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Service Code HCPCS 32560
Hospital Charge Code 76101204
Hospital Revenue Code 761
Min. Negotiated Rate $367.12
Max. Negotiated Rate $2,711.04
Rate for Payer: Aetna Commercial $2,174.48
Rate for Payer: Anthem Medicaid $971.17
Rate for Payer: Anthem Medicare Advantage/PPO $543.24
Rate for Payer: Anthem POS/PPO/Traditional $2,202.72
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $760.54
Rate for Payer: CareSource Just4Me Medicare $733.37
Rate for Payer: Cash Price $1,412.00
Rate for Payer: Cash Price $1,412.00
Rate for Payer: Cigna Commercial $2,343.92
Rate for Payer: First Health Commercial $2,682.80
Rate for Payer: Humana Commercial $2,400.40
Rate for Payer: Humana KY Medicaid $971.17
Rate for Payer: Humana Medicare Advantage $543.24
Rate for Payer: Kentucky WC Medicaid $981.06
Rate for Payer: Medical Mutual Of Ohio HMO $2,315.68
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,084.11
Rate for Payer: Molina Healthcare Benefit Exchange $651.89
Rate for Payer: Molina Healthcare Medicaid $990.66
Rate for Payer: Ohio Health Choice Commercial $2,485.12
Rate for Payer: Ohio Health Group HMO $2,118.00
Rate for Payer: Ohio Health Group PPO Differential $564.80
Rate for Payer: Ohio Health Group PPO No Differential $367.12
Rate for Payer: Ohio Health Group PPO SOMC Employees $875.44
Rate for Payer: PHCS Commercial $2,711.04
Rate for Payer: United Healthcare All Payer $2,485.12
Service Code HCPCS 32560
Hospital Charge Code 76101204
Hospital Revenue Code 761
Min. Negotiated Rate $39.11
Max. Negotiated Rate $2,824.00
Rate for Payer: Aetna Commercial $191.82
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $39.11
Rate for Payer: Anthem Medicaid $89.01
Rate for Payer: Buckeye Medicare Advantage $2,824.00
Rate for Payer: Cash Price $1,412.00
Rate for Payer: Cash Price $1,412.00
Rate for Payer: Cigna Commercial $176.38
Rate for Payer: Healthspan PPO $362.35
Rate for Payer: Humana Medicaid $89.01
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $113.16
Rate for Payer: Molina Healthcare CHIP/Medicaid $90.79
Rate for Payer: Molina Healthcare Passport $89.01
Rate for Payer: Multiplan PHCS $1,694.40
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,976.80
Rate for Payer: UHCCP Medicaid $41.07
Rate for Payer: Wellcare CHIP/Medicaid $89.90
Service Code HCPCS 32560
Hospital Charge Code 76101204
Hospital Revenue Code 761
Min. Negotiated Rate $367.12
Max. Negotiated Rate $2,711.04
Rate for Payer: Aetna Commercial $2,174.48
Rate for Payer: Anthem POS/PPO/Traditional $2,202.72
Rate for Payer: Cash Price $1,412.00
Rate for Payer: Cigna Commercial $2,343.92
Rate for Payer: First Health Commercial $2,682.80
Rate for Payer: Humana Commercial $2,400.40
Rate for Payer: Medical Mutual Of Ohio HMO $2,315.68
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,084.11
Rate for Payer: Molina Healthcare Benefit Exchange $847.20
Rate for Payer: Ohio Health Choice Commercial $2,485.12
Rate for Payer: Ohio Health Group HMO $2,118.00
Rate for Payer: Ohio Health Group PPO Differential $564.80
Rate for Payer: Ohio Health Group PPO No Differential $367.12
Rate for Payer: Ohio Health Group PPO SOMC Employees $875.44
Rate for Payer: PHCS Commercial $2,711.04
Rate for Payer: United Healthcare All Payer $2,485.12
Service Code HCPCS 32560
Hospital Charge Code 761P1204
Hospital Revenue Code 761
Min. Negotiated Rate $39.11
Max. Negotiated Rate $750.00
Rate for Payer: Aetna Commercial $191.82
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $39.11
Rate for Payer: Anthem Medicaid $89.01
