|
CATH 4FR VENOUS CENTRAL 12CM
|
Facility
|
IP
|
$475.50
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.82 |
| Max. Negotiated Rate |
$456.48 |
| Rate for Payer: Aetna Commercial |
$366.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$370.89
|
| Rate for Payer: Cash Price |
$237.75
|
| Rate for Payer: Cigna Commercial |
$394.66
|
| Rate for Payer: First Health Commercial |
$451.72
|
| Rate for Payer: Humana Commercial |
$404.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$389.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$350.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$142.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$418.44
|
| Rate for Payer: Ohio Health Group HMO |
$356.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$95.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61.82
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$147.40
|
| Rate for Payer: PHCS Commercial |
$456.48
|
| Rate for Payer: United Healthcare All Payer |
$418.44
|
|
|
CATH 4FR VENOUS CENTRAL 12CM
|
Facility
|
OP
|
$475.50
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.82 |
| Max. Negotiated Rate |
$456.48 |
| Rate for Payer: Anthem Medicaid |
$163.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$370.89
|
| Rate for Payer: Cash Price |
$237.75
|
| Rate for Payer: Cigna Commercial |
$394.66
|
| Rate for Payer: First Health Commercial |
$451.72
|
| Rate for Payer: Humana Commercial |
$404.18
|
| Rate for Payer: Humana KY Medicaid |
$163.52
|
| Rate for Payer: Kentucky WC Medicaid |
$165.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$389.91
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$350.92
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$142.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$166.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$418.44
|
| Rate for Payer: Ohio Health Group HMO |
$356.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$95.10
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61.82
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$147.40
|
| Rate for Payer: PHCS Commercial |
$456.48
|
| Rate for Payer: United Healthcare All Payer |
$418.44
|
| Rate for Payer: Aetna Commercial |
$366.14
|
|
|
CATH 5FR INFINITI IM 100CM
|
Facility
|
OP
|
$166.02
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.58 |
| Max. Negotiated Rate |
$159.38 |
| Rate for Payer: Aetna Commercial |
$127.84
|
| Rate for Payer: Anthem Medicaid |
$57.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$129.50
|
| Rate for Payer: Cash Price |
$83.01
|
| Rate for Payer: Cigna Commercial |
$137.80
|
| Rate for Payer: First Health Commercial |
$157.72
|
| Rate for Payer: Humana Commercial |
$141.12
|
| Rate for Payer: Humana KY Medicaid |
$57.09
|
| Rate for Payer: Kentucky WC Medicaid |
$57.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$136.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$122.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$49.81
|
| Rate for Payer: Molina Healthcare Medicaid |
$58.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$146.10
|
| Rate for Payer: Ohio Health Group HMO |
$124.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$33.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51.47
|
| Rate for Payer: PHCS Commercial |
$159.38
|
| Rate for Payer: United Healthcare All Payer |
$146.10
|
|
|
CATH 5FR INFINITI IM 100CM
|
Facility
|
IP
|
$166.02
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.58 |
| Max. Negotiated Rate |
$159.38 |
| Rate for Payer: Aetna Commercial |
$127.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$129.50
|
| Rate for Payer: Cash Price |
$83.01
|
| Rate for Payer: Cigna Commercial |
$137.80
|
| Rate for Payer: First Health Commercial |
$157.72
|
| Rate for Payer: Humana Commercial |
$141.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$136.14
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$122.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$49.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$146.10
|
| Rate for Payer: Ohio Health Group HMO |
$124.52
|
| Rate for Payer: Ohio Health Group PPO Differential |
$33.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51.47
|
| Rate for Payer: PHCS Commercial |
$159.38
|
| Rate for Payer: United Healthcare All Payer |
$146.10
|
|
|
CATH 8FR SINGLE LUMEN GROSHONG
|
Facility
|
IP
|
$3,581.80
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$465.63 |
| Max. Negotiated Rate |
$3,438.53 |
| Rate for Payer: Aetna Commercial |
$2,757.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,793.80
|
| Rate for Payer: Cash Price |
$1,790.90
|
| Rate for Payer: Cigna Commercial |
$2,972.89
|
| Rate for Payer: First Health Commercial |
$3,402.71
|
| Rate for Payer: Humana Commercial |
$3,044.53
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,937.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,643.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,074.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,151.98
|
| Rate for Payer: Ohio Health Group HMO |
$2,686.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$716.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$465.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,110.36
|
| Rate for Payer: PHCS Commercial |
$3,438.53
|
| Rate for Payer: United Healthcare All Payer |
$3,151.98
|
|
|
CATH 8FR SINGLE LUMEN GROSHONG
|
Facility
