|
BIOPSY OF VAGINA(P
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
761P2171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.84 |
| Max. Negotiated Rate |
$303.00 |
| 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 |
$252.50
|
| Rate for Payer: Cash Price |
$252.50
|
| 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 |
$303.00
|
| 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(P
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
761P2170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$132.42 |
| 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 |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| 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 |
$120.00
|
| 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(T
|
Facility
|
IP
|
$2,298.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
761T2170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$689.61 |
| Max. Negotiated Rate |
$2,206.75 |
| Rate for Payer: Aetna Commercial |
$1,770.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,792.99
|
| Rate for Payer: Cash Price |
$1,149.35
|
| Rate for Payer: Cigna Commercial |
$1,907.92
|
| Rate for Payer: First Health Commercial |
$2,183.76
|
| Rate for Payer: Humana Commercial |
$1,953.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,884.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,696.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$689.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,022.86
|
| Rate for Payer: Ohio Health Group HMO |
$1,724.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,838.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,999.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,586.10
|
| Rate for Payer: PHCS Commercial |
$2,206.75
|
| Rate for Payer: United Healthcare All Payer |
$2,022.86
|
|
|
BIOPSY OF VAGINA(T
|
Facility
|
OP
|
$2,298.70
|
|
|
Service Code
|
HCPCS 57100
|
| Hospital Charge Code |
761T2170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$790.52 |
| Max. Negotiated Rate |
$2,206.75 |
| Rate for Payer: Aetna Commercial |
$1,770.00
|
| Rate for Payer: Anthem Medicaid |
$790.52
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$804.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,792.99
|
| 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 |
$1,149.35
|
| Rate for Payer: Cash Price |
$1,149.35
|
| Rate for Payer: Cigna Commercial |
$1,907.92
|
| Rate for Payer: First Health Commercial |
$2,183.76
|
| Rate for Payer: Humana Commercial |
$1,953.89
|
| Rate for Payer: Humana KY Medicaid |
$790.52
|
| Rate for Payer: Humana Medicare Advantage |
$804.55
|
| Rate for Payer: Kentucky WC Medicaid |
$798.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,884.93
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,696.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$965.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$806.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,022.86
|
| Rate for Payer: Ohio Health Group HMO |
$1,724.03
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,838.96
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,999.87
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,586.10
|
| Rate for Payer: PHCS Commercial |
$2,206.75
|
| Rate for Payer: United Healthcare All Payer |
$2,022.86
|
|
|
BIOPSY OF VAGINA(T
|
Facility
|
OP
|
$4,604.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
761T2171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,583.64 |
| Max. Negotiated Rate |
$4,420.73 |
| Rate for Payer: Aetna Commercial |
$3,545.80
|
| Rate for Payer: Anthem Medicaid |
$1,583.64
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,937.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,591.85
|
| 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 |
$2,302.47
|
| Rate for Payer: Cash Price |
$2,302.47
|
| Rate for Payer: Cigna Commercial |
$3,822.09
|
| Rate for Payer: First Health Commercial |
$4,374.68
|
| Rate for Payer: Humana Commercial |
$3,914.19
|
| Rate for Payer: Humana KY Medicaid |
$1,583.64
|
| Rate for Payer: Humana Medicare Advantage |
$2,937.82
|
| Rate for Payer: Kentucky WC Medicaid |
$1,599.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,776.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,398.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,525.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,615.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,052.34
|
| Rate for Payer: Ohio Health Group HMO |
$3,453.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,683.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,006.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,177.40
|
| Rate for Payer: PHCS Commercial |
$4,420.73
|
| Rate for Payer: United Healthcare All Payer |
$4,052.34
|
|
|
BIOPSY OF VAGINA(T
|
Facility
|
IP
|
$4,604.93
|
|
|
Service Code
|
HCPCS 57105
|
| Hospital Charge Code |
761T2171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.48 |
| Max. Negotiated Rate |
$4,420.73 |
| Rate for Payer: Aetna Commercial |
$3,545.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,591.85
|
| Rate for Payer: Cash Price |
$2,302.47
|
| Rate for Payer: Cigna Commercial |
$3,822.09
|
| Rate for Payer: First Health Commercial |
$4,374.68
|
| Rate for Payer: Humana Commercial |
$3,914.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,776.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,398.44
