate for Payer: Molina Healthcare Passport |
$160.21
|
| Rate for Payer: Multiplan PHCS |
$495.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$461.50
|
| Rate for Payer: UHCCP Medicaid |
$288.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$161.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$355.00
|
|
|
BIOPSY FOREARM SOFT TISSUES(P
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 25066
|
| Hospital Charge Code |
761P0572
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$160.21 |
| Max. Negotiated Rate |
$707.10 |
| Rate for Payer: Aetna Commercial |
$537.35
|
| Rate for Payer: Ambetter Exchange |
$355.00
|
| Rate for Payer: Anthem Medicaid |
$160.21
|
| Rate for Payer: Buckeye Individual/Medicaid |
$355.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$355.00
|
| Rate for Payer: CareSource Just4Me Medicare |
$426.00
|
| Rate for Payer: Cash Price |
$412.50
|
| Rate for Payer: Cash Price |
$412.50
|
| Rate for Payer: Cigna Commercial |
$707.10
|
| Rate for Payer: Healthspan PPO |
$486.72
|
| Rate for Payer: Humana Medicaid |
$160.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$450.53
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$355.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$355.00
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$163.41
|
| Rate for Payer: Molina Healthcare Passport |
$160.21
|
| Rate for Payer: Multiplan PHCS |
$495.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$461.50
|
| Rate for Payer: UHCCP Medicaid |
$288.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$161.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$355.00
|
|
|
BIOPSY FOREARM SOFT TISSUES(P
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
HCPCS 25065
|
| Hospital Charge Code |
761P0571
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.47 |
| Max. Negotiated Rate |
$456.00 |
| Rate for Payer: Aetna Commercial |
$231.08
|
| Rate for Payer: Ambetter Exchange |
$148.17
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$89.47
|
| Rate for Payer: Anthem Medicaid |
$92.43
|
| Rate for Payer: Buckeye Individual/Medicaid |
$148.17
|
| Rate for Payer: Buckeye Medicare Advantage |
$148.17
|
| Rate for Payer: CareSource Just4Me Medicare |
$177.80
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cigna Commercial |
$250.10
|
| Rate for Payer: Healthspan PPO |
$307.24
|
| Rate for Payer: Humana Medicaid |
$92.43
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$204.76
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$148.17
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$148.17
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$94.28
|
| Rate for Payer: Molina Healthcare Passport |
$92.43
|
| Rate for Payer: Multiplan PHCS |
$456.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$192.62
|
| Rate for Payer: UHCCP Medicaid |
$93.94
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$93.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$148.17
|
|
|
BIOPSY INTRANASAL
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 30100
|
| Hospital Charge Code |
76101119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.03 |
| Max. Negotiated Rate |
$173.24 |
| Rate for Payer: Aetna Commercial |
$101.00
|
| Rate for Payer: Ambetter Exchange |
$64.51
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$48.53
|
| Rate for Payer: Anthem Medicaid |
$48.03
|
| Rate for Payer: Buckeye Individual/Medicaid |
$64.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$64.51
|
| Rate for Payer: CareSource Just4Me Medicare |
$77.41
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cigna Commercial |
$173.24
|
| Rate for Payer: Healthspan PPO |
$158.29
|
| Rate for Payer: Humana Medicaid |
$48.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$87.88
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$64.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$64.51
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$48.99
|
| Rate for Payer: Molina Healthcare Passport |
$48.03
|
| Rate for Payer: Multiplan PHCS |
$105.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$83.86
|
| Rate for Payer: UHCCP Medicaid |
$50.96
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$48.51
|
| Rate for Payer: Wellcare Medicare Advantage |
$64.51
|
|
|
BIOPSY INTRANASAL
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
HCPCS 30100
|
| Hospital Charge Code |
76101119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.18 |
| Max. Negotiated Rate |
$1,916.14 |
| Rate for Payer: Aetna Commercial |
$134.75
|
| Rate for Payer: Anthem Medicaid |
$60.18
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,368.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$136.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,916.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,847.70
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: First Health Commercial |
$166.25
|
| Rate for Payer: Humana Commercial |
$148.75
|
| Rate for Payer: Humana KY Medicaid |
$60.18
|
| Rate for Payer: Humana Medicare Advantage |
$1,368.67
|
| Rate for Payer: Kentucky WC Medicaid |