Rate for Payer: Buckeye Medicare Advantage $750.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Cigna Commercial $176.38
Rate for Payer: Healthspan PPO $362.35
Rate for Payer: Humana Medicaid $89.01
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $113.16
Rate for Payer: Molina Healthcare CHIP/Medicaid $90.79
Rate for Payer: Molina Healthcare Passport $89.01
Rate for Payer: Multiplan PHCS $450.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $525.00
Rate for Payer: UHCCP Medicaid $41.07
Rate for Payer: Wellcare CHIP/Medicaid $89.90
Service Code HCPCS 32560
Hospital Charge Code 761T1204
Hospital Revenue Code 761
Min. Negotiated Rate $269.62
Max. Negotiated Rate $1,991.04
Rate for Payer: Aetna Commercial $1,596.98
Rate for Payer: Anthem Medicaid $713.25
Rate for Payer: Anthem Medicare Advantage/PPO $543.24
Rate for Payer: Anthem POS/PPO/Traditional $1,617.72
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $760.54
Rate for Payer: CareSource Just4Me Medicare $733.37
Rate for Payer: Cash Price $1,037.00
Rate for Payer: Cash Price $1,037.00
Rate for Payer: Cigna Commercial $1,721.42
Rate for Payer: First Health Commercial $1,970.30
Rate for Payer: Humana Commercial $1,762.90
Rate for Payer: Humana KY Medicaid $713.25
Rate for Payer: Humana Medicare Advantage $543.24
Rate for Payer: Kentucky WC Medicaid $720.51
Rate for Payer: Medical Mutual Of Ohio HMO $1,700.68
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,530.61
Rate for Payer: Molina Healthcare Benefit Exchange $651.89
Rate for Payer: Molina Healthcare Medicaid $727.56
Rate for Payer: Ohio Health Choice Commercial $1,825.12
Rate for Payer: Ohio Health Group HMO $1,555.50
Rate for Payer: Ohio Health Group PPO Differential $414.80
Rate for Payer: Ohio Health Group PPO No Differential $269.62
Rate for Payer: Ohio Health Group PPO SOMC Employees $642.94
Rate for Payer: PHCS Commercial $1,991.04
Rate for Payer: United Healthcare All Payer $1,825.12
Service Code HCPCS 32560
Hospital Charge Code 761T1204
Hospital Revenue Code 761
Min. Negotiated Rate $269.62
Max. Negotiated Rate $1,991.04
Rate for Payer: Aetna Commercial $1,596.98
Rate for Payer: Anthem POS/PPO/Traditional $1,617.72
Rate for Payer: Cash Price $1,037.00
Rate for Payer: Cigna Commercial $1,721.42
Rate for Payer: First Health Commercial $1,970.30
Rate for Payer: Humana Commercial $1,762.90
Rate for Payer: Medical Mutual Of Ohio HMO $1,700.68
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,530.61
Rate for Payer: Molina Healthcare Benefit Exchange $622.20
Rate for Payer: Ohio Health Choice Commercial $1,825.12
Rate for Payer: Ohio Health Group HMO $1,555.50
Rate for Payer: Ohio Health Group PPO Differential $414.80
Rate for Payer: Ohio Health Group PPO No Differential $269.62
Rate for Payer: Ohio Health Group PPO SOMC Employees $642.94
Rate for Payer: PHCS Commercial $1,991.04
Rate for Payer: United Healthcare All Payer $1,825.12
Service Code HCPCS 96542
Hospital Charge Code 76102498
Hospital Revenue Code 761
Min. Negotiated Rate $92.82
Max. Negotiated Rate $685.44
Rate for Payer: Aetna Commercial $549.78
Rate for Payer: Anthem Medicaid $245.54
Rate for Payer: Anthem Medicare Advantage/PPO $292.86
Rate for Payer: Anthem POS/PPO/Traditional $556.92
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $410.00
Rate for Payer: CareSource Just4Me Medicare $395.36
Rate for Payer: Cash Price $357.00
Rate for Payer: Cash Price $357.00
Rate for Payer: Cigna Commercial $592.62
Rate for Payer: First Health Commercial $678.30
Rate for Payer: Humana Commercial $606.90
Rate for Payer: Humana KY Medicaid $245.54
Rate for Payer: Humana Medicare Advantage $292.86
Rate for Payer: Kentucky WC Medicaid $248.04
