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Service Code HCPCS 27825
Hospital Charge Code 76100947
Hospital Revenue Code 761
Min. Negotiated Rate $146.90
Max. Negotiated Rate $1,084.80
Rate for Payer: Aetna Commercial $870.10
Rate for Payer: Anthem POS/PPO/Traditional $881.40
Rate for Payer: Cash Price $565.00
Rate for Payer: Cigna Commercial $937.90
Rate for Payer: First Health Commercial $1,073.50
Rate for Payer: Humana Commercial $960.50
Rate for Payer: Medical Mutual Of Ohio HMO $926.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $833.94
Rate for Payer: Molina Healthcare Benefit Exchange $339.00
Rate for Payer: Ohio Health Choice Commercial $994.40
Rate for Payer: Ohio Health Group HMO $847.50
Rate for Payer: Ohio Health Group PPO Differential $226.00
Rate for Payer: Ohio Health Group PPO No Differential $146.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $350.30
Rate for Payer: PHCS Commercial $1,084.80
Rate for Payer: United Healthcare All Payer $994.40
Service Code HCPCS 27825
Hospital Charge Code 45000170
Hospital Revenue Code 450
Min. Negotiated Rate $274.43
Max. Negotiated Rate $2,026.56
Rate for Payer: Aetna Commercial $1,625.47
Rate for Payer: Anthem POS/PPO/Traditional $1,646.58
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cigna Commercial $1,752.13
Rate for Payer: First Health Commercial $2,005.45
Rate for Payer: Humana Commercial $1,794.35
Rate for Payer: Medical Mutual Of Ohio HMO $1,731.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,557.92
Rate for Payer: Molina Healthcare Benefit Exchange $633.30
Rate for Payer: Ohio Health Choice Commercial $1,857.68
Rate for Payer: Ohio Health Group HMO $1,583.25
Rate for Payer: Ohio Health Group PPO Differential $422.20
Rate for Payer: Ohio Health Group PPO No Differential $274.43
Rate for Payer: Ohio Health Group PPO SOMC Employees $654.41
Rate for Payer: PHCS Commercial $2,026.56
Rate for Payer: United Healthcare All Payer $1,857.68
Service Code HCPCS 27825
Hospital Charge Code 76100947
Hospital Revenue Code 761
Min. Negotiated Rate $336.64
Max. Negotiated Rate $1,130.00
Rate for Payer: Aetna Commercial $722.29
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $336.64
Rate for Payer: Anthem Medicaid $349.43
Rate for Payer: Buckeye Medicare Advantage $1,130.00
Rate for Payer: Cash Price $565.00
Rate for Payer: Cash Price $565.00
Rate for Payer: Cigna Commercial $789.06
Rate for Payer: Healthspan PPO $705.63
Rate for Payer: Humana Medicaid $349.43
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $613.22
Rate for Payer: Molina Healthcare CHIP/Medicaid $356.42
Rate for Payer: Molina Healthcare Passport $349.43
Rate for Payer: Multiplan PHCS $678.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $791.00
Rate for Payer: UHCCP Medicaid $353.47
Rate for Payer: Wellcare CHIP/Medicaid $352.92
Service Code HCPCS 27825
Hospital Charge Code 45000170
Hospital Revenue Code 450
Min. Negotiated Rate $274.43
Max. Negotiated Rate $2,026.56
Rate for Payer: Aetna Commercial $1,625.47
Rate for Payer: Anthem Medicaid $725.97
Rate for Payer: Anthem Medicare Advantage/PPO $1,389.84
Rate for Payer: Anthem POS/PPO/Traditional $1,646.58
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,945.78
Rate for Payer: CareSource Just4Me Medicare $1,876.28
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cigna Commercial $1,752.13
Rate for Payer: First Health Commercial $2,005.45
Rate for Payer: Humana Commercial $1,794.35
Rate for Payer: Humana KY Medicaid $725.97
Rate for Payer: Humana Medicare Advantage $1,389.84
Rate for Payer: Kentucky WC Medicaid $733.36