$60.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$143.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$129.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,642.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$61.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$154.00
|
| Rate for Payer: Ohio Health Group HMO |
$131.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$140.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$152.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$120.75
|
| Rate for Payer: PHCS Commercial |
$168.00
|
| Rate for Payer: United Healthcare All Payer |
$154.00
|
|
|
BIOPSY INTRANASAL
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
HCPCS 30100
|
| Hospital Charge Code |
76101119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial |
$134.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$136.50
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cigna Commercial |
$145.25
|
| Rate for Payer: First Health Commercial |
$166.25
|
| Rate for Payer: Humana Commercial |
$148.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$143.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$129.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$52.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$154.00
|
| Rate for Payer: Ohio Health Group HMO |
$131.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$140.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$152.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$120.75
|
| Rate for Payer: PHCS Commercial |
$168.00
|
| Rate for Payer: United Healthcare All Payer |
$154.00
|
|
|
BIOPSY INTRANASAL(P
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 30100
|
| Hospital Charge Code |
761P1119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.03 |
| Max. Negotiated Rate |
$173.24 |
| Rate for Payer: Aetna Commercial |
$101.00
|
| Rate for Payer: Ambetter Exchange |
$64.51
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$48.53
|
| Rate for Payer: Anthem Medicaid |
$48.03
|
| Rate for Payer: Buckeye Individual/Medicaid |
$64.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$64.51
|
| Rate for Payer: CareSource Just4Me Medicare |
$77.41
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cash Price |
$87.50
|
| Rate for Payer: Cigna Commercial |
$173.24
|
| Rate for Payer: Healthspan PPO |
$158.29
|
| Rate for Payer: Humana Medicaid |
$48.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$87.88
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$64.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$64.51
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$48.99
|
| Rate for Payer: Molina Healthcare Passport |
$48.03
|
| Rate for Payer: Multiplan PHCS |
$105.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$83.86
|
| Rate for Payer: UHCCP Medicaid |
$50.96
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$48.51
|
| Rate for Payer: Wellcare Medicare Advantage |
$64.51
|
|
|
BIOPSY LIVER NEEDLE PERC
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
76101945
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$672.00 |
| Rate for Payer: Aetna Commercial |
$539.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$546.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cigna Commercial |
$581.00
|
| Rate for Payer: First Health Commercial |
$665.00
|
| Rate for Payer: Humana Commercial |
$595.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$574.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$516.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$210.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$616.00
|
| Rate for Payer: Ohio Health Group HMO |
$525.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$560.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$609.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$483.00
|
| Rate for Payer: PHCS Commercial |
$672.00
|
| Rate for Payer: United Healthcare All Payer |
$616.00
|
|
|
BIOPSY LIVER NEEDLE PERC
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
76101945
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$240.73 |
| Max. Negotiated Rate |
$2,095.90 |
| Rate for Payer: Aetna Commercial |
$539.00
|
| Rate for Payer: Anthem Medicaid |
$240.73
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,497.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$546.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,095.90
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,021.04
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cigna Commercial |
$581.00
|
| Rate for Payer: First Health Commercial |
$665.00
|
| Rate for Payer: Humana Commercial |
$595.00
|
| Rate for Payer: Humana KY Medicaid |
$240.73
|
| Rate for Payer: Humana Medicare Advantage |
$1,497.07
|
| Rate for Payer: Kentucky WC Medicaid |
$243.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$574.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$516.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,796.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$245.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$616.00
|
| Rate for Payer: Ohio Health Group HMO |
$525.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$560.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$609.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$483.00