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,381.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,052.34
|
| Rate for Payer: Ohio Health Group HMO |
$3,453.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,683.94
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,006.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,177.40
|
| Rate for Payer: PHCS Commercial |
$4,420.73
|
| Rate for Payer: United Healthcare All Payer |
$4,052.34
|
|
|
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION
|
Facility
|
OP
|
$1,126.37
|
|
|
Service Code
|
CPT 56605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$804.55 |
| Max. Negotiated Rate |
$1,126.37 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$804.55
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,126.37
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,086.14
|
| Rate for Payer: Humana Medicare Advantage |
$804.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$965.46
|
|
|
BIOPSY OF VULVA/PERINEUM
|
Facility
|
IP
|
$1,042.00
|
|
|
Service Code
|
HCPCS 56606
|
| Hospital Charge Code |
76102161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.60 |
| Max. Negotiated Rate |
$1,000.32 |
| Rate for Payer: Aetna Commercial |
$802.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$812.76
|
| Rate for Payer: Cash Price |
$521.00
|
| Rate for Payer: Cigna Commercial |
$864.86
|
| Rate for Payer: First Health Commercial |
$989.90
|
| Rate for Payer: Humana Commercial |
$885.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$854.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$769.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$312.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$916.96
|
| Rate for Payer: Ohio Health Group HMO |
$781.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$833.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$906.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$718.98
|
| Rate for Payer: PHCS Commercial |
$1,000.32
|
| Rate for Payer: United Healthcare All Payer |
$916.96
|
|
|
BIOPSY OF VULVA/PERINEUM
|
Facility
|
OP
|
$1,042.00
|
|
|
Service Code
|
HCPCS 56606
|
| Hospital Charge Code |
76102161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.60 |
| Max. Negotiated Rate |
$1,000.32 |
| Rate for Payer: Aetna Commercial |
$802.34
|
| Rate for Payer: Anthem Medicaid |
$358.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$812.76
|
| Rate for Payer: Cash Price |
$521.00
|
| Rate for Payer: Cigna Commercial |
$864.86
|
| Rate for Payer: First Health Commercial |
$989.90
|
| Rate for Payer: Humana Commercial |
$885.70
|
| Rate for Payer: Humana KY Medicaid |
$358.34
|
| Rate for Payer: Kentucky WC Medicaid |
$361.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$854.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$769.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$312.60
|
| Rate for Payer: Molina Healthcare Medicaid |
$365.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$916.96
|
| Rate for Payer: Ohio Health Group HMO |
$781.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$833.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$906.54
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$718.98
|
| Rate for Payer: PHCS Commercial |
$1,000.32
|
| Rate for Payer: United Healthcare All Payer |
$916.96
|
|
|
BIOPSY OF VULVA/PERINEUM
|
Professional
|
Both
|
$1,042.00
|
|
|
Service Code
|
HCPCS 56606
|
| Hospital Charge Code |
76102161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$625.20 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Ambetter Exchange |
$27.24
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$20.24
|
| Rate for Payer: Anthem Medicaid |
$23.95
|
| Rate for Payer: Buckeye Individual/Medicaid |
$27.24
|
| Rate for Payer: Buckeye Medicare Advantage |
$27.24
|
| Rate for Payer: CareSource Just4Me Medicare |
$32.69
|
| Rate for Payer: Cash Price |
$521.00
|
| Rate for Payer: Cash Price |
$521.00
|
| Rate for Payer: Cigna Commercial |
$59.78
|
| Rate for Payer: Healthspan PPO |
$56.30
|
| Rate for Payer: Humana Medicaid |
$23.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$38.12
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$27.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$27.24
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$24.43
|
| Rate for Payer: Molina Healthcare Passport |
$23.95
|
| Rate for Payer: Multiplan PHCS |
$625.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$35.41
|
| Rate for Payer: UHCCP Medicaid |
$21.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$24.19
|
| Rate for Payer: Wellcare Medicare Advantage |
$27.24
|
|
|
BIOPSY OF VULVA/PERINEUM1LE(P
|
Professional
|
Both
|
$345.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
761P2160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.31 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$93.63
|
| Rate for Payer: Ambetter Exchange |
$56.00
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$30.31
|
| Rate for Payer: Anthem Medicaid |
$47.12
|
| Rate for Payer: Buckeye Individual/Medicaid |
$56.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$56.00
|
| Rate for Payer: CareSource Just4Me Medicare |
$67.20
|
| Rate for Payer: Cash Price |
$172.50
|
| Rate for Payer: Cash Price |
$172.50
|
| Rate for Payer: Cigna Commercial |
$125.81
|
| Rate for Payer: Healthspan PPO |
$120.71
|
| Rate for Payer: Humana Medicaid |