Rate for Payer: Medical Mutual Of Ohio HMO $585.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $526.93
Rate for Payer: Molina Healthcare Benefit Exchange $351.43
Rate for Payer: Molina Healthcare Medicaid $250.47
Rate for Payer: Ohio Health Choice Commercial $628.32
Rate for Payer: Ohio Health Group HMO $535.50
Rate for Payer: Ohio Health Group PPO Differential $142.80
Rate for Payer: Ohio Health Group PPO No Differential $92.82
Rate for Payer: Ohio Health Group PPO SOMC Employees $221.34
Rate for Payer: PHCS Commercial $685.44
Rate for Payer: United Healthcare All Payer $628.32
Service Code HCPCS 96542
Hospital Charge Code 76102498
Hospital Revenue Code 761
Min. Negotiated Rate $92.82
Max. Negotiated Rate $685.44
Rate for Payer: Aetna Commercial $549.78
Rate for Payer: Anthem POS/PPO/Traditional $556.92
Rate for Payer: Cash Price $357.00
Rate for Payer: Cigna Commercial $592.62
Rate for Payer: First Health Commercial $678.30
Rate for Payer: Humana Commercial $606.90
Rate for Payer: Medical Mutual Of Ohio HMO $585.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $526.93
Rate for Payer: Molina Healthcare Benefit Exchange $214.20
Rate for Payer: Ohio Health Choice Commercial $628.32
Rate for Payer: Ohio Health Group HMO $535.50
Rate for Payer: Ohio Health Group PPO Differential $142.80
Rate for Payer: Ohio Health Group PPO No Differential $92.82
Rate for Payer: Ohio Health Group PPO SOMC Employees $221.34
Rate for Payer: PHCS Commercial $685.44
Rate for Payer: United Healthcare All Payer $628.32
Service Code HCPCS 96542
Hospital Charge Code 76102498
Hospital Revenue Code 761
Min. Negotiated Rate $21.46
Max. Negotiated Rate $714.00
Rate for Payer: Aetna Commercial $71.83
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $21.46
Rate for Payer: Anthem Medicaid $43.14
Rate for Payer: Buckeye Medicare Advantage $714.00
Rate for Payer: Cash Price $357.00
Rate for Payer: Cash Price $357.00
Rate for Payer: Cigna Commercial $274.96
Rate for Payer: Healthspan PPO $190.68
Rate for Payer: Humana Medicaid $43.14
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $56.72
Rate for Payer: Molina Healthcare CHIP/Medicaid $44.00
Rate for Payer: Molina Healthcare Passport $43.14
Rate for Payer: Multiplan PHCS $428.40
Rate for Payer: Ohio Health Choice Preferred Health Choice $499.80
Rate for Payer: UHCCP Medicaid $22.53
Rate for Payer: Wellcare CHIP/Medicaid $43.57
Service Code HCPCS 96542
Hospital Charge Code 761P2498
Hospital Revenue Code 761
Min. Negotiated Rate $21.46
Max. Negotiated Rate $400.00
Rate for Payer: Aetna Commercial $71.83
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $21.46
Rate for Payer: Anthem Medicaid $43.14
Rate for Payer: Buckeye Medicare Advantage $400.00
Rate for Payer: Cash Price $200.00
Rate for Payer: Cash Price $200.00
Rate for Payer: Cigna Commercial $274.96
Rate for Payer: Healthspan PPO $190.68
Rate for Payer: Humana Medicaid $43.14
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $56.72
Rate for Payer: Molina Healthcare CHIP/Medicaid $44.00
Rate for Payer: Molina Healthcare Passport $43.14
Rate for Payer: Multiplan PHCS $240.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $280.00
Rate for Payer: UHCCP Medicaid $22.53
Rate for Payer: Wellcare CHIP/Medicaid $43.57
Service Code HCPCS 96542
Hospital Charge Code 761T2498
Hospital Revenue Code 761
Min. Negotiated Rate $40.82
Max. Negotiated Rate $410.00
Rate for Payer: Aetna Commercial $241.78
Rate for Payer: Anthem Medicaid $107.98
Rate for Payer: Anthem Medicare Advantage/PPO $292.86
Rate for Payer: Anthem POS/PPO/Traditional $244.92
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $410.00
