|
COBRA PZF 4.00*24
|
Facility
|
IP
|
$4,825.00
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27000125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$627.25 |
| Max. Negotiated Rate |
$4,632.00 |
| Rate for Payer: Aetna Commercial |
$3,715.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,763.50
|
| Rate for Payer: Cash Price |
$2,412.50
|
| Rate for Payer: Cigna Commercial |
$4,004.75
|
| Rate for Payer: First Health Commercial |
$4,583.75
|
| Rate for Payer: Humana Commercial |
$4,101.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,956.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,560.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,447.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,246.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,618.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$965.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$627.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,495.75
|
| Rate for Payer: PHCS Commercial |
$4,632.00
|
| Rate for Payer: United Healthcare All Payer |
$4,246.00
|
|
|
COBRA PZF 4.00*30
|
Facility
|
OP
|
$4,825.00
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27000125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$627.25 |
| Max. Negotiated Rate |
$4,632.00 |
| Rate for Payer: Aetna Commercial |
$3,715.25
|
| Rate for Payer: Anthem Medicaid |
$1,659.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,763.50
|
| Rate for Payer: Cash Price |
$2,412.50
|
| Rate for Payer: Cigna Commercial |
$4,004.75
|
| Rate for Payer: First Health Commercial |
$4,583.75
|
| Rate for Payer: Humana Commercial |
$4,101.25
|
| Rate for Payer: Humana KY Medicaid |
$1,659.32
|
| Rate for Payer: Kentucky WC Medicaid |
$1,676.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,956.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,560.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,447.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,692.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,246.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,618.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$965.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$627.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,495.75
|
| Rate for Payer: PHCS Commercial |
$4,632.00
|
| Rate for Payer: United Healthcare All Payer |
$4,246.00
|
|
|
COBRA PZF 4.00*30
|
Facility
|
IP
|
$4,825.00
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27000125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$627.25 |
| Max. Negotiated Rate |
$4,632.00 |
| Rate for Payer: Aetna Commercial |
$3,715.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,763.50
|
| Rate for Payer: Cash Price |
$2,412.50
|
| Rate for Payer: Cigna Commercial |
$4,004.75
|
| Rate for Payer: First Health Commercial |
$4,583.75
|
| Rate for Payer: Humana Commercial |
$4,101.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,956.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,560.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,447.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,246.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,618.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$965.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$627.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,495.75
|
| Rate for Payer: PHCS Commercial |
$4,632.00
|
| Rate for Payer: United Healthcare All Payer |
$4,246.00
|
|
|
COBRA PZF 4.00*8
|
Facility
|
IP
|
$4,825.00
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27000125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$627.25 |
| Max. Negotiated Rate |
$4,632.00 |
| Rate for Payer: Aetna Commercial |
$3,715.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,763.50
|
| Rate for Payer: Cash Price |
$2,412.50
|
| Rate for Payer: Cigna Commercial |
$4,004.75
|
| Rate for Payer: First Health Commercial |
$4,583.75
|
| Rate for Payer: Humana Commercial |
$4,101.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,956.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,560.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,447.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,246.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,618.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$965.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$627.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,495.75
|
| Rate for Payer: PHCS Commercial |
$4,632.00
|
| Rate for Payer: United Healthcare All Payer |
$4,246.00
|
|
|
COBRA PZF 4.00*8
|
Facility
|
OP
|
$4,825.00
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27000125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$627.25 |
| Max. Negotiated Rate |
$4,632.00 |
| Rate for Payer: Aetna Commercial |
$3,715.25
|
| Rate for Payer: Anthem Medicaid |
$1,659.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,763.50
|
| Rate for Payer: Cash Price |
$2,412.50
|
| Rate for Payer: Cigna Commercial |
$4,004.75
|
| Rate for Payer: First Health Commercial |
$4,583.75
|
| Rate for Payer: Humana Commercial |
$4,101.25
|
| Rate for Payer: Humana KY Medicaid |
$1,659.32
|
| Rate for Payer: Kentucky WC Medicaid |
$1,676.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,956.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,560.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,447.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,692.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,246.00
|
| Rate for Payer: Ohio Health Group HMO |
$3,618.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$965.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$627.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,495.75