|
OP
|
$3,581.80
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27000040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$465.63 |
| Max. Negotiated Rate |
$3,438.53 |
| Rate for Payer: Aetna Commercial |
$2,757.99
|
| Rate for Payer: Anthem Medicaid |
$1,231.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,793.80
|
| Rate for Payer: Cash Price |
$1,790.90
|
| Rate for Payer: Cigna Commercial |
$2,972.89
|
| Rate for Payer: First Health Commercial |
$3,402.71
|
| Rate for Payer: Humana Commercial |
$3,044.53
|
| Rate for Payer: Humana KY Medicaid |
$1,231.78
|
| Rate for Payer: Kentucky WC Medicaid |
$1,244.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,937.08
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,643.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,074.54
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,256.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,151.98
|
| Rate for Payer: Ohio Health Group HMO |
$2,686.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$716.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$465.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,110.36
|
| Rate for Payer: PHCS Commercial |
$3,438.53
|
| Rate for Payer: United Healthcare All Payer |
$3,151.98
|
|
|
CATH ABLT HALO 360+18MM
|
Facility
|
OP
|
$8,253.10
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,072.90 |
| Max. Negotiated Rate |
$7,922.98 |
| Rate for Payer: Aetna Commercial |
$6,354.89
|
| Rate for Payer: Anthem Medicaid |
$2,838.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,437.42
|
| Rate for Payer: Cash Price |
$4,126.55
|
| Rate for Payer: Cigna Commercial |
$6,850.07
|
| Rate for Payer: First Health Commercial |
$7,840.44
|
| Rate for Payer: Humana Commercial |
$7,015.14
|
| Rate for Payer: Humana KY Medicaid |
$2,838.24
|
| Rate for Payer: Kentucky WC Medicaid |
$2,867.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,767.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,090.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,475.93
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,895.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,262.73
|
| Rate for Payer: Ohio Health Group HMO |
$6,189.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,650.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,558.46
|
| Rate for Payer: PHCS Commercial |
$7,922.98
|
| Rate for Payer: United Healthcare All Payer |
$7,262.73
|
|
|
CATH ABLT HALO 360+18MM
|
Facility
|
IP
|
$8,253.10
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,072.90 |
| Max. Negotiated Rate |
$7,922.98 |
| Rate for Payer: Aetna Commercial |
$6,354.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,437.42
|
| Rate for Payer: Cash Price |
$4,126.55
|
| Rate for Payer: Cigna Commercial |
$6,850.07
|
| Rate for Payer: First Health Commercial |
$7,840.44
|
| Rate for Payer: Humana Commercial |
$7,015.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,767.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,090.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,475.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,262.73
|
| Rate for Payer: Ohio Health Group HMO |
$6,189.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,650.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,558.46
|
| Rate for Payer: PHCS Commercial |
$7,922.98
|
| Rate for Payer: United Healthcare All Payer |
$7,262.73
|
|
|
CATH ABLT HALO 360+22MM
|
Facility
|
IP
|
$9,698.50
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,260.80 |
| Max. Negotiated Rate |
$9,310.56 |
| Rate for Payer: Aetna Commercial |
$7,467.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,564.83
|
| Rate for Payer: Cash Price |
$4,849.25
|
| Rate for Payer: Cigna Commercial |
$8,049.76
|
| Rate for Payer: First Health Commercial |
$9,213.58
|
| Rate for Payer: Humana Commercial |
$8,243.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,952.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,157.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,909.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,534.68
|
| Rate for Payer: Ohio Health Group HMO |
$7,273.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,939.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,260.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,006.54
|
| Rate for Payer: PHCS Commercial |
$9,310.56
|
| Rate for Payer: United Healthcare All Payer |
$8,534.68
|
|
|
CATH ABLT HALO 360+22MM
|
Facility
|
OP
|
$9,698.50
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,260.80 |
| Max. Negotiated Rate |
$9,310.56 |
| Rate for Payer: Aetna Commercial |
$7,467.84
|
| Rate for Payer: Anthem Medicaid |
$3,335.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,564.83
|
| Rate for Payer: Cash Price |
$4,849.25
|
| Rate for Payer: Cigna Commercial |
$8,049.76
|
| Rate for Payer: First Health Commercial |
$9,213.58
|
| Rate for Payer: Humana Commercial |
$8,243.72
|
| Rate for Payer: Humana KY Medicaid |
$3,335.31
|
| Rate for Payer: Kentucky WC Medicaid |
$3,369.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,952.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,157.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,909.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,402.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,534.68
|
| Rate for Payer: Ohio Health Group HMO |