Rate for Payer: CareSource Just4Me Medicare $395.36
Rate for Payer: Cash Price $157.00
Rate for Payer: Cash Price $157.00
Rate for Payer: Cigna Commercial $260.62
Rate for Payer: First Health Commercial $298.30
Rate for Payer: Humana Commercial $266.90
Rate for Payer: Humana KY Medicaid $107.98
Rate for Payer: Humana Medicare Advantage $292.86
Rate for Payer: Kentucky WC Medicaid $109.08
Rate for Payer: Medical Mutual Of Ohio HMO $257.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $231.73
Rate for Payer: Molina Healthcare Benefit Exchange $351.43
Rate for Payer: Molina Healthcare Medicaid $110.15
Rate for Payer: Ohio Health Choice Commercial $276.32
Rate for Payer: Ohio Health Group HMO $235.50
Rate for Payer: Ohio Health Group PPO Differential $62.80
Rate for Payer: Ohio Health Group PPO No Differential $40.82
Rate for Payer: Ohio Health Group PPO SOMC Employees $97.34
Rate for Payer: PHCS Commercial $301.44
Rate for Payer: United Healthcare All Payer $276.32
Service Code HCPCS 96542
Hospital Charge Code 761T2498
Hospital Revenue Code 761
Min. Negotiated Rate $40.82
Max. Negotiated Rate $301.44
Rate for Payer: Aetna Commercial $241.78
Rate for Payer: Anthem POS/PPO/Traditional $244.92
Rate for Payer: Cash Price $157.00
Rate for Payer: Cigna Commercial $260.62
Rate for Payer: First Health Commercial $298.30
Rate for Payer: Humana Commercial $266.90
Rate for Payer: Medical Mutual Of Ohio HMO $257.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $231.73
Rate for Payer: Molina Healthcare Benefit Exchange $94.20
Rate for Payer: Ohio Health Choice Commercial $276.32
Rate for Payer: Ohio Health Group HMO $235.50
Rate for Payer: Ohio Health Group PPO Differential $62.80
Rate for Payer: Ohio Health Group PPO No Differential $40.82
Rate for Payer: Ohio Health Group PPO SOMC Employees $97.34
Rate for Payer: PHCS Commercial $301.44
Rate for Payer: United Healthcare All Payer $276.32
Service Code HCPCS 64617
Hospital Charge Code 76102345
Hospital Revenue Code 761
Min. Negotiated Rate $87.04
Max. Negotiated Rate $1,275.00
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $87.04
Rate for Payer: Anthem Medicaid $90.89
Rate for Payer: Buckeye Medicare Advantage $1,275.00
Rate for Payer: Cash Price $637.50
Rate for Payer: Cash Price $637.50
Rate for Payer: Cigna Commercial $319.45
Rate for Payer: Healthspan PPO $250.28
Rate for Payer: Humana Medicaid $90.89
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $146.30
Rate for Payer: Molina Healthcare CHIP/Medicaid $92.71
Rate for Payer: Molina Healthcare Passport $90.89
Rate for Payer: Multiplan PHCS $765.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $892.50
Rate for Payer: UHCCP Medicaid $91.39
Rate for Payer: Wellcare CHIP/Medicaid $91.80
Service Code HCPCS 64617
Hospital Charge Code 761P2345
Hospital Revenue Code 761
Min. Negotiated Rate $87.04
Max. Negotiated Rate $375.00
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $87.04
Rate for Payer: Anthem Medicaid $90.89
Rate for Payer: Buckeye Medicare Advantage $375.00
Rate for Payer: Cash Price $187.50
Rate for Payer: Cash Price $187.50
Rate for Payer: Cigna Commercial $319.45
Rate for Payer: Healthspan PPO $250.28
Rate for Payer: Humana Medicaid $90.89
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $146.30
Rate for Payer: Molina Healthcare CHIP/Medicaid $92.71
Rate for Payer: Molina Healthcare Passport $90.89
Rate for Payer: Multiplan PHCS $225.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $262.50
Rate for Payer: UHCCP Medicaid $91.39
Rate for Payer: Wellcare CHIP/Medicaid $91.80
Service Code HCPCS 64617
Hospital Charge Code 761T2345