|
| Rate for Payer: PHCS Commercial |
$4,632.00
|
| Rate for Payer: United Healthcare All Payer |
$4,246.00
|
|
|
COCR 12/14 FEM HD 22 +0
|
Facility
|
IP
|
$4,705.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.69 |
| Max. Negotiated Rate |
$4,517.09 |
| Rate for Payer: Aetna Commercial |
$3,623.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,670.13
|
| Rate for Payer: Cash Price |
$2,352.65
|
| Rate for Payer: Cigna Commercial |
$3,905.40
|
| Rate for Payer: First Health Commercial |
$4,470.04
|
| Rate for Payer: Humana Commercial |
$3,999.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,858.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,472.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,411.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,140.66
|
| Rate for Payer: Ohio Health Group HMO |
$3,528.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$941.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$611.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,458.64
|
| Rate for Payer: PHCS Commercial |
$4,517.09
|
| Rate for Payer: United Healthcare All Payer |
$4,140.66
|
|
|
COCR 12/14 FEM HD 22 +0
|
Facility
|
OP
|
$4,705.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.69 |
| Max. Negotiated Rate |
$4,517.09 |
| Rate for Payer: Aetna Commercial |
$3,623.08
|
| Rate for Payer: Anthem Medicaid |
$1,618.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,670.13
|
| Rate for Payer: Cash Price |
$2,352.65
|
| Rate for Payer: Cigna Commercial |
$3,905.40
|
| Rate for Payer: First Health Commercial |
$4,470.04
|
| Rate for Payer: Humana Commercial |
$3,999.50
|
| Rate for Payer: Humana KY Medicaid |
$1,618.15
|
| Rate for Payer: Kentucky WC Medicaid |
$1,634.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,858.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,472.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,411.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,650.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,140.66
|
| Rate for Payer: Ohio Health Group HMO |
$3,528.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$941.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$611.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,458.64
|
| Rate for Payer: PHCS Commercial |
$4,517.09
|
| Rate for Payer: United Healthcare All Payer |
$4,140.66
|
|
|
COCR 12/14 FEM HD 22 +12
|
Facility
|
IP
|
$4,703.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.41 |
| Max. Negotiated Rate |
$4,515.00 |
| Rate for Payer: Aetna Commercial |
$3,621.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,668.44
|
| Rate for Payer: Cash Price |
$2,351.56
|
| Rate for Payer: Cigna Commercial |
$3,903.60
|
| Rate for Payer: First Health Commercial |
$4,467.97
|
| Rate for Payer: Humana Commercial |
$3,997.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,856.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,470.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,410.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,138.75
|
| Rate for Payer: Ohio Health Group HMO |
$3,527.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$940.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$611.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,457.97
|
| Rate for Payer: PHCS Commercial |
$4,515.00
|
| Rate for Payer: United Healthcare All Payer |
$4,138.75
|
|
|
COCR 12/14 FEM HD 22 +12
|
Facility
|
OP
|
$4,703.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.41 |
| Max. Negotiated Rate |
$4,515.00 |
| Rate for Payer: Aetna Commercial |
$3,621.41
|
| Rate for Payer: Anthem Medicaid |
$1,617.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,668.44
|
| Rate for Payer: Cash Price |
$2,351.56
|
| Rate for Payer: Cigna Commercial |
$3,903.60
|
| Rate for Payer: First Health Commercial |
$4,467.97
|
| Rate for Payer: Humana Commercial |
$3,997.66
|
| Rate for Payer: Humana KY Medicaid |
$1,617.41
|
| Rate for Payer: Kentucky WC Medicaid |
$1,633.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,856.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,470.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,410.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,649.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,138.75
|
| Rate for Payer: Ohio Health Group HMO |
$3,527.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$940.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$611.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,457.97
|
| Rate for Payer: PHCS Commercial |
$4,515.00
|
| Rate for Payer: United Healthcare All Payer |
$4,138.75
|
|
|
COCR 12/14 FEM HD 22 +4
|
Facility
|
OP
|
$4,705.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.69 |
| Max. Negotiated Rate |
$4,517.09 |
| Rate for Payer: Aetna Commercial |
$3,623.08
|
| Rate for Payer: Anthem Medicaid |
$1,618.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,670.13
|
| Rate for Payer: Cash Price |
$2,352.65
|
| Rate for Payer: Cigna Commercial |
$3,905.40
|
| Rate for Payer: First Health Commercial |
$4,470.04
|
| Rate for Payer: Humana Commercial |
$3,999.50
|
| Rate for Payer: Humana KY Medicaid |
$1,618.15
|
| Rate for Payer: Kentucky WC Medicaid |
$1,634.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,858.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,472.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,411.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,650.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,140.66
|
| Rate for Payer: Ohio Health Group HMO |
$3,528.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$941.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$611.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,458.64