|
| Rate for Payer: PHCS Commercial |
$672.00
|
| Rate for Payer: United Healthcare All Payer |
$616.00
|
|
|
BIOPSY LIVER NEEDLE PERC
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
76101945
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.70 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: Ambetter Exchange |
$81.70
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$88.25
|
| Rate for Payer: Anthem Medicaid |
$96.46
|
| Rate for Payer: Buckeye Individual/Medicaid |
$81.70
|
| Rate for Payer: Buckeye Medicare Advantage |
$81.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$98.04
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cigna Commercial |
$141.95
|
| Rate for Payer: Healthspan PPO |
$392.19
|
| Rate for Payer: Humana Medicaid |
$96.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$126.81
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$81.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$81.70
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$98.39
|
| Rate for Payer: Molina Healthcare Passport |
$96.46
|
| Rate for Payer: Multiplan PHCS |
$420.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$106.21
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$97.42
|
| Rate for Payer: Wellcare Medicare Advantage |
$81.70
|
|
|
BIOPSY LIVER NEEDLE PERC
|
Facility
|
IP
|
$2,750.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
76102851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$2,640.00 |
| Rate for Payer: Aetna Commercial |
$2,117.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,145.00
|
| Rate for Payer: Cash Price |
$1,375.00
|
| Rate for Payer: Cigna Commercial |
$2,282.50
|
| Rate for Payer: First Health Commercial |
$2,612.50
|
| Rate for Payer: Humana Commercial |
$2,337.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,255.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,029.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$825.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,420.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,062.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,200.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,392.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,897.50
|
| Rate for Payer: PHCS Commercial |
$2,640.00
|
| Rate for Payer: United Healthcare All Payer |
$2,420.00
|
|
|
BIOPSY LIVER NEEDLE PERC
|
Professional
|
Both
|
$2,750.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
76102851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.70 |
| Max. Negotiated Rate |
$1,650.00 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: Ambetter Exchange |
$81.70
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$88.25
|
| Rate for Payer: Anthem Medicaid |
$96.46
|
| Rate for Payer: Buckeye Individual/Medicaid |
$81.70
|
| Rate for Payer: Buckeye Medicare Advantage |
$81.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$98.04
|
| Rate for Payer: Cash Price |
$1,375.00
|
| Rate for Payer: Cash Price |
$1,375.00
|
| Rate for Payer: Cigna Commercial |
$141.95
|
| Rate for Payer: Healthspan PPO |
$392.19
|
| Rate for Payer: Humana Medicaid |
$96.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$126.81
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$81.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$81.70
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$98.39
|
| Rate for Payer: Molina Healthcare Passport |
$96.46
|
| Rate for Payer: Multiplan PHCS |
$1,650.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$106.21
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$97.42
|
| Rate for Payer: Wellcare Medicare Advantage |
$81.70
|
|
|
BIOPSY LIVER NEEDLE PERC
|
Facility
|
OP
|
$2,750.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
76102851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$945.73 |
| Max. Negotiated Rate |
$2,640.00 |
| Rate for Payer: Aetna Commercial |
$2,117.50
|
| Rate for Payer: Anthem Medicaid |
$945.73
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,497.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,145.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,095.90
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,021.04
|
| Rate for Payer: Cash Price |
$1,375.00
|
| Rate for Payer: Cash Price |
$1,375.00
|
| Rate for Payer: Cigna Commercial |
$2,282.50
|
| Rate for Payer: First Health Commercial |
$2,612.50
|
| Rate for Payer: Humana Commercial |
$2,337.50
|
| Rate for Payer: Humana KY Medicaid |
$945.73
|
| Rate for Payer: Humana Medicare Advantage |
$1,497.07
|
| Rate for Payer: Kentucky WC Medicaid |
$955.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,255.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,029.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,796.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$964.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,420.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,062.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,200.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,392.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,897.50
|