Rate for Payer: Medical Mutual Of Ohio HMO $1,731.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,557.92
Rate for Payer: Molina Healthcare Benefit Exchange $1,667.81
Rate for Payer: Molina Healthcare Medicaid $740.54
Rate for Payer: Ohio Health Choice Commercial $1,857.68
Rate for Payer: Ohio Health Group HMO $1,583.25
Rate for Payer: Ohio Health Group PPO Differential $422.20
Rate for Payer: Ohio Health Group PPO No Differential $274.43
Rate for Payer: Ohio Health Group PPO SOMC Employees $654.41
Rate for Payer: PHCS Commercial $2,026.56
Rate for Payer: United Healthcare All Payer $1,857.68
Service Code HCPCS 28475
Hospital Charge Code 76101020
Hospital Revenue Code 761
Min. Negotiated Rate $119.07
Max. Negotiated Rate $630.00
Rate for Payer: Aetna Commercial $345.68
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $141.77
Rate for Payer: Anthem Medicaid $119.07
Rate for Payer: Buckeye Medicare Advantage $630.00
Rate for Payer: Cash Price $315.00
Rate for Payer: Cash Price $315.00
Rate for Payer: Cigna Commercial $411.45
Rate for Payer: Healthspan PPO $336.39
Rate for Payer: Humana Medicaid $119.07
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $281.49
Rate for Payer: Molina Healthcare CHIP/Medicaid $121.45
Rate for Payer: Molina Healthcare Passport $119.07
Rate for Payer: Multiplan PHCS $378.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $441.00
Rate for Payer: UHCCP Medicaid $148.86
Rate for Payer: Wellcare CHIP/Medicaid $120.26
Service Code HCPCS 28475
Hospital Charge Code 76101020
Hospital Revenue Code 761
Min. Negotiated Rate $81.90
Max. Negotiated Rate $604.80
Rate for Payer: Aetna Commercial $485.10
Rate for Payer: Anthem POS/PPO/Traditional $491.40
Rate for Payer: Cash Price $315.00
Rate for Payer: Cigna Commercial $522.90
Rate for Payer: First Health Commercial $598.50
Rate for Payer: Humana Commercial $535.50
Rate for Payer: Medical Mutual Of Ohio HMO $516.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $464.94
Rate for Payer: Molina Healthcare Benefit Exchange $189.00
Rate for Payer: Ohio Health Choice Commercial $554.40
Rate for Payer: Ohio Health Group HMO $472.50
Rate for Payer: Ohio Health Group PPO Differential $126.00
Rate for Payer: Ohio Health Group PPO No Differential $81.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $195.30
Rate for Payer: PHCS Commercial $604.80
Rate for Payer: United Healthcare All Payer $554.40
Service Code HCPCS 28475
Hospital Charge Code 45000178
Hospital Revenue Code 450
Min. Negotiated Rate $41.86
Max. Negotiated Rate $309.12
Rate for Payer: Aetna Commercial $247.94
Rate for Payer: Anthem POS/PPO/Traditional $251.16
Rate for Payer: Cash Price $161.00
Rate for Payer: Cigna Commercial $267.26
Rate for Payer: First Health Commercial $305.90
Rate for Payer: Humana Commercial $273.70
Rate for Payer: Medical Mutual Of Ohio HMO $264.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $237.64
Rate for Payer: Molina Healthcare Benefit Exchange $96.60
Rate for Payer: Ohio Health Choice Commercial $283.36
Rate for Payer: Ohio Health Group HMO $241.50
Rate for Payer: Ohio Health Group PPO Differential $64.40
Rate for Payer: Ohio Health Group PPO No Differential $41.86
Rate for Payer: Ohio Health Group PPO SOMC Employees $99.82
Rate for Payer: PHCS Commercial $309.12
Rate for Payer: United Healthcare All Payer $283.36
Service Code HCPCS 28475
Hospital Charge Code 45000178
Hospital Revenue Code 450
Min. Negotiated Rate $41.86
Max. Negotiated Rate $309.12
Rate for Payer: Aetna Commercial $247.94
Rate for Payer: Anthem Medicaid $110.74
Rate for Payer: Anthem Medicare Advantage/PPO $203.93
