|
CEMENTRALIZER 11.0
|
Facility
|
OP
|
$2,010.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$603.18 |
| Max. Negotiated Rate |
$1,930.18 |
| Rate for Payer: Aetna Commercial |
$1,548.16
|
| Rate for Payer: Anthem Medicaid |
$691.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,568.27
|
| Rate for Payer: Cash Price |
$1,005.30
|
| Rate for Payer: Cigna Commercial |
$1,668.80
|
| Rate for Payer: First Health Commercial |
$1,910.07
|
| Rate for Payer: Humana Commercial |
$1,709.01
|
| Rate for Payer: Humana KY Medicaid |
$691.45
|
| Rate for Payer: Kentucky WC Medicaid |
$698.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,648.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,483.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$603.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$705.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,769.33
|
| Rate for Payer: Ohio Health Group HMO |
$1,507.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,608.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,749.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,387.31
|
| Rate for Payer: PHCS Commercial |
$1,930.18
|
| Rate for Payer: United Healthcare All Payer |
$1,769.33
|
|
|
CEMENTRALIZER 11.0
|
Facility
|
IP
|
$2,010.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$603.18 |
| Max. Negotiated Rate |
$1,930.18 |
| Rate for Payer: Aetna Commercial |
$1,548.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,568.27
|
| Rate for Payer: Cash Price |
$1,005.30
|
| Rate for Payer: Cigna Commercial |
$1,668.80
|
| Rate for Payer: First Health Commercial |
$1,910.07
|
| Rate for Payer: Humana Commercial |
$1,709.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,648.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,483.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$603.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,769.33
|
| Rate for Payer: Ohio Health Group HMO |
$1,507.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,608.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,749.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,387.31
|
| Rate for Payer: PHCS Commercial |
$1,930.18
|
| Rate for Payer: United Healthcare All Payer |
$1,769.33
|
|
|
CEMENTRALIZER 11.5
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 11.5
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 12.0
|
Facility
|
OP
|
$2,010.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$603.18 |
| Max. Negotiated Rate |
$1,930.18 |
| Rate for Payer: Aetna Commercial |
$1,548.16
|
| Rate for Payer: Anthem Medicaid |
$691.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,568.27
|
| Rate for Payer: Cash Price |
$1,005.30
|
| Rate for Payer: Cigna Commercial |
$1,668.80
|
| Rate for Payer: First Health Commercial |
$1,910.07
|
| Rate for Payer: Humana Commercial |
$1,709.01
|
| Rate for Payer: Humana KY Medicaid |
$691.45
|
| Rate for Payer: Kentucky WC Medicaid |
$698.48
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,648.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,483.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$603.18
|
| Rate for Payer: Molina Healthcare Medicaid |
$705.32
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,769.33
|
| Rate for Payer: Ohio Health Group HMO |
$1,507.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,608.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,749.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,387.31
|
| Rate for Payer: PHCS Commercial |
$1,930.18
|
| Rate for Payer: United Healthcare All Payer |
$1,769.33
|
|
|
CEMENTRALIZER 12.0
|
Facility
|
IP
|
$2,010.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$603.18 |
| Max. Negotiated Rate |
$1,930.18 |
| Rate for Payer: Aetna Commercial |
$1,548.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,568.27
|
| Rate for Payer: Cash Price |
$1,005.30
|
| Rate for Payer: Cigna Commercial |
$1,668.80
|
| Rate for Payer: First Health Commercial |
$1,910.07
|
| Rate for Payer: Humana Commercial |
$1,709.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,648.69
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,483.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$603.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,769.33
|
| Rate for Payer: Ohio Health Group HMO |
$1,507.95
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,608.48
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,749.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,387.31
|
| Rate for Payer: PHCS Commercial |
$1,930.18
|
| Rate for Payer: United Healthcare All Payer |
$1,769.33
|
|
|
CEMENTRALIZER 12.5
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 12.5
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 13.0
|
Facility
|
IP
|
$2,037.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.16 |
| Max. Negotiated Rate |
$1,955.71 |
| Rate for Payer: Aetna Commercial |
$1,568.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,589.02
|
| Rate for Payer: Cash Price |
$1,018.60
|
| Rate for Payer: Cigna Commercial |
$1,690.88
|
| Rate for Payer: First Health Commercial |
$1,935.34
|
| Rate for Payer: Humana Commercial |
$1,731.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,670.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,503.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$611.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,792.74
|
| Rate for Payer: Ohio Health Group HMO |
$1,527.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,629.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,772.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,405.67
