|
COCR 12/14 FEM HD 28 -3
|
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 -3
|
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 +4
|
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 +4
|
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 32 +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 32 +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 32 +12
|
Facility
|
IP
|
$7,065.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$918.57 |
| Max. Negotiated Rate |
$6,783.30 |
| Rate for Payer: Aetna Commercial |
$5,440.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,511.43
|
| Rate for Payer: Cash Price |
$3,532.97
|
| Rate for Payer: Cigna Commercial |
$5,864.73
|
| Rate for Payer: First Health Commercial |
$6,712.64
|
| Rate for Payer: Humana Commercial |
$6,006.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,794.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,214.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,119.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,218.03
|
| Rate for Payer: Ohio Health Group HMO |
$5,299.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,413.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,190.44
|
| Rate for Payer: PHCS Commercial |
$6,783.30
|
| Rate for Payer: United Healthcare All Payer |
$6,218.03
|
|
|
COCR 12/14 FEM HD 32 +12
|
Facility
|
OP
|
$7,065.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$918.57 |
| Max. Negotiated Rate |
$6,783.30 |
| Rate for Payer: Aetna Commercial |
$5,440.77
|
| Rate for Payer: Anthem Medicaid |
$2,429.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,511.43
|
| Rate for Payer: Cash Price |
$3,532.97
|
| Rate for Payer: Cigna Commercial |
$5,864.73
|
| Rate for Payer: First Health Commercial |
$6,712.64
|
| Rate for Payer: Humana Commercial |
$6,006.05
|
| Rate for Payer: Humana KY Medicaid |
$2,429.98
|
| Rate for Payer: Kentucky WC Medicaid |
$2,454.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,794.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,214.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,119.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,478.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,218.03
|
| Rate for Payer: Ohio Health Group HMO |
$5,299.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,413.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,190.44
|
| Rate for Payer: PHCS Commercial |
$6,783.30
|
| Rate for Payer: United Healthcare All Payer |
$6,218.03
|
|
|
COCR 12/14 FEM HD 32 +16
|
Facility
|
IP
|
$7,065.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$918.57 |
| Max. Negotiated Rate |
$6,783.30 |
| Rate for Payer: Aetna Commercial |
$5,440.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,511.43
|
| Rate for Payer: Cash Price |
$3,532.97
|
| Rate for Payer: Cigna Commercial |
$5,864.73
|
| Rate for Payer: First Health Commercial |
$6,712.64
|
| Rate for Payer: Humana Commercial |
$6,006.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,794.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,214.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,119.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,218.03
|
| Rate for Payer: Ohio Health Group HMO |
$5,299.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,413.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,190.44
|
| Rate for Payer: PHCS Commercial |
$6,783.30
|
| Rate for Payer: United Healthcare All Payer |
$6,218.03
|
|
|
COCR 12/14 FEM HD 32 +16
|
Facility
|
OP
|
$7,065.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$918.57 |
| Max. Negotiated Rate |
$6,783.30 |
| Rate for Payer: Aetna Commercial |
$5,440.77
|
| Rate for Payer: Anthem Medicaid |
$2,429.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,511.43
|
| Rate for Payer: Cash Price |
$3,532.97
|
| Rate for Payer: Cigna Commercial |
$5,864.73
|
| Rate for Payer: First Health Commercial |
$6,712.64
|
| Rate for Payer: Humana Commercial |
$6,006.05
|
| Rate for Payer: Humana KY Medicaid |
$2,429.98
|
| Rate for Payer: Kentucky WC Medicaid |
$2,454.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,794.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,214.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,119.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,478.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,218.03
|
| Rate for Payer: Ohio Health Group HMO |
$5,299.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,413.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,190.44
|
| Rate for Payer: PHCS Commercial |
$6,783.30
|
| Rate for Payer: United Healthcare All Payer |
$6,218.03
|
|
|
COCR 12/14 FEM HD 32 -3
|
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 32 -3
|
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 32 +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 32 +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 32 +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 32 +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 36 +0
|
Facility
|
OP
|
