|
COLECTOMY - PARTIAL; WITH ANA
|
Facility
|
OP
|
$2,350.00
|
|
|
Service Code
|
HCPCS 44140
|
| Hospital Charge Code |
76101814
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$305.50 |
| Max. Negotiated Rate |
$2,256.00 |
| Rate for Payer: Aetna Commercial |
$1,809.50
|
| Rate for Payer: Anthem Medicaid |
$808.16
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,833.00
|
| Rate for Payer: Cash Price |
$1,175.00
|
| Rate for Payer: Cigna Commercial |
$1,950.50
|
| Rate for Payer: First Health Commercial |
$2,232.50
|
| Rate for Payer: Humana Commercial |
$1,997.50
|
| Rate for Payer: Humana KY Medicaid |
$808.16
|
| Rate for Payer: Kentucky WC Medicaid |
$816.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,927.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,734.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$705.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$824.38
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,068.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,762.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$470.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$305.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$728.50
|
| Rate for Payer: PHCS Commercial |
$2,256.00
|
| Rate for Payer: United Healthcare All Payer |
$2,068.00
|
|
|
COLECTOMY - PARTIAL; WITH AN(P
|
Professional
|
Both
|
$2,350.00
|
|
|
Service Code
|
HCPCS 44140
|
| Hospital Charge Code |
761P1814
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$822.50 |
| Max. Negotiated Rate |
$2,350.00 |
| Rate for Payer: Aetna Commercial |
$1,944.45
|
| Rate for Payer: Anthem Medicaid |
$920.07
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,350.00
|
| Rate for Payer: Cash Price |
$1,175.00
|
| Rate for Payer: Cash Price |
$1,175.00
|
| Rate for Payer: Cigna Commercial |
$1,816.00
|
| Rate for Payer: Healthspan PPO |
$1,639.79
|
| Rate for Payer: Humana Medicaid |
$920.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$1,712.13
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$938.47
|
| Rate for Payer: Molina Healthcare Passport |
$920.07
|
| Rate for Payer: Multiplan PHCS |
$1,410.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,645.00
|
| Rate for Payer: UHCCP Medicaid |
$822.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$929.27
|
|
|
COLECTOMY - PARTIAL; WITH COL
|
Professional
|
Both
|
$2,800.00
|
|
|
Service Code
|
HCPCS 44146
|
| Hospital Charge Code |
76101819
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$980.00 |
| Max. Negotiated Rate |
$3,001.97 |
| Rate for Payer: Aetna Commercial |
$3,001.97
|
| Rate for Payer: Anthem Medicaid |
$1,130.11
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,800.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cigna Commercial |
$2,775.21
|
| Rate for Payer: Healthspan PPO |
$2,531.61
|
| Rate for Payer: Humana Medicaid |
$1,130.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,687.25
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,152.71
|
| Rate for Payer: Molina Healthcare Passport |
$1,130.11
|
| Rate for Payer: Multiplan PHCS |
$1,680.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,960.00
|
| Rate for Payer: UHCCP Medicaid |
$980.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,141.41
|
|
|
COLECTOMY - PARTIAL; WITH COL
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 44146
|
| Hospital Charge Code |
76101819
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$2,688.00 |
| Rate for Payer: Aetna Commercial |
$2,156.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,184.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cigna Commercial |
$2,324.00
|
| Rate for Payer: First Health Commercial |
$2,660.00
|
| Rate for Payer: Humana Commercial |
$2,380.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,296.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,066.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$840.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,464.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,100.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$560.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$364.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$868.00
|
| Rate for Payer: PHCS Commercial |
$2,688.00
|
| Rate for Payer: United Healthcare All Payer |
$2,464.00
|
|
|
COLECTOMY - PARTIAL; WITH COL
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 44146
|
| Hospital Charge Code |
76101819
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$2,688.00 |
| Rate for Payer: Aetna Commercial |
$2,156.00
|
| Rate for Payer: Anthem Medicaid |
$962.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,184.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cigna Commercial |
$2,324.00
|
| Rate for Payer: First Health Commercial |
$2,660.00
|
| Rate for Payer: Humana Commercial |
$2,380.00
|
| Rate for Payer: Humana KY Medicaid |
$962.92
|
| Rate for Payer: Kentucky WC Medicaid |
$972.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,296.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,066.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$840.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$982.24
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,464.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,100.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$560.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$364.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$868.00
|
| Rate for Payer: PHCS Commercial |
$2,688.00
|
| Rate for Payer: United Healthcare All Payer |
$2,464.00
|
|
|
COLECTOMY - PARTIAL; WITH CO(P
|
Professional