| Rate for Payer: PHCS Commercial |
$2,640.00
|
| Rate for Payer: United Healthcare All Payer |
$2,420.00
|
|
|
BIOPSY LIVER NEEDLE PERC (P
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
761P2851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.70 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: Ambetter Exchange |
$81.70
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$88.25
|
| Rate for Payer: Anthem Medicaid |
$96.46
|
| Rate for Payer: Buckeye Individual/Medicaid |
$81.70
|
| Rate for Payer: Buckeye Medicare Advantage |
$81.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$98.04
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cigna Commercial |
$141.95
|
| Rate for Payer: Healthspan PPO |
$392.19
|
| Rate for Payer: Humana Medicaid |
$96.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$126.81
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$81.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$81.70
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$98.39
|
| Rate for Payer: Molina Healthcare Passport |
$96.46
|
| Rate for Payer: Multiplan PHCS |
$420.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$106.21
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$97.42
|
| Rate for Payer: Wellcare Medicare Advantage |
$81.70
|
|
|
BIOPSY LIVER NEEDLE PERC(P
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
761P1945
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.70 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: Ambetter Exchange |
$81.70
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$88.25
|
| Rate for Payer: Anthem Medicaid |
$96.46
|
| Rate for Payer: Buckeye Individual/Medicaid |
$81.70
|
| Rate for Payer: Buckeye Medicare Advantage |
$81.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$98.04
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cigna Commercial |
$141.95
|
| Rate for Payer: Healthspan PPO |
$392.19
|
| Rate for Payer: Humana Medicaid |
$96.46
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$126.81
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$81.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$81.70
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$98.39
|
| Rate for Payer: Molina Healthcare Passport |
$96.46
|
| Rate for Payer: Multiplan PHCS |
$420.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$106.21
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$97.42
|
| Rate for Payer: Wellcare Medicare Advantage |
$81.70
|
|
|
BIOPSY LIVER NEEDLE PERC (T
|
Facility
|
IP
|
$2,050.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
761T2851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$615.00 |
| Max. Negotiated Rate |
$1,968.00 |
| Rate for Payer: Aetna Commercial |
$1,578.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,599.00
|
| Rate for Payer: Cash Price |
$1,025.00
|
| Rate for Payer: Cigna Commercial |
$1,701.50
|
| Rate for Payer: First Health Commercial |
$1,947.50
|
| Rate for Payer: Humana Commercial |
$1,742.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,681.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,512.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$615.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,804.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,537.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,640.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,783.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,414.50
|
| Rate for Payer: PHCS Commercial |
$1,968.00
|
| Rate for Payer: United Healthcare All Payer |
$1,804.00
|
|
|
BIOPSY LIVER NEEDLE PERC (T
|
Facility
|
OP
|
$2,050.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
761T2851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$705.00 |
| Max. Negotiated Rate |
$2,095.90 |
| Rate for Payer: Aetna Commercial |
$1,578.50
|
| Rate for Payer: Anthem Medicaid |
$705.00
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,497.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,599.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,095.90
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,021.04
|
| Rate for Payer: Cash Price |
$1,025.00
|
| Rate for Payer: Cash Price |
$1,025.00
|
| Rate for Payer: Cigna Commercial |
$1,701.50
|
| Rate for Payer: First Health Commercial |
$1,947.50
|
| Rate for Payer: Humana Commercial |
$1,742.50
|
| Rate for Payer: Humana KY Medicaid |
$705.00
|
| Rate for Payer: Humana Medicare Advantage |
$1,497.07
|
| Rate for Payer: Kentucky WC Medicaid |
$712.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,681.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,512.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,796.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$719.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,804.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,537.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,640.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,783.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,414.50
|
| Rate for Payer: PHCS Commercial |
$1,968.00
|
| Rate for Payer: United Healthcare All Payer |
$1,804.00
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