Hospital Revenue Code 761
Min. Negotiated Rate $117.00
Max. Negotiated Rate $864.00
Rate for Payer: Aetna Commercial $693.00
Rate for Payer: Anthem Medicaid $309.51
Rate for Payer: Anthem Medicare Advantage/PPO $598.02
Rate for Payer: Anthem POS/PPO/Traditional $702.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $837.23
Rate for Payer: CareSource Just4Me Medicare $807.33
Rate for Payer: Cash Price $450.00
Rate for Payer: Cash Price $450.00
Rate for Payer: Cigna Commercial $747.00
Rate for Payer: First Health Commercial $855.00
Rate for Payer: Humana Commercial $765.00
Rate for Payer: Humana KY Medicaid $309.51
Rate for Payer: Humana Medicare Advantage $598.02
Rate for Payer: Kentucky WC Medicaid $312.66
Rate for Payer: Medical Mutual Of Ohio HMO $738.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $664.20
Rate for Payer: Molina Healthcare Benefit Exchange $717.62
Rate for Payer: Molina Healthcare Medicaid $315.72
Rate for Payer: Ohio Health Choice Commercial $792.00
Rate for Payer: Ohio Health Group HMO $675.00
Rate for Payer: Ohio Health Group PPO Differential $180.00
Rate for Payer: Ohio Health Group PPO No Differential $117.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $279.00
Rate for Payer: PHCS Commercial $864.00
Rate for Payer: United Healthcare All Payer $792.00
Service Code HCPCS 64617
Hospital Charge Code 761T2345
Hospital Revenue Code 761
Min. Negotiated Rate $117.00
Max. Negotiated Rate $864.00
Rate for Payer: Aetna Commercial $693.00
Rate for Payer: Anthem POS/PPO/Traditional $702.00
Rate for Payer: Cash Price $450.00
Rate for Payer: Cigna Commercial $747.00
Rate for Payer: First Health Commercial $855.00
Rate for Payer: Humana Commercial $765.00
Rate for Payer: Medical Mutual Of Ohio HMO $738.00
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $664.20
Rate for Payer: Molina Healthcare Benefit Exchange $270.00
Rate for Payer: Ohio Health Choice Commercial $792.00
Rate for Payer: Ohio Health Group HMO $675.00
Rate for Payer: Ohio Health Group PPO Differential $180.00
Rate for Payer: Ohio Health Group PPO No Differential $117.00
Rate for Payer: Ohio Health Group PPO SOMC Employees $279.00
Rate for Payer: PHCS Commercial $864.00
Rate for Payer: United Healthcare All Payer $792.00
Service Code HCPCS 64643
Hospital Charge Code 76102352
Hospital Revenue Code 761
Min. Negotiated Rate $55.18
Max. Negotiated Rate $692.00
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $55.18
Rate for Payer: Anthem Medicaid $57.03
Rate for Payer: Buckeye Medicare Advantage $692.00
Rate for Payer: Cash Price $346.00
Rate for Payer: Cash Price $346.00
Rate for Payer: Cigna Commercial $155.22
Rate for Payer: Healthspan PPO $122.66
Rate for Payer: Humana Medicaid $57.03
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $92.76
Rate for Payer: Molina Healthcare CHIP/Medicaid $58.17
Rate for Payer: Molina Healthcare Passport $57.03
Rate for Payer: Multiplan PHCS $415.20
Rate for Payer: Ohio Health Choice Preferred Health Choice $484.40
Rate for Payer: UHCCP Medicaid $57.94
Rate for Payer: Wellcare CHIP/Medicaid $57.60
Service Code HCPCS 64643
Hospital Charge Code 76102352
Hospital Revenue Code 761
Min. Negotiated Rate $89.96
Max. Negotiated Rate $664.32
Rate for Payer: Aetna Commercial $532.84
Rate for Payer: Anthem Medicaid $237.98
Rate for Payer: Anthem POS/PPO/Traditional $539.76
Rate for Payer: Cash Price $346.00
Rate for Payer: Cigna Commercial $574.36
Rate for Payer: First Health Commercial $657.40
Rate for Payer: Humana Commercial $588.20
Rate for Payer: Humana KY Medicaid $237.98
Rate for Payer: Kentucky WC Medicaid $240.40
Rate for Payer: Medical Mutual Of Ohio HMO $567.44