Rate for Payer: Anthem POS/PPO/Traditional $251.16
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $285.50
Rate for Payer: CareSource Just4Me Medicare $275.31
Rate for Payer: Cash Price $161.00
Rate for Payer: Cash Price $161.00
Rate for Payer: Cigna Commercial $267.26
Rate for Payer: First Health Commercial $305.90
Rate for Payer: Humana Commercial $273.70
Rate for Payer: Humana KY Medicaid $110.74
Rate for Payer: Humana Medicare Advantage $203.93
Rate for Payer: Kentucky WC Medicaid $111.86
Rate for Payer: Medical Mutual Of Ohio HMO $264.04
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $237.64
Rate for Payer: Molina Healthcare Benefit Exchange $244.72
Rate for Payer: Molina Healthcare Medicaid $112.96
Rate for Payer: Ohio Health Choice Commercial $283.36
Rate for Payer: Ohio Health Group HMO $241.50
Rate for Payer: Ohio Health Group PPO Differential $64.40
Rate for Payer: Ohio Health Group PPO No Differential $41.86
Rate for Payer: Ohio Health Group PPO SOMC Employees $99.82
Rate for Payer: PHCS Commercial $309.12
Rate for Payer: United Healthcare All Payer $283.36
Service Code HCPCS 28475
Hospital Charge Code 76101020
Hospital Revenue Code 761
Min. Negotiated Rate $81.90
Max. Negotiated Rate $604.80
Rate for Payer: Aetna Commercial $485.10
Rate for Payer: Anthem Medicaid $216.66
Rate for Payer: Anthem Medicare Advantage/PPO $203.93
Rate for Payer: Anthem POS/PPO/Traditional $491.40
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $285.50
Rate for Payer: CareSource Just4Me Medicare $275.31
Rate for Payer: Cash Price $315.00
Rate for Payer: Cash Price $315.00
Rate for Payer: Cigna Commercial $522.90
Rate for Payer: First Health Commercial $598.50
Rate for Payer: Humana Commercial $535.50
Rate for Payer: Humana KY Medicaid $216.66
Rate for Payer: Humana Medicare Advantage $203.93
Rate for Payer: Kentucky WC Medicaid $218.86
Rate for Payer: Medical Mutual Of Ohio HMO $516.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $464.94
Rate for Payer: Molina Healthcare Benefit Exchange $244.72
Rate for Payer: Molina Healthcare Medicaid $221.00
Rate for Payer: Ohio Health Choice Commercial $554.40
Rate for Payer: Ohio Health Group HMO $472.50
Rate for Payer: Ohio Health Group PPO Differential $126.00
Rate for Payer: Ohio Health Group PPO No Differential $81.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $195.30
Rate for Payer: PHCS Commercial $604.80
Rate for Payer: United Healthcare All Payer $554.40
Service Code HCPCS 28475
Hospital Charge Code 761P1020
Hospital Revenue Code 761
Min. Negotiated Rate $119.07
Max. Negotiated Rate $630.00
Rate for Payer: Aetna Commercial $345.68
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $141.77
Rate for Payer: Anthem Medicaid $119.07
Rate for Payer: Buckeye Medicare Advantage $630.00
Rate for Payer: Cash Price $315.00
Rate for Payer: Cash Price $315.00
Rate for Payer: Cigna Commercial $411.45
Rate for Payer: Healthspan PPO $336.39
Rate for Payer: Humana Medicaid $119.07
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $281.49
Rate for Payer: Molina Healthcare CHIP/Medicaid $121.45
Rate for Payer: Molina Healthcare Passport $119.07
Rate for Payer: Multiplan PHCS $378.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $441.00
Rate for Payer: UHCCP Medicaid $148.86
Rate for Payer: Wellcare CHIP/Medicaid $120.26
Service Code HCPCS 27752
Hospital Charge Code 45000165
Hospital Revenue Code 450
Min. Negotiated Rate $274.43
Max. Negotiated Rate $2,026.56
Rate for Payer: Aetna Commercial $1,625.47
Rate for Payer: Anthem POS/PPO/Traditional $1,646.58
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cigna Commercial $1,752.13