$47.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$78.97
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$56.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$56.00
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$48.06
|
| Rate for Payer: Molina Healthcare Passport |
$47.12
|
| Rate for Payer: Multiplan PHCS |
$207.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$72.80
|
| Rate for Payer: UHCCP Medicaid |
$31.83
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$47.59
|
| Rate for Payer: Wellcare Medicare Advantage |
$56.00
|
|
|
BIOPSY OF VULVA/PERINEUM1LES
|
Facility
|
OP
|
$2,314.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
76102160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$795.78 |
| Max. Negotiated Rate |
$2,221.44 |
| Rate for Payer: Aetna Commercial |
$1,781.78
|
| Rate for Payer: Anthem Medicaid |
$795.78
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$804.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,804.92
|
| 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 |
$1,157.00
|
| Rate for Payer: Cash Price |
$1,157.00
|
| Rate for Payer: Cigna Commercial |
$1,920.62
|
| Rate for Payer: First Health Commercial |
$2,198.30
|
| Rate for Payer: Humana Commercial |
$1,966.90
|
| Rate for Payer: Humana KY Medicaid |
$795.78
|
| Rate for Payer: Humana Medicare Advantage |
$804.55
|
| Rate for Payer: Kentucky WC Medicaid |
$803.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,897.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,707.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$965.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$811.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,036.32
|
| Rate for Payer: Ohio Health Group HMO |
$1,735.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,851.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,013.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,596.66
|
| Rate for Payer: PHCS Commercial |
$2,221.44
|
| Rate for Payer: United Healthcare All Payer |
$2,036.32
|
|
|
BIOPSY OF VULVA/PERINEUM1LES
|
Facility
|
IP
|
$2,314.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
76102160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$694.20 |
| Max. Negotiated Rate |
$2,221.44 |
| Rate for Payer: Aetna Commercial |
$1,781.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,804.92
|
| Rate for Payer: Cash Price |
$1,157.00
|
| Rate for Payer: Cigna Commercial |
$1,920.62
|
| Rate for Payer: First Health Commercial |
$2,198.30
|
| Rate for Payer: Humana Commercial |
$1,966.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,897.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,707.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$694.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,036.32
|
| Rate for Payer: Ohio Health Group HMO |
$1,735.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,851.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,013.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,596.66
|
| Rate for Payer: PHCS Commercial |
$2,221.44
|
| Rate for Payer: United Healthcare All Payer |
$2,036.32
|
|
|
BIOPSY OF VULVA/PERINEUM1LES
|
Professional
|
Both
|
$2,314.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
76102160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.31 |
| Max. Negotiated Rate |
$1,388.40 |
| Rate for Payer: Aetna Commercial |
$93.63
|
| Rate for Payer: Ambetter Exchange |
$56.00
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$30.31
|
| Rate for Payer: Anthem Medicaid |
$47.12
|
| Rate for Payer: Buckeye Individual/Medicaid |
$56.00
|
| Rate for Payer: Buckeye Medicare Advantage |
$56.00
|
| Rate for Payer: CareSource Just4Me Medicare |
$67.20
|
| Rate for Payer: Cash Price |
$1,157.00
|
| Rate for Payer: Cash Price |
$1,157.00
|
| Rate for Payer: Cigna Commercial |
$125.81
|
| Rate for Payer: Healthspan PPO |
$120.71
|
| Rate for Payer: Humana Medicaid |
$47.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$78.97
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$56.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$56.00
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$48.06
|
| Rate for Payer: Molina Healthcare Passport |
$47.12
|
| Rate for Payer: Multiplan PHCS |
$1,388.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$72.80
|
| Rate for Payer: UHCCP Medicaid |
$31.83
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$47.59
|
| Rate for Payer: Wellcare Medicare Advantage |
$56.00
|
|
|
BIOPSY OF VULVA/PERINEUM1LE(T
|
Facility
|
IP
|
$1,969.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
761T2160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$590.70 |
| Max. Negotiated Rate |
$1,890.24 |
| Rate for Payer: Aetna Commercial |
$1,516.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,535.82
|
| Rate for Payer: Cash Price |
$984.50
|
| Rate for Payer: Cigna Commercial |
$1,634.27
|
| Rate for Payer: First Health Commercial |
$1,870.55
|
| Rate for Payer: Humana Commercial |
$1,673.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,614.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,453.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$590.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,732.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,476.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,575.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,713.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,358.61