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $510.70
Rate for Payer: Molina Healthcare Benefit Exchange $207.60
Rate for Payer: Molina Healthcare Medicaid $242.75
Rate for Payer: Ohio Health Choice Commercial $608.96
Rate for Payer: Ohio Health Group HMO $519.00
Rate for Payer: Ohio Health Group PPO Differential $138.40
Rate for Payer: Ohio Health Group PPO No Differential $89.96
Rate for Payer: Ohio Health Group PPO SOMC Employees $214.52
Rate for Payer: PHCS Commercial $664.32
Rate for Payer: United Healthcare All Payer $608.96
Service Code HCPCS 64643
Hospital Charge Code 76102352
Hospital Revenue Code 761
Min. Negotiated Rate $89.96
Max. Negotiated Rate $664.32
Rate for Payer: Aetna Commercial $532.84
Rate for Payer: Anthem POS/PPO/Traditional $539.76
Rate for Payer: Cash Price $346.00
Rate for Payer: Cigna Commercial $574.36
Rate for Payer: First Health Commercial $657.40
Rate for Payer: Humana Commercial $588.20
Rate for Payer: Medical Mutual Of Ohio HMO $567.44
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $510.70
Rate for Payer: Molina Healthcare Benefit Exchange $207.60
Rate for Payer: Ohio Health Choice Commercial $608.96
Rate for Payer: Ohio Health Group HMO $519.00
Rate for Payer: Ohio Health Group PPO Differential $138.40
Rate for Payer: Ohio Health Group PPO No Differential $89.96
Rate for Payer: Ohio Health Group PPO SOMC Employees $214.52
Rate for Payer: PHCS Commercial $664.32
Rate for Payer: United Healthcare All Payer $608.96
Service Code HCPCS 64643
Hospital Charge Code 761P2352
Hospital Revenue Code 761
Min. Negotiated Rate $55.18
Max. Negotiated Rate $175.00
Rate for Payer: Wellcare CHIP/Medicaid $57.60
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $55.18
Rate for Payer: Anthem Medicaid $57.03
Rate for Payer: Buckeye Medicare Advantage $175.00
Rate for Payer: Cash Price $87.50
Rate for Payer: Cash Price $87.50
Rate for Payer: Cigna Commercial $155.22
Rate for Payer: Healthspan PPO $122.66
Rate for Payer: Humana Medicaid $57.03
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $92.76
Rate for Payer: Molina Healthcare CHIP/Medicaid $58.17
Rate for Payer: Molina Healthcare Passport $57.03
Rate for Payer: Multiplan PHCS $105.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $122.50
Rate for Payer: UHCCP Medicaid $57.94
Service Code HCPCS 64643
Hospital Charge Code 761T2352
Hospital Revenue Code 761
Min. Negotiated Rate $67.21
Max. Negotiated Rate $496.32
Rate for Payer: Aetna Commercial $398.09
Rate for Payer: Anthem POS/PPO/Traditional $403.26
Rate for Payer: Cash Price $258.50
Rate for Payer: Cigna Commercial $429.11
Rate for Payer: First Health Commercial $491.15
Rate for Payer: Humana Commercial $439.45
Rate for Payer: Medical Mutual Of Ohio HMO $423.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $381.55
Rate for Payer: Molina Healthcare Benefit Exchange $155.10
Rate for Payer: Ohio Health Choice Commercial $454.96
Rate for Payer: Ohio Health Group HMO $387.75
Rate for Payer: Ohio Health Group PPO Differential $103.40
Rate for Payer: Ohio Health Group PPO No Differential $67.21
Rate for Payer: Ohio Health Group PPO SOMC Employees $160.27
Rate for Payer: PHCS Commercial $496.32
Rate for Payer: United Healthcare All Payer $454.96
Service Code HCPCS 64643
Hospital Charge Code 761T2352
Hospital Revenue Code 761
Min. Negotiated Rate $67.21
Max. Negotiated Rate $496.32
Rate for Payer: Aetna Commercial $398.09
Rate for Payer: Anthem Medicaid $177.80
Rate for Payer: Anthem POS/PPO/Traditional $403.26
Rate for Payer: Cash Price $258.50
Rate for Payer: Cigna Commercial $429.11