$7,273.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,939.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,260.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,006.54
|
| Rate for Payer: PHCS Commercial |
$9,310.56
|
| Rate for Payer: United Healthcare All Payer |
$8,534.68
|
|
|
CATH ABLT HALO 360+25MM
|
Facility
|
OP
|
$8,253.10
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,072.90 |
| Max. Negotiated Rate |
$7,922.98 |
| Rate for Payer: Aetna Commercial |
$6,354.89
|
| Rate for Payer: Anthem Medicaid |
$2,838.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,437.42
|
| Rate for Payer: Cash Price |
$4,126.55
|
| Rate for Payer: Cigna Commercial |
$6,850.07
|
| Rate for Payer: First Health Commercial |
$7,840.44
|
| Rate for Payer: Humana Commercial |
$7,015.14
|
| Rate for Payer: Humana KY Medicaid |
$2,838.24
|
| Rate for Payer: Kentucky WC Medicaid |
$2,867.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,767.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,090.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,475.93
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,895.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,262.73
|
| Rate for Payer: Ohio Health Group HMO |
$6,189.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,650.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,558.46
|
| Rate for Payer: PHCS Commercial |
$7,922.98
|
| Rate for Payer: United Healthcare All Payer |
$7,262.73
|
|
|
CATH ABLT HALO 360+25MM
|
Facility
|
IP
|
$8,253.10
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,072.90 |
| Max. Negotiated Rate |
$7,922.98 |
| Rate for Payer: Aetna Commercial |
$6,354.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,437.42
|
| Rate for Payer: Cash Price |
$4,126.55
|
| Rate for Payer: Cigna Commercial |
$6,850.07
|
| Rate for Payer: First Health Commercial |
$7,840.44
|
| Rate for Payer: Humana Commercial |
$7,015.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,767.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,090.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,475.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,262.73
|
| Rate for Payer: Ohio Health Group HMO |
$6,189.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,650.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,558.46
|
| Rate for Payer: PHCS Commercial |
$7,922.98
|
| Rate for Payer: United Healthcare All Payer |
$7,262.73
|
|
|
CATH ABLT HALO 360+28MM
|
Facility
|
OP
|
$9,698.50
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,260.80 |
| Max. Negotiated Rate |
$9,310.56 |
| Rate for Payer: Aetna Commercial |
$7,467.84
|
| Rate for Payer: Anthem Medicaid |
$3,335.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,564.83
|
| Rate for Payer: Cash Price |
$4,849.25
|
| Rate for Payer: Cigna Commercial |
$8,049.76
|
| Rate for Payer: First Health Commercial |
$9,213.58
|
| Rate for Payer: Humana Commercial |
$8,243.72
|
| Rate for Payer: Humana KY Medicaid |
$3,335.31
|
| Rate for Payer: Kentucky WC Medicaid |
$3,369.26
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,952.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,157.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,909.55
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,402.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,534.68
|
| Rate for Payer: Ohio Health Group HMO |
$7,273.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,939.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,260.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,006.54
|
| Rate for Payer: PHCS Commercial |
$9,310.56
|
| Rate for Payer: United Healthcare All Payer |
$8,534.68
|
|
|
CATH ABLT HALO 360+28MM
|
Facility
|
IP
|
$9,698.50
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,260.80 |
| Max. Negotiated Rate |
$9,310.56 |
| Rate for Payer: Aetna Commercial |
$7,467.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,564.83
|
| Rate for Payer: Cash Price |
$4,849.25
|
| Rate for Payer: Cigna Commercial |
$8,049.76
|
| Rate for Payer: First Health Commercial |
$9,213.58
|
| Rate for Payer: Humana Commercial |
$8,243.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,952.77
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,157.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,909.55
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,534.68
|
| Rate for Payer: Ohio Health Group HMO |
$7,273.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,939.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,260.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,006.54
|
| Rate for Payer: PHCS Commercial |
$9,310.56
|
| Rate for Payer: United Healthcare All Payer |
$8,534.68
|
|
|
CATH ABLT HALO 360+31MM
|
Facility
|
OP
|
$8,253.10
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,072.90 |
| Max. Negotiated Rate |
$7,922.98 |
| Rate for Payer: Aetna Commercial |
$6,354.89
|
| Rate for Payer: Anthem Medicaid |
$2,838.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,437.42
|
| Rate for Payer: Cash Price |
$4,126.55
|
| Rate for Payer: Cigna Commercial |
$6,850.07
|
| Rate for Payer: First Health Commercial |
$7,840.44
|
| Rate for Payer: Humana Commercial |
$7,015.14
|
| Rate for Payer: Humana KY Medicaid |
$2,838.24
|
| Rate for Payer: Kentucky WC Medicaid |
$2,867.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,767.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,090.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,475.93