$7,065.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$918.57 |
| Max. Negotiated Rate |
$6,783.30 |
| Rate for Payer: Aetna Commercial |
$5,440.77
|
| Rate for Payer: Anthem Medicaid |
$2,429.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,511.43
|
| Rate for Payer: Cash Price |
$3,532.97
|
| Rate for Payer: Cigna Commercial |
$5,864.73
|
| Rate for Payer: First Health Commercial |
$6,712.64
|
| Rate for Payer: Humana Commercial |
$6,006.05
|
| Rate for Payer: Humana KY Medicaid |
$2,429.98
|
| Rate for Payer: Kentucky WC Medicaid |
$2,454.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,794.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,214.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,119.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,478.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,218.03
|
| Rate for Payer: Ohio Health Group HMO |
$5,299.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,413.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,190.44
|
| Rate for Payer: PHCS Commercial |
$6,783.30
|
| Rate for Payer: United Healthcare All Payer |
$6,218.03
|
|
|
COCR 12/14 FEM HD 36 +0
|
Facility
|
IP
|
$7,065.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$918.57 |
| Max. Negotiated Rate |
$6,783.30 |
| Rate for Payer: Aetna Commercial |
$5,440.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,511.43
|
| Rate for Payer: Cash Price |
$3,532.97
|
| Rate for Payer: Cigna Commercial |
$5,864.73
|
| Rate for Payer: First Health Commercial |
$6,712.64
|
| Rate for Payer: Humana Commercial |
$6,006.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,794.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,214.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,119.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,218.03
|
| Rate for Payer: Ohio Health Group HMO |
$5,299.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,413.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,190.44
|
| Rate for Payer: PHCS Commercial |
$6,783.30
|
| Rate for Payer: United Healthcare All Payer |
$6,218.03
|
|
|
COCR 12/14 FEM HD 36 +12
|
Facility
|
IP
|
$7,745.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,006.90 |
| Max. Negotiated Rate |
$7,435.56 |
| Rate for Payer: Aetna Commercial |
$5,963.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,041.40
|
| Rate for Payer: Cash Price |
$3,872.69
|
| Rate for Payer: Cigna Commercial |
$6,428.67
|
| Rate for Payer: First Health Commercial |
$7,358.11
|
| Rate for Payer: Humana Commercial |
$6,583.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,351.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,716.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,323.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,815.93
|
| Rate for Payer: Ohio Health Group HMO |
$5,809.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,549.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,006.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,401.07
|
| Rate for Payer: PHCS Commercial |
$7,435.56
|
| Rate for Payer: United Healthcare All Payer |
$6,815.93
|
|
|
COCR 12/14 FEM HD 36 +12
|
Facility
|
OP
|
$7,745.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,006.90 |
| Max. Negotiated Rate |
$7,435.56 |
| Rate for Payer: Aetna Commercial |
$5,963.94
|
| Rate for Payer: Anthem Medicaid |
$2,663.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,041.40
|
| Rate for Payer: Cash Price |
$3,872.69
|
| Rate for Payer: Cigna Commercial |
$6,428.67
|
| Rate for Payer: First Health Commercial |
$7,358.11
|
| Rate for Payer: Humana Commercial |
$6,583.57
|
| Rate for Payer: Humana KY Medicaid |
$2,663.64
|
| Rate for Payer: Kentucky WC Medicaid |
$2,690.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,351.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,716.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,323.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,717.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,815.93
|
| Rate for Payer: Ohio Health Group HMO |
$5,809.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,549.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,006.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,401.07
|
| Rate for Payer: PHCS Commercial |
$7,435.56
|
| Rate for Payer: United Healthcare All Payer |
$6,815.93
|
|
|
COCR 12/14 FEM HD 36 -3
|
Facility
|
IP
|
$7,065.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$918.57 |
| Max. Negotiated Rate |
$6,783.30 |
| Rate for Payer: Aetna Commercial |
$5,440.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,511.43
|
| Rate for Payer: Cash Price |
$3,532.97
|
| Rate for Payer: Cigna Commercial |
$5,864.73
|
| Rate for Payer: First Health Commercial |
$6,712.64
|
| Rate for Payer: Humana Commercial |
$6,006.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,794.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,214.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,119.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,218.03
|