Rate for Payer: First Health Commercial $2,005.45
Rate for Payer: Humana Commercial $1,794.35
Rate for Payer: Medical Mutual Of Ohio HMO $1,731.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,557.92
Rate for Payer: Molina Healthcare Benefit Exchange $633.30
Rate for Payer: Ohio Health Choice Commercial $1,857.68
Rate for Payer: Ohio Health Group HMO $1,583.25
Rate for Payer: Ohio Health Group PPO Differential $422.20
Rate for Payer: Ohio Health Group PPO No Differential $274.43
Rate for Payer: Ohio Health Group PPO SOMC Employees $654.41
Rate for Payer: PHCS Commercial $2,026.56
Rate for Payer: United Healthcare All Payer $1,857.68
Service Code HCPCS 27752
Hospital Charge Code 45000165
Hospital Revenue Code 450
Min. Negotiated Rate $274.43
Max. Negotiated Rate $2,026.56
Rate for Payer: Aetna Commercial $1,625.47
Rate for Payer: Anthem Medicaid $725.97
Rate for Payer: Anthem Medicare Advantage/PPO $1,389.84
Rate for Payer: Anthem POS/PPO/Traditional $1,646.58
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,945.78
Rate for Payer: CareSource Just4Me Medicare $1,876.28
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cigna Commercial $1,752.13
Rate for Payer: First Health Commercial $2,005.45
Rate for Payer: Humana Commercial $1,794.35
Rate for Payer: Humana KY Medicaid $725.97
Rate for Payer: Humana Medicare Advantage $1,389.84
Rate for Payer: Kentucky WC Medicaid $733.36
Rate for Payer: Medical Mutual Of Ohio HMO $1,731.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,557.92
Rate for Payer: Molina Healthcare Benefit Exchange $1,667.81
Rate for Payer: Molina Healthcare Medicaid $740.54
Rate for Payer: Ohio Health Choice Commercial $1,857.68
Rate for Payer: Ohio Health Group HMO $1,583.25
Rate for Payer: Ohio Health Group PPO Differential $422.20
Rate for Payer: Ohio Health Group PPO No Differential $274.43
Rate for Payer: Ohio Health Group PPO SOMC Employees $654.41
Rate for Payer: PHCS Commercial $2,026.56
Rate for Payer: United Healthcare All Payer $1,857.68
Service Code HCPCS 27752
Hospital Charge Code 76100924
Hospital Revenue Code 761
Min. Negotiated Rate $260.34
Max. Negotiated Rate $1,040.00
Rate for Payer: Aetna Commercial $711.12
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $260.34
Rate for Payer: Anthem Medicaid $307.62
Rate for Payer: Buckeye Medicare Advantage $1,040.00
Rate for Payer: Cash Price $520.00
Rate for Payer: Cash Price $520.00
Rate for Payer: Cigna Commercial $779.13
Rate for Payer: Healthspan PPO $685.81
Rate for Payer: Humana Medicaid $307.62
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $608.46
Rate for Payer: Molina Healthcare CHIP/Medicaid $313.77
Rate for Payer: Molina Healthcare Passport $307.62
Rate for Payer: Multiplan PHCS $624.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $728.00
Rate for Payer: UHCCP Medicaid $273.36
Rate for Payer: Wellcare CHIP/Medicaid $310.70
Service Code HCPCS 27752
Hospital Charge Code 76100924
Hospital Revenue Code 761
Min. Negotiated Rate $135.20
Max. Negotiated Rate $1,945.78
Rate for Payer: Aetna Commercial $800.80
Rate for Payer: Anthem Medicaid $357.66
Rate for Payer: Anthem Medicare Advantage/PPO $1,389.84
Rate for Payer: Anthem POS/PPO/Traditional $811.20
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,945.78
Rate for Payer: CareSource Just4Me Medicare $1,876.28
Rate for Payer: Cash Price $520.00
Rate for Payer: Cash Price $520.00
Rate for Payer: Cigna Commercial $863.20
Rate for Payer: First Health Commercial $988.00
Rate for Payer: Humana Commercial $884.00
Rate for Payer: Humana KY Medicaid $357.66