|
| Rate for Payer: PHCS Commercial |
$4,517.09
|
| Rate for Payer: United Healthcare All Payer |
$4,140.66
|
|
|
COCR 12/14 FEM HD 22 +4
|
Facility
|
IP
|
$4,705.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.69 |
| Max. Negotiated Rate |
$4,517.09 |
| Rate for Payer: Aetna Commercial |
$3,623.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,670.13
|
| Rate for Payer: Cash Price |
$2,352.65
|
| Rate for Payer: Cigna Commercial |
$3,905.40
|
| Rate for Payer: First Health Commercial |
$4,470.04
|
| Rate for Payer: Humana Commercial |
$3,999.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,858.35
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,472.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,411.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,140.66
|
| Rate for Payer: Ohio Health Group HMO |
$3,528.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$941.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$611.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,458.64
|
| Rate for Payer: PHCS Commercial |
$4,517.09
|
| Rate for Payer: United Healthcare All Payer |
$4,140.66
|
|
|
COCR 12/14 FEM HD 22 +8
|
Facility
|
IP
|
$4,703.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.41 |
| Max. Negotiated Rate |
$4,515.00 |
| Rate for Payer: Aetna Commercial |
$3,621.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,668.44
|
| Rate for Payer: Cash Price |
$2,351.56
|
| Rate for Payer: Cigna Commercial |
$3,903.60
|
| Rate for Payer: First Health Commercial |
$4,467.97
|
| Rate for Payer: Humana Commercial |
$3,997.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,856.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,470.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,410.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,138.75
|
| Rate for Payer: Ohio Health Group HMO |
$3,527.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$940.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$611.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,457.97
|
| Rate for Payer: PHCS Commercial |
$4,515.00
|
| Rate for Payer: United Healthcare All Payer |
$4,138.75
|
|
|
COCR 12/14 FEM HD 22 +8
|
Facility
|
OP
|
$4,703.13
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.41 |
| Max. Negotiated Rate |
$4,515.00 |
| Rate for Payer: Aetna Commercial |
$3,621.41
|
| Rate for Payer: Anthem Medicaid |
$1,617.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,668.44
|
| Rate for Payer: Cash Price |
$2,351.56
|
| Rate for Payer: Cigna Commercial |
$3,903.60
|
| Rate for Payer: First Health Commercial |
$4,467.97
|
| Rate for Payer: Humana Commercial |
$3,997.66
|
| Rate for Payer: Humana KY Medicaid |
$1,617.41
|
| Rate for Payer: Kentucky WC Medicaid |
$1,633.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,856.57
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,470.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,410.94
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,649.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,138.75
|
| Rate for Payer: Ohio Health Group HMO |
$3,527.35
|
| Rate for Payer: Ohio Health Group PPO Differential |
$940.63
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$611.41
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,457.97
|
| Rate for Payer: PHCS Commercial |
$4,515.00
|
| Rate for Payer: United Healthcare All Payer |
$4,138.75
|
|
|
COCR 12/14 FEM HD 26 +0
|
Facility
|
IP
|
$6,501.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.17 |
| Max. Negotiated Rate |
$6,241.23 |
| Rate for Payer: Aetna Commercial |
$5,005.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,071.00
|
| Rate for Payer: Cash Price |
$3,250.64
|
| Rate for Payer: Cigna Commercial |
$5,396.06
|
| Rate for Payer: First Health Commercial |
$6,176.22
|
| Rate for Payer: Humana Commercial |
$5,526.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,331.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,797.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,950.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,721.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,875.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,300.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$845.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,015.40
|
| Rate for Payer: PHCS Commercial |
$6,241.23
|
| Rate for Payer: United Healthcare All Payer |
$5,721.13
|
|
|
COCR 12/14 FEM HD 26 +0
|
Facility
|
OP
|
$6,501.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.17 |
| Max. Negotiated Rate |
$6,241.23 |
| Rate for Payer: Aetna Commercial |
$5,005.99
|
| Rate for Payer: Anthem Medicaid |
$2,235.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,071.00
|
| Rate for Payer: Cash Price |
$3,250.64
|
| Rate for Payer: Cigna Commercial |
$5,396.06
|
| Rate for Payer: First Health Commercial |
$6,176.22
|
| Rate for Payer: Humana Commercial |
$5,526.09
|
| Rate for Payer: Humana KY Medicaid |
$2,235.79
|
| Rate for Payer: Kentucky WC Medicaid |
$2,258.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,331.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,797.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,950.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,280.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,721.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,875.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,300.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$845.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,015.40
|
| Rate for Payer: PHCS Commercial |
$6,241.23
|