Rate for Payer: First Health Commercial $491.15
Rate for Payer: Humana Commercial $439.45
Rate for Payer: Humana KY Medicaid $177.80
Rate for Payer: Kentucky WC Medicaid $179.61
Rate for Payer: Medical Mutual Of Ohio HMO $423.94
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $381.55
Rate for Payer: Molina Healthcare Benefit Exchange $155.10
Rate for Payer: Molina Healthcare Medicaid $181.36
Rate for Payer: Ohio Health Choice Commercial $454.96
Rate for Payer: Ohio Health Group HMO $387.75
Rate for Payer: Ohio Health Group PPO Differential $103.40
Rate for Payer: Ohio Health Group PPO No Differential $67.21
Rate for Payer: Ohio Health Group PPO SOMC Employees $160.27
Rate for Payer: PHCS Commercial $496.32
Rate for Payer: United Healthcare All Payer $454.96
Service Code HCPCS 64645
Hospital Charge Code 76102354
Hospital Revenue Code 761
Min. Negotiated Rate $96.98
Max. Negotiated Rate $716.16
Rate for Payer: Aetna Commercial $574.42
Rate for Payer: Anthem Medicaid $256.55
Rate for Payer: Anthem POS/PPO/Traditional $581.88
Rate for Payer: Cash Price $373.00
Rate for Payer: Cigna Commercial $619.18
Rate for Payer: First Health Commercial $708.70
Rate for Payer: Humana Commercial $634.10
Rate for Payer: Humana KY Medicaid $256.55
Rate for Payer: Kentucky WC Medicaid $259.16
Rate for Payer: Medical Mutual Of Ohio HMO $611.72
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $550.55
Rate for Payer: Molina Healthcare Benefit Exchange $223.80
Rate for Payer: Molina Healthcare Medicaid $261.70
Rate for Payer: Ohio Health Choice Commercial $656.48
Rate for Payer: Ohio Health Group HMO $559.50
Rate for Payer: Ohio Health Group PPO Differential $149.20
Rate for Payer: Ohio Health Group PPO No Differential $96.98
Rate for Payer: Ohio Health Group PPO SOMC Employees $231.26
Rate for Payer: PHCS Commercial $716.16
Rate for Payer: United Healthcare All Payer $656.48
Service Code HCPCS 64645
Hospital Charge Code 76102354
Hospital Revenue Code 761
Min. Negotiated Rate $96.98
Max. Negotiated Rate $716.16
Rate for Payer: Aetna Commercial $574.42
Rate for Payer: Anthem POS/PPO/Traditional $581.88
Rate for Payer: Cash Price $373.00
Rate for Payer: Cigna Commercial $619.18
Rate for Payer: First Health Commercial $708.70
Rate for Payer: Humana Commercial $634.10
Rate for Payer: Medical Mutual Of Ohio HMO $611.72
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $550.55
Rate for Payer: Molina Healthcare Benefit Exchange $223.80
Rate for Payer: Ohio Health Choice Commercial $656.48
Rate for Payer: Ohio Health Group HMO $559.50
Rate for Payer: Ohio Health Group PPO Differential $149.20
Rate for Payer: Ohio Health Group PPO No Differential $96.98
Rate for Payer: Ohio Health Group PPO SOMC Employees $231.26
Rate for Payer: PHCS Commercial $716.16
Rate for Payer: United Healthcare All Payer $656.48
Service Code HCPCS 64645
Hospital Charge Code 76102354
Hospital Revenue Code 761
Min. Negotiated Rate $63.28
Max. Negotiated Rate $746.00
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $63.28
Rate for Payer: Anthem Medicaid $65.32
Rate for Payer: Buckeye Medicare Advantage $746.00
Rate for Payer: Cash Price $373.00
Rate for Payer: Cash Price $373.00
Rate for Payer: Cigna Commercial $189.42
Rate for Payer: Healthspan PPO $149.57
Rate for Payer: Humana Medicaid $65.32
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $106.37
Rate for Payer: Molina Healthcare CHIP/Medicaid $66.63
Rate for Payer: Molina Healthcare Passport $65.32
Rate for Payer: Multiplan PHCS $447.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $522.20
Rate for Payer: UHCCP Medicaid $66.44
Rate for Payer: Wellcare CHIP/Medicaid $65.97