Rate for Payer: Humana Medicare Advantage $1,389.84
Rate for Payer: Kentucky WC Medicaid $361.30
Rate for Payer: Medical Mutual Of Ohio HMO $852.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $767.52
Rate for Payer: Molina Healthcare Benefit Exchange $1,667.81
Rate for Payer: Molina Healthcare Medicaid $364.83
Rate for Payer: Ohio Health Choice Commercial $915.20
Rate for Payer: Ohio Health Group HMO $780.00
Rate for Payer: Ohio Health Group PPO Differential $208.00
Rate for Payer: Ohio Health Group PPO No Differential $135.20
Rate for Payer: Ohio Health Group PPO SOMC Employees $322.40
Rate for Payer: PHCS Commercial $998.40
Rate for Payer: United Healthcare All Payer $915.20
Service Code HCPCS 27752
Hospital Charge Code 76100924
Hospital Revenue Code 761
Min. Negotiated Rate $135.20
Max. Negotiated Rate $998.40
Rate for Payer: Aetna Commercial $800.80
Rate for Payer: Anthem POS/PPO/Traditional $811.20
Rate for Payer: Cash Price $520.00
Rate for Payer: Cigna Commercial $863.20
Rate for Payer: First Health Commercial $988.00
Rate for Payer: Humana Commercial $884.00
Rate for Payer: Medical Mutual Of Ohio HMO $852.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $767.52
Rate for Payer: Molina Healthcare Benefit Exchange $312.00
Rate for Payer: Ohio Health Choice Commercial $915.20
Rate for Payer: Ohio Health Group HMO $780.00
Rate for Payer: Ohio Health Group PPO Differential $208.00
Rate for Payer: Ohio Health Group PPO No Differential $135.20
Rate for Payer: Ohio Health Group PPO SOMC Employees $322.40
Rate for Payer: PHCS Commercial $998.40
Rate for Payer: United Healthcare All Payer $915.20
Service Code HCPCS 27752
Hospital Charge Code 761P0924
Hospital Revenue Code 761
Min. Negotiated Rate $260.34
Max. Negotiated Rate $1,040.00
Rate for Payer: Aetna Commercial $711.12
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $260.34
Rate for Payer: Anthem Medicaid $307.62
Rate for Payer: Buckeye Medicare Advantage $1,040.00
Rate for Payer: Cash Price $520.00
Rate for Payer: Cash Price $520.00
Rate for Payer: Cigna Commercial $779.13
Rate for Payer: Healthspan PPO $685.81
Rate for Payer: Humana Medicaid $307.62
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $608.46
Rate for Payer: Molina Healthcare CHIP/Medicaid $313.77
Rate for Payer: Molina Healthcare Passport $307.62
Rate for Payer: Multiplan PHCS $624.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $728.00
Rate for Payer: UHCCP Medicaid $273.36
Rate for Payer: Wellcare CHIP/Medicaid $310.70
Service Code HCPCS 23540
Hospital Charge Code 761T0474
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 $203.93
Rate for Payer: Anthem POS/PPO/Traditional $702.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $285.50
Rate for Payer: CareSource Just4Me Medicare $275.31
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 $203.93
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 $244.72
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 23540
Hospital Charge Code 76100474
Hospital Revenue Code 761
Min. Negotiated Rate $189.15
Max. Negotiated Rate $1,396.80
Rate for Payer: Aetna Commercial $1,120.35
Rate for Payer: Anthem POS/PPO/Traditional $1,134.90
Rate for Payer: Cash Price $727.50
Rate for Payer: Cigna Commercial $1,207.65
Rate for Payer: First Health Commercial $1,382.25
Rate for Payer: Humana Commercial $1,236.75
Rate for Payer: Medical Mutual Of Ohio HMO $1,193.10
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,073.79
Rate for Payer: Molina Healthcare Benefit Exchange $436.50
Rate for Payer: Ohio Health Choice Commercial $1,280.40
Rate for Payer: Ohio Health Group HMO $1,091.25