| Rate for Payer: United Healthcare All Payer |
$5,721.13
|
|
|
COCR 12/14 FEM HD 26 +12
|
Facility
|
IP
|
$6,501.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.17 |
| Max. Negotiated Rate |
$6,241.23 |
| Rate for Payer: Aetna Commercial |
$5,005.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,071.00
|
| Rate for Payer: Cash Price |
$3,250.64
|
| Rate for Payer: Cigna Commercial |
$5,396.06
|
| Rate for Payer: First Health Commercial |
$6,176.22
|
| Rate for Payer: Humana Commercial |
$5,526.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,331.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,797.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,950.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,721.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,875.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,300.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$845.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,015.40
|
| Rate for Payer: PHCS Commercial |
$6,241.23
|
| Rate for Payer: United Healthcare All Payer |
$5,721.13
|
|
|
COCR 12/14 FEM HD 26 +12
|
Facility
|
OP
|
$6,501.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.17 |
| Max. Negotiated Rate |
$6,241.23 |
| Rate for Payer: Aetna Commercial |
$5,005.99
|
| Rate for Payer: Anthem Medicaid |
$2,235.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,071.00
|
| Rate for Payer: Cash Price |
$3,250.64
|
| Rate for Payer: Cigna Commercial |
$5,396.06
|
| Rate for Payer: First Health Commercial |
$6,176.22
|
| Rate for Payer: Humana Commercial |
$5,526.09
|
| Rate for Payer: Humana KY Medicaid |
$2,235.79
|
| Rate for Payer: Kentucky WC Medicaid |
$2,258.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,331.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,797.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,950.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,280.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,721.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,875.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,300.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$845.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,015.40
|
| Rate for Payer: PHCS Commercial |
$6,241.23
|
| Rate for Payer: United Healthcare All Payer |
$5,721.13
|
|
|
COCR 12/14 FEM HD 26 +4
|
Facility
|
OP
|
$6,501.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.17 |
| Max. Negotiated Rate |
$6,241.23 |
| Rate for Payer: Aetna Commercial |
$5,005.99
|
| Rate for Payer: Anthem Medicaid |
$2,235.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,071.00
|
| Rate for Payer: Cash Price |
$3,250.64
|
| Rate for Payer: Cigna Commercial |
$5,396.06
|
| Rate for Payer: First Health Commercial |
$6,176.22
|
| Rate for Payer: Humana Commercial |
$5,526.09
|
| Rate for Payer: Humana KY Medicaid |
$2,235.79
|
| Rate for Payer: Kentucky WC Medicaid |
$2,258.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,331.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,797.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,950.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,280.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,721.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,875.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,300.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$845.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,015.40
|
| Rate for Payer: PHCS Commercial |
$6,241.23
|
| Rate for Payer: United Healthcare All Payer |
$5,721.13
|
|
|
COCR 12/14 FEM HD 26 +4
|
Facility
|
IP
|
$6,501.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.17 |
| Max. Negotiated Rate |
$6,241.23 |
| Rate for Payer: Aetna Commercial |
$5,005.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,071.00
|
| Rate for Payer: Cash Price |
$3,250.64
|
| Rate for Payer: Cigna Commercial |
$5,396.06
|
| Rate for Payer: First Health Commercial |
$6,176.22
|
| Rate for Payer: Humana Commercial |
$5,526.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,331.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,797.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,950.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,721.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,875.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,300.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$845.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,015.40
|
| Rate for Payer: PHCS Commercial |
$6,241.23
|
| Rate for Payer: United Healthcare All Payer |
$5,721.13
|
|
|
COCR 12/14 FEM HD 26 +8
|
Facility
|
IP
|
$6,501.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.17 |
| Max. Negotiated Rate |
$6,241.23 |
| Rate for Payer: Aetna Commercial |
$5,005.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,071.00
|
| Rate for Payer: Cash Price |
$3,250.64
|
| Rate for Payer: Cigna Commercial |
$5,396.06
|
| Rate for Payer: First Health Commercial |
$6,176.22
|
| Rate for Payer: Humana Commercial |
$5,526.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,331.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,797.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,950.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,721.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,875.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,300.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$845.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,015.40
|
| Rate for Payer: PHCS Commercial |
$6,241.23
|
| Rate for Payer: United Healthcare All Payer |
$5,721.13
|
|
|
COCR 12/14 FEM HD 26 +8
|
Facility
|
OP
|
$6,501.28
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$845.17 |