| Rate for Payer: Ohio Health Group HMO |
$5,299.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,413.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,190.44
|
| Rate for Payer: PHCS Commercial |
$6,783.30
|
| Rate for Payer: United Healthcare All Payer |
$6,218.03
|
|
|
COCR 12/14 FEM HD 36 -3
|
Facility
|
OP
|
$7,065.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$918.57 |
| Max. Negotiated Rate |
$6,783.30 |
| Rate for Payer: Aetna Commercial |
$5,440.77
|
| Rate for Payer: Anthem Medicaid |
$2,429.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,511.43
|
| Rate for Payer: Cash Price |
$3,532.97
|
| Rate for Payer: Cigna Commercial |
$5,864.73
|
| Rate for Payer: First Health Commercial |
$6,712.64
|
| Rate for Payer: Humana Commercial |
$6,006.05
|
| Rate for Payer: Humana KY Medicaid |
$2,429.98
|
| Rate for Payer: Kentucky WC Medicaid |
$2,454.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,794.07
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,214.66
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,119.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,478.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,218.03
|
| Rate for Payer: Ohio Health Group HMO |
$5,299.46
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,413.19
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$918.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,190.44
|
| Rate for Payer: PHCS Commercial |
$6,783.30
|
| Rate for Payer: United Healthcare All Payer |
$6,218.03
|
|
|
COCR 12/14 FEM HD 36 +4
|
Facility
|
IP
|
$7,745.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,006.90 |
| Max. Negotiated Rate |
$7,435.56 |
| Rate for Payer: Aetna Commercial |
$5,963.94
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,041.40
|
| Rate for Payer: Cash Price |
$3,872.69
|
| Rate for Payer: Cigna Commercial |
$6,428.67
|
| Rate for Payer: First Health Commercial |
$7,358.11
|
| Rate for Payer: Humana Commercial |
$6,583.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,351.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,716.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,323.61
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,815.93
|
| Rate for Payer: Ohio Health Group HMO |
$5,809.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,549.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,006.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,401.07
|
| Rate for Payer: PHCS Commercial |
$7,435.56
|
| Rate for Payer: United Healthcare All Payer |
$6,815.93
|
|
|
COCR 12/14 FEM HD 36 +4
|
Facility
|
OP
|
$7,745.38
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,006.90 |
| Max. Negotiated Rate |
$7,435.56 |
| Rate for Payer: Aetna Commercial |
$5,963.94
|
| Rate for Payer: Anthem Medicaid |
$2,663.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,041.40
|
| Rate for Payer: Cash Price |
$3,872.69
|
| Rate for Payer: Cigna Commercial |
$6,428.67
|
| Rate for Payer: First Health Commercial |
$7,358.11
|
| Rate for Payer: Humana Commercial |
$6,583.57
|
| Rate for Payer: Humana KY Medicaid |
$2,663.64
|
| Rate for Payer: Kentucky WC Medicaid |
$2,690.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,351.21
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$5,716.09
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,323.61
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,717.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$6,815.93
|
| Rate for Payer: Ohio Health Group HMO |
$5,809.04
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,549.08
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,006.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,401.07
|
| Rate for Payer: PHCS Commercial |
$7,435.56
|
| Rate for Payer: United Healthcare All Payer |
$6,815.93
|
|
|
COCR 12/14 FEM HD 36 +8
|
Facility
|
OP
|
$5,526.36
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$718.43 |
| Max. Negotiated Rate |
$5,305.31 |
| Rate for Payer: Aetna Commercial |
$4,255.30
|
| Rate for Payer: Anthem Medicaid |
$1,900.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,310.56
|
| Rate for Payer: Cash Price |
$2,763.18
|
| Rate for Payer: Cigna Commercial |
$4,586.88
|
| Rate for Payer: First Health Commercial |
$5,250.04
|
| Rate for Payer: Humana Commercial |
$4,697.41
|
| Rate for Payer: Humana KY Medicaid |
$1,900.52
|
| Rate for Payer: Kentucky WC Medicaid |
$1,919.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,531.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,078.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,657.91
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,938.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,863.20
|
| Rate for Payer: Ohio Health Group HMO |
$4,144.77
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,105.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$718.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,713.17
|
| Rate for Payer: PHCS Commercial |
$5,305.31
|
| Rate for Payer: United Healthcare All Payer |
$4,863.20
|
|