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,895.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,262.73
|
| Rate for Payer: Ohio Health Group HMO |
$6,189.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,650.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,558.46
|
| Rate for Payer: PHCS Commercial |
$7,922.98
|
| Rate for Payer: United Healthcare All Payer |
$7,262.73
|
|
|
CATH ABLT HALO 360+31MM
|
Facility
|
IP
|
$8,253.10
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,072.90 |
| Max. Negotiated Rate |
$7,922.98 |
| Rate for Payer: Aetna Commercial |
$6,354.89
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,437.42
|
| Rate for Payer: Cash Price |
$4,126.55
|
| Rate for Payer: Cigna Commercial |
$6,850.07
|
| Rate for Payer: First Health Commercial |
$7,840.44
|
| Rate for Payer: Humana Commercial |
$7,015.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,767.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,090.79
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,475.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,262.73
|
| Rate for Payer: Ohio Health Group HMO |
$6,189.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,650.62
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,072.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,558.46
|
| Rate for Payer: PHCS Commercial |
$7,922.98
|
| Rate for Payer: United Healthcare All Payer |
$7,262.73
|
|
|
CATH ABLT HALO60
|
Facility
|
IP
|
$8,216.60
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,068.16 |
| Max. Negotiated Rate |
$7,887.94 |
| Rate for Payer: Aetna Commercial |
$6,326.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,408.95
|
| Rate for Payer: Cash Price |
$4,108.30
|
| Rate for Payer: Cigna Commercial |
$6,819.78
|
| Rate for Payer: First Health Commercial |
$7,805.77
|
| Rate for Payer: Humana Commercial |
$6,984.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,737.61
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,063.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,464.98
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,230.61
|
| Rate for Payer: Ohio Health Group HMO |
$6,162.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,643.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,068.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,547.15
|
| Rate for Payer: PHCS Commercial |
$7,887.94
|
| Rate for Payer: United Healthcare All Payer |
$7,230.61
|
|
|
CATH ABLT HALO60
|
Facility
|
OP
|
$8,216.60
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,068.16 |
| Max. Negotiated Rate |
$7,887.94 |
| Rate for Payer: Aetna Commercial |
$6,326.78
|
| Rate for Payer: Anthem Medicaid |
$2,825.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,408.95
|
| Rate for Payer: Cash Price |
$4,108.30
|
| Rate for Payer: Cigna Commercial |
$6,819.78
|
| Rate for Payer: First Health Commercial |
$7,805.77
|
| Rate for Payer: Humana Commercial |
$6,984.11
|
| Rate for Payer: Humana KY Medicaid |
$2,825.69
|
| Rate for Payer: Kentucky WC Medicaid |
$2,854.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,737.61
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,063.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,464.98
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,882.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,230.61
|
| Rate for Payer: Ohio Health Group HMO |
$6,162.45
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,643.32
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,068.16
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,547.15
|
| Rate for Payer: PHCS Commercial |
$7,887.94
|
| Rate for Payer: United Healthcare All Payer |
$7,230.61
|
|
|
CATH ABLT HALO90
|
Facility
|
OP
|
$8,118.05
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,055.35 |
| Max. Negotiated Rate |
$7,793.33 |
| Rate for Payer: Aetna Commercial |
$6,250.90
|
| Rate for Payer: Anthem Medicaid |
$2,791.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,332.08
|
| Rate for Payer: Cash Price |
$4,059.02
|
| Rate for Payer: Cigna Commercial |
$6,737.98
|
| Rate for Payer: First Health Commercial |
$7,712.15
|
| Rate for Payer: Humana Commercial |
$6,900.34
|
| Rate for Payer: Humana KY Medicaid |
$2,791.80
|
| Rate for Payer: Kentucky WC Medicaid |
$2,820.21
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,656.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,991.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,435.42
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,847.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,143.88
|
| Rate for Payer: Ohio Health Group HMO |
$6,088.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,623.61
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,055.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,516.60
|
| Rate for Payer: PHCS Commercial |
$7,793.33
|
| Rate for Payer: United Healthcare All Payer |
$7,143.88
|
|
|
CATH ABLT HALO90
|
Facility
|
IP
|
$8,118.05
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27000010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,055.35 |
| Max. Negotiated Rate |
$7,793.33 |
| Rate for Payer: Aetna Commercial |
$6,250.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,332.08
|
| Rate for Payer: Cash Price |
$4,059.02
|
| Rate for Payer: Cigna Commercial |