| Max. Negotiated Rate |
$6,241.23 |
| Rate for Payer: Aetna Commercial |
$5,005.99
|
| Rate for Payer: Anthem Medicaid |
$2,235.79
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,071.00
|
| Rate for Payer: Cash Price |
$3,250.64
|
| Rate for Payer: Cigna Commercial |
$5,396.06
|
| Rate for Payer: First Health Commercial |
$6,176.22
|
| Rate for Payer: Humana Commercial |
$5,526.09
|
| Rate for Payer: Humana KY Medicaid |
$2,235.79
|
| Rate for Payer: Kentucky WC Medicaid |
$2,258.54
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,331.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,797.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,950.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,280.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,721.13
|
| Rate for Payer: Ohio Health Group HMO |
$4,875.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,300.26
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$845.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,015.40
|
| Rate for Payer: PHCS Commercial |
$6,241.23
|
| Rate for Payer: United Healthcare All Payer |
$5,721.13
|
|
|
COCR 12/14 FEM HD 28 +12
|
Facility
|
IP
|
$3,775.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$490.75 |
| Max. Negotiated Rate |
$3,624.00 |
| Rate for Payer: Aetna Commercial |
$2,906.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,944.50
|
| Rate for Payer: Cash Price |
$1,887.50
|
| Rate for Payer: Cigna Commercial |
$3,133.25
|
| Rate for Payer: First Health Commercial |
$3,586.25
|
| Rate for Payer: Humana Commercial |
$3,208.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,095.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,785.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,132.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,322.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,831.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$755.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$490.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,170.25
|
| Rate for Payer: PHCS Commercial |
$3,624.00
|
| Rate for Payer: United Healthcare All Payer |
$3,322.00
|
|
|
COCR 12/14 FEM HD 28 +12
|
Facility
|
OP
|
$3,775.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$490.75 |
| Max. Negotiated Rate |
$3,624.00 |
| Rate for Payer: Aetna Commercial |
$2,906.75
|
| Rate for Payer: Anthem Medicaid |
$1,298.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,944.50
|
| Rate for Payer: Cash Price |
$1,887.50
|
| Rate for Payer: Cigna Commercial |
$3,133.25
|
| Rate for Payer: First Health Commercial |
$3,586.25
|
| Rate for Payer: Humana Commercial |
$3,208.75
|
| Rate for Payer: Humana KY Medicaid |
$1,298.22
|
| Rate for Payer: Kentucky WC Medicaid |
$1,311.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,095.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,785.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,132.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,324.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,322.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,831.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$755.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$490.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,170.25
|
| Rate for Payer: PHCS Commercial |
$3,624.00
|
| Rate for Payer: United Healthcare All Payer |
$3,322.00
|
|
|
COCR 12/14 FEM HD 28 +16
|
Facility
|
IP
|
$3,775.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$490.75 |
| Max. Negotiated Rate |
$3,624.00 |
| Rate for Payer: Aetna Commercial |
$2,906.75
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,944.50
|
| Rate for Payer: Cash Price |
$1,887.50
|
| Rate for Payer: Cigna Commercial |
$3,133.25
|
| Rate for Payer: First Health Commercial |
$3,586.25
|
| Rate for Payer: Humana Commercial |
$3,208.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,095.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,785.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,132.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,322.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,831.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$755.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$490.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,170.25
|
| Rate for Payer: PHCS Commercial |
$3,624.00
|
| Rate for Payer: United Healthcare All Payer |
$3,322.00
|
|
|
COCR 12/14 FEM HD 28 +16
|
Facility
|
OP
|
$3,775.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$490.75 |
| Max. Negotiated Rate |
$3,624.00 |
| Rate for Payer: Aetna Commercial |
$2,906.75
|
| Rate for Payer: Anthem Medicaid |
$1,298.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,944.50
|
| Rate for Payer: Cash Price |
$1,887.50
|
| Rate for Payer: Cigna Commercial |
$3,133.25
|
| Rate for Payer: First Health Commercial |
$3,586.25
|
| Rate for Payer: Humana Commercial |
$3,208.75
|
| Rate for Payer: Humana KY Medicaid |
$1,298.22
|
| Rate for Payer: Kentucky WC Medicaid |
$1,311.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,095.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,785.95
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,132.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,324.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,322.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,831.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$755.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$490.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,170.25
|
| Rate for Payer: PHCS Commercial |
$3,624.00
|
| Rate for Payer: United Healthcare All Payer |
$3,322.00
|
|
