|
BIOPSY OF SPLEEN (T
|
Facility
|
IP
|
$4,759.50
|
|
|
Service Code
|
HCPCS 38999
|
| Hospital Charge Code |
761T2725
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,427.85 |
| Max. Negotiated Rate |
$4,569.12 |
| Rate for Payer: Aetna Commercial |
$3,664.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,712.41
|
| Rate for Payer: Cash Price |
$2,379.75
|
| Rate for Payer: Cigna Commercial |
$3,950.39
|
| Rate for Payer: First Health Commercial |
$4,521.52
|
| Rate for Payer: Humana Commercial |
$4,045.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,902.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,512.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,427.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,188.36
|
| Rate for Payer: Ohio Health Group HMO |
$3,569.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,807.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,140.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,284.05
|
| Rate for Payer: PHCS Commercial |
$4,569.12
|
| Rate for Payer: United Healthcare All Payer |
$4,188.36
|
|
|
BIOPSY OF THYROID
|
Facility
|
IP
|
$1,124.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
76102269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$337.20 |
| Max. Negotiated Rate |
$1,079.04 |
| Rate for Payer: Aetna Commercial |
$865.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$876.72
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cigna Commercial |
$932.92
|
| Rate for Payer: First Health Commercial |
$1,067.80
|
| Rate for Payer: Humana Commercial |
$955.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$921.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$829.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$337.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$989.12
|
| Rate for Payer: Ohio Health Group HMO |
$843.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$899.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$977.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$775.56
|
| Rate for Payer: PHCS Commercial |
$1,079.04
|
| Rate for Payer: United Healthcare All Payer |
$989.12
|
|
|
BIOPSY OF THYROID
|
Professional
|
Both
|
$1,124.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
76102269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.12 |
| Max. Negotiated Rate |
$674.40 |
| Rate for Payer: Aetna Commercial |
$127.15
|
| Rate for Payer: Ambetter Exchange |
$71.72
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$45.12
|
| Rate for Payer: Anthem Medicaid |
$59.54
|
| Rate for Payer: Buckeye Individual/Medicaid |
$71.72
|
| Rate for Payer: Buckeye Medicare Advantage |
$71.72
|
| Rate for Payer: CareSource Just4Me Medicare |
$86.06
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cigna Commercial |
$162.76
|
| Rate for Payer: Healthspan PPO |
$143.79
|
| Rate for Payer: Humana Medicaid |
$59.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$103.25
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$71.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$71.72
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$60.73
|
| Rate for Payer: Molina Healthcare Passport |
$59.54
|
| Rate for Payer: Multiplan PHCS |
$674.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$93.24
|
| Rate for Payer: UHCCP Medicaid |
$47.38
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$60.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$71.72
|
|
|
BIOPSY OF THYROID
|
Facility
|
OP
|
$1,124.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
76102269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$386.54 |
| Max. Negotiated Rate |
$1,079.04 |
| Rate for Payer: Aetna Commercial |
$865.48
|
| Rate for Payer: Anthem Medicaid |
$386.54
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$650.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$876.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$910.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$877.63
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cash Price |
$562.00
|
| Rate for Payer: Cigna Commercial |
$932.92
|
| Rate for Payer: First Health Commercial |
$1,067.80
|
| Rate for Payer: Humana Commercial |
$955.40
|
| Rate for Payer: Humana KY Medicaid |
$386.54
|
| Rate for Payer: Humana Medicare Advantage |
$650.10
|
| Rate for Payer: Kentucky WC Medicaid |
$390.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$921.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$829.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$394.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$989.12
|
| Rate for Payer: Ohio Health Group HMO |
$843.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$899.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$977.88
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$775.56
|
| Rate for Payer: PHCS Commercial |
$1,079.04
|
| Rate for Payer: United Healthcare All Payer |
$989.12
|
|
|
BIOPSY OF THYROID(P
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
761P2269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.12 |
| Max. Negotiated Rate |
$162.76 |
| Rate for Payer: Aetna Commercial |
$127.15
|
| Rate for Payer: Ambetter Exchange |
$71.72
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$45.12
|
| Rate for Payer: Anthem Medicaid |
$59.54
|
| Rate for Payer: Buckeye Individual/Medicaid |