OP
|
$6,188.00
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
76101597
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,128.05 |
| Max. Negotiated Rate |
$5,940.48 |
| Rate for Payer: Aetna Commercial |
$4,764.76
|
| Rate for Payer: Anthem Medicaid |
$2,128.05
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,538.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,826.64
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,953.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,776.54
|
| Rate for Payer: Cash Price |
$3,094.00
|
| Rate for Payer: Cash Price |
$3,094.00
|
| Rate for Payer: Cigna Commercial |
$5,136.04
|
| Rate for Payer: First Health Commercial |
$5,878.60
|
| Rate for Payer: Humana Commercial |
$5,259.80
|
| Rate for Payer: Humana KY Medicaid |
$2,128.05
|
| Rate for Payer: Humana Medicare Advantage |
$3,538.18
|
| Rate for Payer: Kentucky WC Medicaid |
$2,149.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,074.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,566.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,245.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,170.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,445.44
|
| Rate for Payer: Ohio Health Group HMO |
$4,641.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,950.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,383.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,269.72
|
| Rate for Payer: PHCS Commercial |
$5,940.48
|
| Rate for Payer: United Healthcare All Payer |
$5,445.44
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
45000245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,953.35 |
| Max. Negotiated Rate |
$5,452.80 |
| Rate for Payer: Aetna Commercial |
$4,373.60
|
| Rate for Payer: Anthem Medicaid |
$1,953.35
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,538.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,430.40
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,953.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,776.54
|
| Rate for Payer: Cash Price |
$2,840.00
|
| Rate for Payer: Cash Price |
$2,840.00
|
| Rate for Payer: Cigna Commercial |
$4,714.40
|
| Rate for Payer: First Health Commercial |
$5,396.00
|
| Rate for Payer: Humana Commercial |
$4,828.00
|
| Rate for Payer: Humana KY Medicaid |
$1,953.35
|
| Rate for Payer: Humana Medicare Advantage |
$3,538.18
|
| Rate for Payer: Kentucky WC Medicaid |
$1,973.23
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,657.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,191.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,245.82
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,992.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,998.40
|
| Rate for Payer: Ohio Health Group HMO |
$4,260.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,544.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,941.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,919.20
|
| Rate for Payer: PHCS Commercial |
$5,452.80
|
| Rate for Payer: United Healthcare All Payer |
$4,998.40
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
45000245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,704.00 |
| Max. Negotiated Rate |
$5,452.80 |
| Rate for Payer: Aetna Commercial |
$4,373.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,430.40
|
| Rate for Payer: Cash Price |
$2,840.00
|
| Rate for Payer: Cigna Commercial |
$4,714.40
|
| Rate for Payer: First Health Commercial |
$5,396.00
|
| Rate for Payer: Humana Commercial |
$4,828.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,657.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,191.84
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,704.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,998.40
|
| Rate for Payer: Ohio Health Group HMO |
$4,260.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,544.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,941.60
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,919.20
|
| Rate for Payer: PHCS Commercial |
$5,452.80
|
| Rate for Payer: United Healthcare All Payer |
$4,998.40
|
|
|
BIOPSY LYMPH NODE
|
Facility
|
IP
|
$6,188.00
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
76101597
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,856.40 |
| Max. Negotiated Rate |
$5,940.48 |
| Rate for Payer: Aetna Commercial |
$4,764.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,826.64
|
| Rate for Payer: Cash Price |
$3,094.00
|
| Rate for Payer: Cigna Commercial |
$5,136.04
|
| Rate for Payer: First Health Commercial |
$5,878.60
|
| Rate for Payer: Humana Commercial |
$5,259.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,074.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,566.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,856.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,445.44
|
| Rate for Payer: Ohio Health Group HMO |
$4,641.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,950.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,383.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,269.72
|
| Rate for Payer: PHCS Commercial |
$5,940.48
|
| Rate for Payer: United Healthcare All Payer |
$5,445.44
|
|