$6,737.98
|
| Rate for Payer: First Health Commercial |
$7,712.15
|
| Rate for Payer: Humana Commercial |
$6,900.34
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,656.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,991.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,435.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,143.88
|
| Rate for Payer: Ohio Health Group HMO |
$6,088.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,623.61
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,055.35
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,516.60
|
| Rate for Payer: PHCS Commercial |
$7,793.33
|
| Rate for Payer: United Healthcare All Payer |
$7,143.88
|
|
|
CATH ABLT HALO90 ULTRA
|
Facility
|
OP
|
$10,603.65
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,378.47 |
| Max. Negotiated Rate |
$10,179.50 |
| Rate for Payer: Aetna Commercial |
$8,164.81
|
| Rate for Payer: Anthem Medicaid |
$3,646.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,270.85
|
| Rate for Payer: Cash Price |
$5,301.82
|
| Rate for Payer: Cigna Commercial |
$8,801.03
|
| Rate for Payer: First Health Commercial |
$10,073.47
|
| Rate for Payer: Humana Commercial |
$9,013.10
|
| Rate for Payer: Humana KY Medicaid |
$3,646.60
|
| Rate for Payer: Kentucky WC Medicaid |
$3,683.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,694.99
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,825.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,181.10
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,719.76
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,331.21
|
| Rate for Payer: Ohio Health Group HMO |
$7,952.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,120.73
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,378.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,287.13
|
| Rate for Payer: PHCS Commercial |
$10,179.50
|
| Rate for Payer: United Healthcare All Payer |
$9,331.21
|
|
|
CATH ABLT HALO90 ULTRA
|
Facility
|
IP
|
$10,603.65
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,378.47 |
| Max. Negotiated Rate |
$10,179.50 |
| Rate for Payer: Aetna Commercial |
$8,164.81
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$8,270.85
|
| Rate for Payer: Cash Price |
$5,301.82
|
| Rate for Payer: Cigna Commercial |
$8,801.03
|
| Rate for Payer: First Health Commercial |
$10,073.47
|
| Rate for Payer: Humana Commercial |
$9,013.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$8,694.99
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$7,825.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,181.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$9,331.21
|
| Rate for Payer: Ohio Health Group HMO |
$7,952.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,120.73
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,378.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,287.13
|
| Rate for Payer: PHCS Commercial |
$10,179.50
|
| Rate for Payer: United Healthcare All Payer |
$9,331.21
|
|
|
CATH ACUITY GUIDING 55CM/49CM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem Medicaid |
$7.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Humana KY Medicaid |
$7.91
|
| Rate for Payer: Kentucky WC Medicaid |
$7.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$8.07
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
CATH ACUITY GUIDING 55CM/49CM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27000243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$22.08 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17.94
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna Commercial |
$19.09
|
| Rate for Payer: First Health Commercial |
$21.85
|
| Rate for Payer: Humana Commercial |
$19.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18.86
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$20.24
|
| Rate for Payer: Ohio Health Group HMO |
$17.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2.99
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7.13
|
| Rate for Payer: PHCS Commercial |
$22.08
|
| Rate for Payer: United Healthcare All Payer |
$20.24
|
|
|
CATH ANGLED TAPER 5FR*100CM
|
Facility
|
OP
|
$1,129.50
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27000009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.84 |
| Max. Negotiated Rate |
$1,084.32 |
| Rate for Payer: Aetna Commercial |
$869.72
|
| Rate for Payer: Anthem Medicaid |
$388.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$881.01
|
| Rate for Payer: Cash Price |
$564.75
|
| Rate for Payer: Cigna Commercial |
$937.48
|
| Rate for Payer: First Health Commercial |
$1,073.02
|
| Rate for Payer: Humana Commercial |
$960.08
|
| Rate for Payer: Humana KY Medicaid |
$388.44
|
| Rate for Payer: Kentucky WC Medicaid |
$392.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$926.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$833.57
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$338.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$396.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$993.96
|
| Rate for Payer: Ohio Health Group HMO |
$847.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$225.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$146.84
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$350.14
|
| Rate for Payer: PHCS Commercial |
$1,084.32
|
| Rate for Payer: United Healthcare All Payer |
$993.96
|
|