$71.72
|
| Rate for Payer: Buckeye Medicare Advantage |
$71.72
|
| Rate for Payer: CareSource Just4Me Medicare |
$86.06
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cigna Commercial |
$162.76
|
| Rate for Payer: Healthspan PPO |
$143.79
|
| Rate for Payer: Humana Medicaid |
$59.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$103.25
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$71.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$71.72
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$60.73
|
| Rate for Payer: Molina Healthcare Passport |
$59.54
|
| Rate for Payer: Multiplan PHCS |
$150.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$93.24
|
| Rate for Payer: UHCCP Medicaid |
$47.38
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$60.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$71.72
|
|
|
BIOPSY OF THYROID(T
|
Facility
|
IP
|
$874.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
761T2269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$262.20 |
| Max. Negotiated Rate |
$839.04 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$681.72
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$725.42
|
| Rate for Payer: First Health Commercial |
$830.30
|
| Rate for Payer: Humana Commercial |
$742.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$716.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$645.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$262.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$769.12
|
| Rate for Payer: Ohio Health Group HMO |
$655.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$699.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$760.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$603.06
|
| Rate for Payer: PHCS Commercial |
$839.04
|
| Rate for Payer: United Healthcare All Payer |
$769.12
|
|
|
BIOPSY OF THYROID(T
|
Facility
|
OP
|
$874.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
761T2269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$300.57 |
| Max. Negotiated Rate |
$910.14 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: Anthem Medicaid |
$300.57
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$650.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$681.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$910.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$877.63
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cash Price |
$437.00
|
| Rate for Payer: Cigna Commercial |
$725.42
|
| Rate for Payer: First Health Commercial |
$830.30
|
| Rate for Payer: Humana Commercial |
$742.90
|
| Rate for Payer: Humana KY Medicaid |
$300.57
|
| Rate for Payer: Humana Medicare Advantage |
$650.10
|
| Rate for Payer: Kentucky WC Medicaid |
$303.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$716.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$645.01
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$306.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$769.12
|
| Rate for Payer: Ohio Health Group HMO |
$655.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$699.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$760.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$603.06
|
| Rate for Payer: PHCS Commercial |
$839.04
|
| Rate for Payer: United Healthcare All Payer |
$769.12
|
|
|
BIOPSY OF TONGUE
|
Professional
|
Both
|
$4,052.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
76101652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.74 |
| Max. Negotiated Rate |
$2,431.20 |
| Rate for Payer: Aetna Commercial |
$159.28
|
| Rate for Payer: Ambetter Exchange |
$103.66
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$75.25
|
| Rate for Payer: Anthem Medicaid |
$70.74
|
| Rate for Payer: Buckeye Individual/Medicaid |
$103.66
|
| Rate for Payer: Buckeye Medicare Advantage |
$103.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$124.39
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cigna Commercial |
$220.40
|
| Rate for Payer: Healthspan PPO |
$194.36
|
| Rate for Payer: Humana Medicaid |
$70.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$143.17
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$103.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$103.66
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$72.15
|
| Rate for Payer: Molina Healthcare Passport |
$70.74
|
| Rate for Payer: Multiplan PHCS |
$2,431.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$134.76
|
| Rate for Payer: UHCCP Medicaid |
$79.01
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$71.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.66
|
|
|
BIOPSY OF TONGUE
|
Facility
|
IP
|
$4,052.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
76101652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,215.60 |
| Max. Negotiated Rate |
$3,889.92 |
| Rate for Payer: Aetna Commercial |
$3,120.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,160.56
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cigna Commercial |
$3,363.16
|
| Rate for Payer: First Health Commercial |
$3,849.40
|
| Rate for Payer: Humana Commercial |