Rate for Payer: Ohio Health Group PPO Differential $291.00
Rate for Payer: Ohio Health Group PPO No Differential $189.15
Rate for Payer: Ohio Health Group PPO SOMC Employees $451.05
Rate for Payer: PHCS Commercial $1,396.80
Rate for Payer: United Healthcare All Payer $1,280.40
Service Code HCPCS 23540
Hospital Charge Code 76100474
Hospital Revenue Code 761
Min. Negotiated Rate $189.15
Max. Negotiated Rate $1,396.80
Rate for Payer: Aetna Commercial $1,120.35
Rate for Payer: Anthem Medicaid $500.37
Rate for Payer: Anthem Medicare Advantage/PPO $203.93
Rate for Payer: Anthem POS/PPO/Traditional $1,134.90
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $285.50
Rate for Payer: CareSource Just4Me Medicare $275.31
Rate for Payer: Cash Price $727.50
Rate for Payer: Cash Price $727.50
Rate for Payer: Cigna Commercial $1,207.65
Rate for Payer: First Health Commercial $1,382.25
Rate for Payer: Humana Commercial $1,236.75
Rate for Payer: Humana KY Medicaid $500.37
Rate for Payer: Humana Medicare Advantage $203.93
Rate for Payer: Kentucky WC Medicaid $505.47
Rate for Payer: Medical Mutual Of Ohio HMO $1,193.10
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,073.79
Rate for Payer: Molina Healthcare Benefit Exchange $244.72
Rate for Payer: Molina Healthcare Medicaid $510.41
Rate for Payer: Ohio Health Choice Commercial $1,280.40
Rate for Payer: Ohio Health Group HMO $1,091.25
Rate for Payer: Ohio Health Group PPO Differential $291.00
Rate for Payer: Ohio Health Group PPO No Differential $189.15
Rate for Payer: Ohio Health Group PPO SOMC Employees $451.05
Rate for Payer: PHCS Commercial $1,396.80
Rate for Payer: United Healthcare All Payer $1,280.40
Service Code HCPCS 23540
Hospital Charge Code 76100474
Hospital Revenue Code 761
Min. Negotiated Rate $107.81
Max. Negotiated Rate $1,455.00
Rate for Payer: Aetna Commercial $291.43
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $122.51
Rate for Payer: Anthem Medicaid $107.81
Rate for Payer: Buckeye Medicare Advantage $1,455.00
Rate for Payer: Cash Price $727.50
Rate for Payer: Cash Price $727.50
Rate for Payer: Cigna Commercial $329.95
Rate for Payer: Healthspan PPO $267.37
Rate for Payer: Humana Medicaid $107.81
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $262.53
Rate for Payer: Molina Healthcare CHIP/Medicaid $109.97
Rate for Payer: Molina Healthcare Passport $107.81
Rate for Payer: Multiplan PHCS $873.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,018.50
Rate for Payer: UHCCP Medicaid $128.64
Rate for Payer: Wellcare CHIP/Medicaid $108.89
Service Code HCPCS 23540
Hospital Charge Code 761P0474
Hospital Revenue Code 761
Min. Negotiated Rate $107.81
Max. Negotiated Rate $555.00
Rate for Payer: Aetna Commercial $291.43
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $122.51
Rate for Payer: Anthem Medicaid $107.81
Rate for Payer: Buckeye Medicare Advantage $555.00
Rate for Payer: Cash Price $277.50
Rate for Payer: Cash Price $277.50
Rate for Payer: Cigna Commercial $329.95
Rate for Payer: Healthspan PPO $267.37
Rate for Payer: Humana Medicaid $107.81
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $262.53
Rate for Payer: Molina Healthcare CHIP/Medicaid $109.97
Rate for Payer: Molina Healthcare Passport $107.81
Rate for Payer: Multiplan PHCS $333.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $388.50
Rate for Payer: UHCCP Medicaid $128.64
Rate for Payer: Wellcare CHIP/Medicaid $108.89
Service Code HCPCS 23540
Hospital Charge Code 761T0474
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 27842
Hospital Charge Code 76100953
Hospital Revenue Code 761
Min. Negotiated Rate $274.43