|
| Rate for Payer: PHCS Commercial |
$1,890.24
|
| Rate for Payer: United Healthcare All Payer |
$1,732.72
|
|
|
BIOPSY OF VULVA/PERINEUM1LE(T
|
Facility
|
OP
|
$1,969.00
|
|
|
Service Code
|
HCPCS 56605
|
| Hospital Charge Code |
761T2160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$677.14 |
| Max. Negotiated Rate |
$1,890.24 |
| Rate for Payer: Aetna Commercial |
$1,516.13
|
| Rate for Payer: Anthem Medicaid |
$677.14
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$804.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,535.82
|
| 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 |
$984.50
|
| Rate for Payer: Cash Price |
$984.50
|
| Rate for Payer: Cigna Commercial |
$1,634.27
|
| Rate for Payer: First Health Commercial |
$1,870.55
|
| Rate for Payer: Humana Commercial |
$1,673.65
|
| Rate for Payer: Humana KY Medicaid |
$677.14
|
| Rate for Payer: Humana Medicare Advantage |
$804.55
|
| Rate for Payer: Kentucky WC Medicaid |
$684.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,614.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,453.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$965.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$690.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,732.72
|
| Rate for Payer: Ohio Health Group HMO |
$1,476.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,575.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,713.03
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,358.61
|
| Rate for Payer: PHCS Commercial |
$1,890.24
|
| Rate for Payer: United Healthcare All Payer |
$1,732.72
|
|
|
BIOPSY OF VULVA/PERINEUM(P
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 56606
|
| Hospital Charge Code |
761P2161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$59.78 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Ambetter Exchange |
$27.24
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$20.24
|
| Rate for Payer: Anthem Medicaid |
$23.95
|
| Rate for Payer: Buckeye Individual/Medicaid |
$27.24
|
| Rate for Payer: Buckeye Medicare Advantage |
$27.24
|
| Rate for Payer: CareSource Just4Me Medicare |
$32.69
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cash Price |
$37.50
|
| Rate for Payer: Cigna Commercial |
$59.78
|
| Rate for Payer: Healthspan PPO |
$56.30
|
| Rate for Payer: Humana Medicaid |
$23.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$38.12
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$27.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$27.24
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$24.43
|
| Rate for Payer: Molina Healthcare Passport |
$23.95
|
| Rate for Payer: Multiplan PHCS |
$45.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$35.41
|
| Rate for Payer: UHCCP Medicaid |
$21.25
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$24.19
|
| Rate for Payer: Wellcare Medicare Advantage |
$27.24
|
|
|
BIOPSY OF VULVA/PERINEUM(T
|
Facility
|
OP
|
$967.00
|
|
|
Service Code
|
HCPCS 56606
|
| Hospital Charge Code |
761T2161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$290.10 |
| Max. Negotiated Rate |
$928.32 |
| Rate for Payer: Aetna Commercial |
$744.59
|
| Rate for Payer: Anthem Medicaid |
$332.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$754.26
|
| Rate for Payer: Cash Price |
$483.50
|
| Rate for Payer: Cigna Commercial |
$802.61
|
| Rate for Payer: First Health Commercial |
$918.65
|
| Rate for Payer: Humana Commercial |
$821.95
|
| Rate for Payer: Humana KY Medicaid |
$332.55
|
| Rate for Payer: Kentucky WC Medicaid |
$335.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$792.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$713.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$290.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$339.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$850.96
|
| Rate for Payer: Ohio Health Group HMO |
$725.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$773.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$841.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$667.23
|
| Rate for Payer: PHCS Commercial |
$928.32
|
| Rate for Payer: United Healthcare All Payer |
$850.96
|
|
|
BIOPSY OF VULVA/PERINEUM(T
|
Facility
|
IP
|
$967.00
|
|
|
Service Code
|
HCPCS 56606
|
| Hospital Charge Code |
761T2161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$290.10 |
| Max. Negotiated Rate |
$928.32 |
| Rate for Payer: Aetna Commercial |
$744.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$754.26
|
| Rate for Payer: Cash Price |
$483.50
|
| Rate for Payer: Cigna Commercial |
$802.61
|
| Rate for Payer: First Health Commercial |
$918.65
|
| Rate for Payer: Humana Commercial |
$821.95
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$792.94
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$713.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$290.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$850.96
|
| Rate for Payer: Ohio Health Group HMO |
$725.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$773.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$841.29
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$667.23
|
| Rate for Payer: PHCS Commercial |
$928.32
|
| Rate for Payer: United Healthcare All Payer |
$850.96
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP AXILLARY NODE(S)
|
Facility
|
OP
|
$4,953.45
|
|
|
Service Code