|
| Rate for Payer: PHCS Commercial |
$1,955.71
|
| Rate for Payer: United Healthcare All Payer |
$1,792.74
|
|
|
CEMENTRALIZER 13.0
|
Facility
|
OP
|
$2,037.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$611.16 |
| Max. Negotiated Rate |
$1,955.71 |
| Rate for Payer: Aetna Commercial |
$1,568.64
|
| Rate for Payer: Anthem Medicaid |
$700.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,589.02
|
| Rate for Payer: Cash Price |
$1,018.60
|
| Rate for Payer: Cigna Commercial |
$1,690.88
|
| Rate for Payer: First Health Commercial |
$1,935.34
|
| Rate for Payer: Humana Commercial |
$1,731.62
|
| Rate for Payer: Humana KY Medicaid |
$700.59
|
| Rate for Payer: Kentucky WC Medicaid |
$707.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,670.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,503.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$611.16
|
| Rate for Payer: Molina Healthcare Medicaid |
$714.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,792.74
|
| Rate for Payer: Ohio Health Group HMO |
$1,527.90
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,629.76
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,772.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,405.67
|
| Rate for Payer: PHCS Commercial |
$1,955.71
|
| Rate for Payer: United Healthcare All Payer |
$1,792.74
|
|
|
CEMENTRALIZER 13.5
|
Facility
|
IP
|
$1,702.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$510.84 |
| Max. Negotiated Rate |
$1,634.69 |
| Rate for Payer: Aetna Commercial |
$1,311.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,328.18
|
| Rate for Payer: Cash Price |
$851.40
|
| Rate for Payer: Cigna Commercial |
$1,413.32
|
| Rate for Payer: First Health Commercial |
$1,617.66
|
| Rate for Payer: Humana Commercial |
$1,447.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,396.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,256.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$510.84
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,498.46
|
| Rate for Payer: Ohio Health Group HMO |
$1,277.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,362.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,481.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,174.93
|
| Rate for Payer: PHCS Commercial |
$1,634.69
|
| Rate for Payer: United Healthcare All Payer |
$1,498.46
|
|
|
CEMENTRALIZER 13.5
|
Facility
|
OP
|
$1,702.80
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$510.84 |
| Max. Negotiated Rate |
$1,634.69 |
| Rate for Payer: Aetna Commercial |
$1,311.16
|
| Rate for Payer: Anthem Medicaid |
$585.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,328.18
|
| Rate for Payer: Cash Price |
$851.40
|
| Rate for Payer: Cigna Commercial |
$1,413.32
|
| Rate for Payer: First Health Commercial |
$1,617.66
|
| Rate for Payer: Humana Commercial |
$1,447.38
|
| Rate for Payer: Humana KY Medicaid |
$585.59
|
| Rate for Payer: Kentucky WC Medicaid |
$591.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,396.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,256.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$510.84
|
| Rate for Payer: Molina Healthcare Medicaid |
$597.34
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,498.46
|
| Rate for Payer: Ohio Health Group HMO |
$1,277.10
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,362.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,481.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,174.93
|
| Rate for Payer: PHCS Commercial |
$1,634.69
|
| Rate for Payer: United Healthcare All Payer |
$1,498.46
|
|
|
CEMENTRALIZER 14.0
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 14.0
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 14.5
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 14.5
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 15.0
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 15.0
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 15.5
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 15.5
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 16.0
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 16.0
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 17.0
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 17.0
|
Facility
|
OP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem Medicaid |
$684.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Humana KY Medicaid |
$684.91
|
| Rate for Payer: Kentucky WC Medicaid |
$691.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$698.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
|
CEMENTRALIZER 17.5
|
Facility
|
IP
|
$1,991.60
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$597.48 |
| Max. Negotiated Rate |
$1,911.94 |
| Rate for Payer: Aetna Commercial |
$1,533.53
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,553.45
|
| Rate for Payer: Cash Price |
$995.80
|
| Rate for Payer: Cigna Commercial |
$1,653.03
|
| Rate for Payer: First Health Commercial |
$1,892.02
|
| Rate for Payer: Humana Commercial |
$1,692.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,633.11
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,469.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$597.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,752.61
|
| Rate for Payer: Ohio Health Group HMO |
$1,493.70
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,593.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,732.69
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,374.20
|
| Rate for Payer: PHCS Commercial |
$1,911.94
|
| Rate for Payer: United Healthcare All Payer |
$1,752.61
|
|