$3,444.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,322.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,990.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,215.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,565.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,039.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,241.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,525.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,795.88
|
| Rate for Payer: PHCS Commercial |
$3,889.92
|
| Rate for Payer: United Healthcare All Payer |
$3,565.76
|
|
|
BIOPSY OF TONGUE
|
Facility
|
OP
|
$4,052.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
76101652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,393.48 |
| Max. Negotiated Rate |
$4,195.14 |
| Rate for Payer: Aetna Commercial |
$3,120.04
|
| Rate for Payer: Anthem Medicaid |
$1,393.48
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,996.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,160.56
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,195.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,045.32
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cash Price |
$2,026.00
|
| Rate for Payer: Cigna Commercial |
$3,363.16
|
| Rate for Payer: First Health Commercial |
$3,849.40
|
| Rate for Payer: Humana Commercial |
$3,444.20
|
| Rate for Payer: Humana KY Medicaid |
$1,393.48
|
| Rate for Payer: Humana Medicare Advantage |
$2,996.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,407.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,322.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,990.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,595.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,421.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,565.76
|
| Rate for Payer: Ohio Health Group HMO |
$3,039.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,241.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,525.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,795.88
|
| Rate for Payer: PHCS Commercial |
$3,889.92
|
| Rate for Payer: United Healthcare All Payer |
$3,565.76
|
|
|
BIOPSY OF TONGUE(P
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
761P1652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.74 |
| Max. Negotiated Rate |
$220.40 |
| Rate for Payer: Aetna Commercial |
$159.28
|
| Rate for Payer: Ambetter Exchange |
$103.66
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$75.25
|
| Rate for Payer: Anthem Medicaid |
$70.74
|
| Rate for Payer: Buckeye Individual/Medicaid |
$103.66
|
| Rate for Payer: Buckeye Medicare Advantage |
$103.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$124.39
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$220.40
|
| Rate for Payer: Healthspan PPO |
$194.36
|
| Rate for Payer: Humana Medicaid |
$70.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$143.17
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$103.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$103.66
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$72.15
|
| Rate for Payer: Molina Healthcare Passport |
$70.74
|
| Rate for Payer: Multiplan PHCS |
$180.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$134.76
|
| Rate for Payer: UHCCP Medicaid |
$79.01
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$71.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.66
|
|
|
BIOPSY OF TONGUE(T
|
Facility
|
IP
|
$3,752.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
761T1652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,125.60 |
| Max. Negotiated Rate |
$3,601.92 |
| Rate for Payer: Aetna Commercial |
$2,889.04
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,926.56
|
| Rate for Payer: Cash Price |
$1,876.00
|
| Rate for Payer: Cigna Commercial |
$3,114.16
|
| Rate for Payer: First Health Commercial |
$3,564.40
|
| Rate for Payer: Humana Commercial |
$3,189.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,076.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,768.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,125.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,301.76
|
| Rate for Payer: Ohio Health Group HMO |
$2,814.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,001.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,264.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,588.88
|
| Rate for Payer: PHCS Commercial |
$3,601.92
|
| Rate for Payer: United Healthcare All Payer |
$3,301.76
|
|
|
BIOPSY OF TONGUE(T
|
Facility
|
OP
|
$3,752.00
|
|
|
Service Code
|
HCPCS 41105
|
| Hospital Charge Code |
761T1652
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,290.31 |
| Max. Negotiated Rate |
$4,195.14 |
| Rate for Payer: Aetna Commercial |
$2,889.04
|
| Rate for Payer: Anthem Medicaid |
$1,290.31
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,996.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,926.56
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,195.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,045.32
|
| Rate for Payer: Cash Price |
$1,876.00
|
| Rate for Payer: Cash Price |
$1,876.00
|
| Rate for Payer: Cigna Commercial |
$3,114.16
|
| Rate for Payer: First Health Commercial |
$3,564.40
|
| Rate for Payer: Humana Commercial |
$3,189.20
|
| Rate for Payer: Humana KY Medicaid |
$1,290.31
|
| Rate for Payer: Humana Medicare Advantage |
$2,996.53
|
| Rate for Payer: Kentucky WC Medicaid |