|
CPT 38525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,538.18 |
| Max. Negotiated Rate |
$4,953.45 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,538.18
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,953.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,776.54
|
| Rate for Payer: Humana Medicare Advantage |
$3,538.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,245.82
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, INGUINOFEMORAL NODE(S)
|
Facility
|
OP
|
$4,953.45
|
|
|
Service Code
|
CPT 38531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,538.18 |
| Max. Negotiated Rate |
$4,953.45 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,538.18
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,953.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,776.54
|
| Rate for Payer: Humana Medicare Advantage |
$3,538.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,245.82
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, SUPERFICIAL
|
Facility
|
OP
|
$4,953.45
|
|
|
Service Code
|
CPT 38500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,538.18 |
| Max. Negotiated Rate |
$4,953.45 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$3,538.18
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$4,953.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$4,776.54
|
| Rate for Payer: Humana Medicare Advantage |
$3,538.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,245.82
|
|
|
BIOPSY OROPHARYNX
|
Facility
|
OP
|
$3,502.00
|
|
|
Service Code
|
HCPCS 42800
|
| Hospital Charge Code |
76101699
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,204.34 |
| Max. Negotiated Rate |
$3,361.92 |
| Rate for Payer: Aetna Commercial |
$2,696.54
|
| Rate for Payer: Anthem Medicaid |
$1,204.34
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,368.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,731.56
|
| 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 |
$1,751.00
|
| Rate for Payer: Cash Price |
$1,751.00
|
| Rate for Payer: Cigna Commercial |
$2,906.66
|
| Rate for Payer: First Health Commercial |
$3,326.90
|
| Rate for Payer: Humana Commercial |
$2,976.70
|
| Rate for Payer: Humana KY Medicaid |
$1,204.34
|
| Rate for Payer: Humana Medicare Advantage |
$1,368.67
|
| Rate for Payer: Kentucky WC Medicaid |
$1,216.59
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,871.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,584.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,642.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,228.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,081.76
|
| Rate for Payer: Ohio Health Group HMO |
$2,626.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,801.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,046.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,416.38
|
| Rate for Payer: PHCS Commercial |
$3,361.92
|
| Rate for Payer: United Healthcare All Payer |
$3,081.76
|
|
|
BIOPSY OROPHARYNX
|
Facility
|
IP
|
$3,502.00
|
|
|
Service Code
|
HCPCS 42800
|
| Hospital Charge Code |
76101699
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,050.60 |
| Max. Negotiated Rate |
$3,361.92 |
| Rate for Payer: Aetna Commercial |
$2,696.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,731.56
|
| Rate for Payer: Cash Price |
$1,751.00
|
| Rate for Payer: Cigna Commercial |
$2,906.66
|
| Rate for Payer: First Health Commercial |
$3,326.90
|
| Rate for Payer: Humana Commercial |
$2,976.70
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,871.64
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,584.48
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,050.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,081.76
|
| Rate for Payer: Ohio Health Group HMO |
$2,626.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,801.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,046.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,416.38
|
| Rate for Payer: PHCS Commercial |
$3,361.92
|
| Rate for Payer: United Healthcare All Payer |
$3,081.76
|
|
|
BIOPSY OROPHARYNX
|
Professional
|
Both
|
$3,502.00
|
|
|
Service Code
|
HCPCS 42800
|
| Hospital Charge Code |
76101699
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.11 |
| Max. Negotiated Rate |
$2,101.20 |
| Rate for Payer: Aetna Commercial |
$160.42
|
| Rate for Payer: Ambetter Exchange |
$110.47
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$67.03
|
| Rate for Payer: Anthem Medicaid |
$61.11
|
| Rate for Payer: Buckeye Individual/Medicaid |
$110.47
|
| Rate for Payer: Buckeye Medicare Advantage |
$110.47
|
| Rate for Payer: CareSource Just4Me Medicare |
$132.56
|
| Rate for Payer: Cash Price |
$1,751.00
|
| Rate for Payer: Cash Price |
$1,751.00
|
| Rate for Payer: Cigna Commercial |
$208.37
|
| Rate for Payer: Healthspan PPO |
$182.67
|
| Rate for Payer: Humana Medicaid |
$61.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$145.20
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$110.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$110.47
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$62.33
|
| Rate for Payer: Molina Healthcare Passport |
$61.11
|
| Rate for Payer: Multiplan PHCS |
$2,101.20
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$143.61
|
| Rate for Payer: UHCCP Medicaid |
$70.38
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$61.72
|
| Rate for Payer: Wellcare Medicare Advantage |
$110.47
|
|