Max. Negotiated Rate $2,026.56
Rate for Payer: Aetna Commercial $1,625.47
Rate for Payer: Anthem Medicaid $725.97
Rate for Payer: Anthem Medicare Advantage/PPO $1,389.84
Rate for Payer: Anthem POS/PPO/Traditional $1,646.58
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,945.78
Rate for Payer: CareSource Just4Me Medicare $1,876.28
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cigna Commercial $1,752.13
Rate for Payer: First Health Commercial $2,005.45
Rate for Payer: Humana Commercial $1,794.35
Rate for Payer: Humana KY Medicaid $725.97
Rate for Payer: Humana Medicare Advantage $1,389.84
Rate for Payer: Kentucky WC Medicaid $733.36
Rate for Payer: Medical Mutual Of Ohio HMO $1,731.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,557.92
Rate for Payer: Molina Healthcare Benefit Exchange $1,667.81
Rate for Payer: Molina Healthcare Medicaid $740.54
Rate for Payer: Ohio Health Choice Commercial $1,857.68
Rate for Payer: Ohio Health Group HMO $1,583.25
Rate for Payer: Ohio Health Group PPO Differential $422.20
Rate for Payer: Ohio Health Group PPO No Differential $274.43
Rate for Payer: Ohio Health Group PPO SOMC Employees $654.41
Rate for Payer: PHCS Commercial $2,026.56
Rate for Payer: United Healthcare All Payer $1,857.68
Service Code HCPCS 27842
Hospital Charge Code 45000172
Hospital Revenue Code 450
Min. Negotiated Rate $274.43
Max. Negotiated Rate $2,026.56
Rate for Payer: Aetna Commercial $1,625.47
Rate for Payer: Anthem POS/PPO/Traditional $1,646.58
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cigna Commercial $1,752.13
Rate for Payer: First Health Commercial $2,005.45
Rate for Payer: Humana Commercial $1,794.35
Rate for Payer: Medical Mutual Of Ohio HMO $1,731.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,557.92
Rate for Payer: Molina Healthcare Benefit Exchange $633.30
Rate for Payer: Ohio Health Choice Commercial $1,857.68
Rate for Payer: Ohio Health Group HMO $1,583.25
Rate for Payer: Ohio Health Group PPO Differential $422.20
Rate for Payer: Ohio Health Group PPO No Differential $274.43
Rate for Payer: Ohio Health Group PPO SOMC Employees $654.41
Rate for Payer: PHCS Commercial $2,026.56
Rate for Payer: United Healthcare All Payer $1,857.68
Service Code HCPCS 27842
Hospital Charge Code 45000172
Hospital Revenue Code 450
Min. Negotiated Rate $274.43
Max. Negotiated Rate $2,026.56
Rate for Payer: Aetna Commercial $1,625.47
Rate for Payer: Anthem Medicaid $725.97
Rate for Payer: Anthem Medicare Advantage/PPO $1,389.84
Rate for Payer: Anthem POS/PPO/Traditional $1,646.58
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,945.78
Rate for Payer: CareSource Just4Me Medicare $1,876.28
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cash Price $1,055.50
Rate for Payer: Cigna Commercial $1,752.13
Rate for Payer: First Health Commercial $2,005.45
Rate for Payer: Humana Commercial $1,794.35
Rate for Payer: Humana KY Medicaid $725.97
Rate for Payer: Humana Medicare Advantage $1,389.84
Rate for Payer: Kentucky WC Medicaid $733.36
Rate for Payer: Medical Mutual Of Ohio HMO $1,731.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,557.92
Rate for Payer: Molina Healthcare Benefit Exchange $1,667.81
Rate for Payer: Molina Healthcare Medicaid $740.54
Rate for Payer: Ohio Health Choice Commercial $1,857.68
Rate for Payer: Ohio Health Group HMO $1,583.25
Rate for Payer: Ohio Health Group PPO Differential $422.20
Rate for Payer: Ohio Health Group PPO No Differential $274.43
Rate for Payer: Ohio Health Group PPO SOMC Employees $654.41
Rate for Payer: PHCS Commercial $2,026.56
Rate for Payer: United Healthcare All Payer $1,857.68