$1,303.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,076.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,768.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,595.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,316.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,301.76
|
| Rate for Payer: Ohio Health Group HMO |
$2,814.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,001.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,264.24
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,588.88
|
| Rate for Payer: PHCS Commercial |
$3,601.92
|
| Rate for Payer: United Healthcare All Payer |
$3,301.76
|
|
|
BIOPSY OF UTERUS LINING
|
Professional
|
Both
|
$832.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
76102207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.94 |
| Max. Negotiated Rate |
$499.20 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Ambetter Exchange |
$59.97
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$59.98
|
| Rate for Payer: Anthem Medicaid |
$41.94
|
| Rate for Payer: Buckeye Individual/Medicaid |
$59.97
|
| Rate for Payer: Buckeye Medicare Advantage |
$59.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$71.96
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cigna Commercial |
$165.93
|
| Rate for Payer: Healthspan PPO |
$160.12
|
| Rate for Payer: Humana Medicaid |
$41.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$114.37
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$59.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$59.97
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$42.78
|
| Rate for Payer: Molina Healthcare Passport |
$41.94
|
| Rate for Payer: Multiplan PHCS |
$499.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$77.96
|
| Rate for Payer: UHCCP Medicaid |
$62.98
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$42.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$59.97
|
|
|
BIOPSY OF UTERUS LINING
|
Facility
|
OP
|
$832.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
76102207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.88 |
| Max. Negotiated Rate |
$798.72 |
| Rate for Payer: Aetna Commercial |
$640.64
|
| Rate for Payer: Anthem Medicaid |
$286.12
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$185.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$648.96
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$260.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$250.94
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cigna Commercial |
$690.56
|
| Rate for Payer: First Health Commercial |
$790.40
|
| Rate for Payer: Humana Commercial |
$707.20
|
| Rate for Payer: Humana KY Medicaid |
$286.12
|
| Rate for Payer: Humana Medicare Advantage |
$185.88
|
| Rate for Payer: Kentucky WC Medicaid |
$289.04
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$682.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$614.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$223.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$291.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$732.16
|
| Rate for Payer: Ohio Health Group HMO |
$624.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$665.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$723.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$574.08
|
| Rate for Payer: PHCS Commercial |
$798.72
|
| Rate for Payer: United Healthcare All Payer |
$732.16
|
|
|
BIOPSY OF UTERUS LINING
|
Facility
|
IP
|
$832.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
76102207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$249.60 |
| Max. Negotiated Rate |
$798.72 |
| Rate for Payer: Aetna Commercial |
$640.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$648.96
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cigna Commercial |
$690.56
|
| Rate for Payer: First Health Commercial |
$790.40
|
| Rate for Payer: Humana Commercial |
$707.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$682.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$614.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$249.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$732.16
|
| Rate for Payer: Ohio Health Group HMO |
$624.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$665.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$723.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$574.08
|
| Rate for Payer: PHCS Commercial |
$798.72
|
| Rate for Payer: United Healthcare All Payer |
$732.16
|
|
|
BIOPSY OF UTERUS LINING(P
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
761P2207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.94 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Ambetter Exchange |
$59.97
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$59.98
|
| Rate for Payer: Anthem Medicaid |
$41.94
|
| Rate for Payer: Buckeye Individual/Medicaid |
$59.97
|
| Rate for Payer: Buckeye Medicare Advantage |
$59.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$71.96
|
| Rate for Payer: Cash Price |
$212.50
|
| Rate for Payer: Cash Price |
$212.50
|
| Rate for Payer: Cigna Commercial |
$165.93
|
| Rate for Payer: Healthspan PPO |
$160.12
|
| Rate for Payer: Humana Medicaid |
$41.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$114.37
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$59.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$59.97
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$42.78
|
| Rate for Payer: Molina Healthcare Passport |
$41.94
|
| Rate for Payer: Multiplan PHCS |
$255.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$77.96
|
| Rate for Payer: UHCCP Medicaid |
$62.98
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$42.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$59.97
|
|
|
BIOPSY OF UTERUS LINING(T
|
Facility
|
IP
|
$407.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
761T2207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.10 |
| Max. Negotiated Rate |
$390.72 |
| Rate for Payer: Aetna Commercial |
$313.39
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$317.46
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cigna Commercial |
$337.81
|
| Rate for Payer: First Health Commercial |
$386.65
|
| Rate for Payer: Humana Commercial |
$345.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$333.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$300.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$122.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$358.16
|
| Rate for Payer: Ohio Health Group HMO |
$305.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$325.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$354.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$280.83
|
| Rate for Payer: PHCS Commercial |
$390.72
|
| Rate for Payer: United Healthcare All Payer |
$358.16
|
|
|
BIOPSY OF UTERUS LINING(T
|
Facility
|
OP
|
$407.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
761T2207
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.97 |
| Max. Negotiated Rate |
$390.72 |
| Rate for Payer: Aetna Commercial |
$313.39
|
| Rate for Payer: Anthem Medicaid |
$139.97
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$185.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$317.46
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$260.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$250.94
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cash Price |
$203.50
|
| Rate for Payer: Cigna Commercial |
$337.81
|
| Rate for Payer: First Health Commercial |
$386.65
|
| Rate for Payer: Humana Commercial |
$345.95
|
| Rate for Payer: Humana KY Medicaid |
$139.97
|
| Rate for Payer: Humana Medicare Advantage |
$185.88
|
| Rate for Payer: Kentucky WC Medicaid |
$141.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$333.74
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$300.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$223.06
|
| Rate for Payer: Molina Healthcare Medicaid |
$142.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$358.16
|
| Rate for Payer: Ohio Health Group HMO |
$305.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$325.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$354.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$280.83
|
| Rate for Payer: PHCS Commercial |
$390.72
|
| Rate for Payer: United Healthcare All Payer |
$358.16
|
|
|
BIOPSY OF VAGINA
|
Professional
|
Both
|
$5,109.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
76102171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.84 |
| Max. Negotiated Rate |
$3,065.96 |
| Rate for Payer: Aetna Commercial |
$186.27
|
| Rate for Payer: Ambetter Exchange |
$136.36
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$92.84
|
| Rate for Payer: Anthem Medicaid |
$98.25
|
| Rate for Payer: Buckeye Individual/Medicaid |
$136.36
|
| Rate for Payer: Buckeye Medicare Advantage |
$136.36
|
| Rate for Payer: CareSource Just4Me Medicare |
$163.63
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cigna Commercial |
$184.14
|
| Rate for Payer: Healthspan PPO |
$194.88
|
| Rate for Payer: Humana Medicaid |
$98.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$160.51
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$136.36
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$136.36
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$100.22
|
| Rate for Payer: Molina Healthcare Passport |
$98.25
|
| Rate for Payer: Multiplan PHCS |
$3,065.96
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$177.27
|
| Rate for Payer: UHCCP Medicaid |
$97.48
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$99.23
|
| Rate for Payer: Wellcare Medicare Advantage |
$136.36
|
|
|
BIOPSY OF VAGINA
|
Facility
|
OP
|
$5,109.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
76102171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,757.30 |
| Max. Negotiated Rate |
$4,905.53 |
| Rate for Payer: Aetna Commercial |
$3,934.65
|
| Rate for Payer: Anthem Medicaid |
$1,757.30
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,937.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,985.75
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,112.95
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,966.06
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cigna Commercial |
$4,241.24
|
| Rate for Payer: First Health Commercial |
$4,854.43
|
| Rate for Payer: Humana Commercial |
$4,343.44
|
| Rate for Payer: Humana KY Medicaid |
$1,757.30
|
| Rate for Payer: Humana Medicare Advantage |
$2,937.82
|
| Rate for Payer: Kentucky WC Medicaid |
$1,775.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,190.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,771.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,525.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,792.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,496.74
|
| Rate for Payer: Ohio Health Group HMO |
$3,832.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,087.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,445.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,525.85
|
| Rate for Payer: PHCS Commercial |
$4,905.53
|
| Rate for Payer: United Healthcare All Payer |
$4,496.74
|
|
|
BIOPSY OF VAGINA
|
Professional
|
Both
|
$2,498.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
76102170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$1,499.22 |
| Rate for Payer: Aetna Commercial |
$101.19
|
| Rate for Payer: Ambetter Exchange |
$62.30
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$39.53
|
| Rate for Payer: Anthem Medicaid |
$48.25
|
| Rate for Payer: Buckeye Individual/Medicaid |
$62.30
|
| Rate for Payer: Buckeye Medicare Advantage |
$62.30
|
| Rate for Payer: CareSource Just4Me Medicare |
$74.76
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cigna Commercial |
$132.42
|
| Rate for Payer: Healthspan PPO |
$128.03
|
| Rate for Payer: Humana Medicaid |
$48.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$85.62
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$62.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$62.30
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$49.22
|
| Rate for Payer: Molina Healthcare Passport |
$48.25
|
| Rate for Payer: Multiplan PHCS |
$1,499.22
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$80.99
|
| Rate for Payer: UHCCP Medicaid |
$41.51
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$48.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$62.30
|
|
|
BIOPSY OF VAGINA
|
Facility
|
IP
|
$2,498.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
76102170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$749.61 |
| Max. Negotiated Rate |
$2,398.75 |
| Rate for Payer: Aetna Commercial |
$1,924.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,948.99
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cigna Commercial |
$2,073.92
|
| Rate for Payer: First Health Commercial |
$2,373.76
|
| Rate for Payer: Humana Commercial |
$2,123.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,048.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,844.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$749.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,198.86
|
| Rate for Payer: Ohio Health Group HMO |
$1,874.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,998.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,173.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,724.10
|
| Rate for Payer: PHCS Commercial |
$2,398.75
|
| Rate for Payer: United Healthcare All Payer |
$2,198.86
|
|
|
BIOPSY OF VAGINA
|
Facility
|
IP
|
$5,109.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
76102171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,532.98 |
| Max. Negotiated Rate |
$4,905.53 |
| Rate for Payer: Aetna Commercial |
$3,934.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,985.75
|
| Rate for Payer: Cash Price |
$2,554.97
|
| Rate for Payer: Cigna Commercial |
$4,241.24
|
| Rate for Payer: First Health Commercial |
$4,854.43
|
| Rate for Payer: Humana Commercial |
$4,343.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,190.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,771.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,532.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,496.74
|
| Rate for Payer: Ohio Health Group HMO |
$3,832.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,087.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,445.64
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,525.85
|
| Rate for Payer: PHCS Commercial |
$4,905.53
|
| Rate for Payer: United Healthcare All Payer |
$4,496.74
|
|
|
BIOPSY OF VAGINA
|
Facility
|
OP
|
$2,498.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
76102170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$804.55 |
| Max. Negotiated Rate |
$2,398.75 |
| Rate for Payer: Aetna Commercial |
$1,924.00
|
| Rate for Payer: Anthem Medicaid |
$859.30
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$804.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,948.99
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,126.37
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,086.14
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cash Price |
$1,249.35
|
| Rate for Payer: Cigna Commercial |
$2,073.92
|
| Rate for Payer: First Health Commercial |
$2,373.76
|
| Rate for Payer: Humana Commercial |
$2,123.89
|
| Rate for Payer: Humana KY Medicaid |
$859.30
|
| Rate for Payer: Humana Medicare Advantage |
$804.55
|
| Rate for Payer: Kentucky WC Medicaid |
$868.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,048.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,844.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$965.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$876.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,198.86
|
| Rate for Payer: Ohio Health Group HMO |
$1,874.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,998.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,173.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,724.10
|
| Rate for Payer: PHCS Commercial |
$2,398.75
|
| Rate for Payer: United Healthcare All Payer |
$2,198.86
|
|