|
Both
|
$2,800.00
|
|
|
Service Code
|
HCPCS 44146
|
| Hospital Charge Code |
761P1819
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$980.00 |
| Max. Negotiated Rate |
$3,001.97 |
| Rate for Payer: Aetna Commercial |
$3,001.97
|
| Rate for Payer: Anthem Medicaid |
$1,130.11
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,800.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cigna Commercial |
$2,775.21
|
| Rate for Payer: Healthspan PPO |
$2,531.61
|
| Rate for Payer: Humana Medicaid |
$1,130.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,687.25
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,152.71
|
| Rate for Payer: Molina Healthcare Passport |
$1,130.11
|
| Rate for Payer: Multiplan PHCS |
$1,680.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,960.00
|
| Rate for Payer: UHCCP Medicaid |
$980.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,141.41
|
|
|
COLECTOMY - PARTIAL; WITH END
|
Facility
|
IP
|
$2,400.00
|
|
|
Service Code
|
HCPCS 44143
|
| Hospital Charge Code |
76101816
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.00 |
| Max. Negotiated Rate |
$2,304.00 |
| Rate for Payer: Aetna Commercial |
$1,848.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cigna Commercial |
$1,992.00
|
| Rate for Payer: First Health Commercial |
$2,280.00
|
| Rate for Payer: Humana Commercial |
$2,040.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,968.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,771.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$720.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,112.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,800.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$480.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$312.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$744.00
|
| Rate for Payer: PHCS Commercial |
$2,304.00
|
| Rate for Payer: United Healthcare All Payer |
$2,112.00
|
|
|
COLECTOMY - PARTIAL; WITH END
|
Facility
|
OP
|
$2,400.00
|
|
|
Service Code
|
HCPCS 44143
|
| Hospital Charge Code |
76101816
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.00 |
| Max. Negotiated Rate |
$2,304.00 |
| Rate for Payer: Aetna Commercial |
$1,848.00
|
| Rate for Payer: Anthem Medicaid |
$825.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cigna Commercial |
$1,992.00
|
| Rate for Payer: First Health Commercial |
$2,280.00
|
| Rate for Payer: Humana Commercial |
$2,040.00
|
| Rate for Payer: Humana KY Medicaid |
$825.36
|
| Rate for Payer: Kentucky WC Medicaid |
$833.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,968.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,771.20
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$720.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$841.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,112.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,800.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$480.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$312.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$744.00
|
| Rate for Payer: PHCS Commercial |
$2,304.00
|
| Rate for Payer: United Healthcare All Payer |
$2,112.00
|
|
|
COLECTOMY - PARTIAL; WITH END
|
Professional
|
Both
|
$2,400.00
|
|
|
Service Code
|
HCPCS 44143
|
| Hospital Charge Code |
76101816
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$832.65 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$2,385.94
|
| Rate for Payer: Anthem Medicaid |
$832.65
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,400.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cigna Commercial |
$2,224.50
|
| Rate for Payer: Healthspan PPO |
$2,012.11
|
| Rate for Payer: Humana Medicaid |
$832.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,123.80
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$849.30
|
| Rate for Payer: Molina Healthcare Passport |
$832.65
|
| Rate for Payer: Multiplan PHCS |
$1,440.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,680.00
|
| Rate for Payer: UHCCP Medicaid |
$840.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$840.98
|
|
|
COLECTOMY - PARTIAL; WITH EN(P
|
Professional
|
Both
|
$2,400.00
|
|
|
Service Code
|
HCPCS 44143
|
| Hospital Charge Code |
761P1816
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$832.65 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$2,385.94
|
| Rate for Payer: Anthem Medicaid |
$832.65
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,400.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cigna Commercial |
$2,224.50
|
| Rate for Payer: Healthspan PPO |
$2,012.11
|
| Rate for Payer: Humana Medicaid |
$832.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,123.80
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$849.30
|
| Rate for Payer: Molina Healthcare Passport |
$832.65
|
| Rate for Payer: Multiplan PHCS |
$1,440.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,680.00
|
| Rate for Payer: UHCCP Medicaid |
$840.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$840.98
|
|
|
COLECTOMY - PARTIAL; WITH SKI
|
Facility
|
OP
|
$2,600.00
|
|
|
Service Code
|
HCPCS 44141
|
| Hospital Charge Code |
76101815
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$338.00 |
| Max. Negotiated Rate |
$2,496.00 |
| Rate for Payer: Aetna Commercial |
$2,002.00
|
| Rate for Payer: Anthem Medicaid |
$894.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,028.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cigna Commercial |
$2,158.00
|
| Rate for Payer: First Health Commercial |
$2,470.00
|
| Rate for Payer: Humana Commercial |
$2,210.00
|
| Rate for Payer: Humana KY Medicaid |
$894.14
|
| Rate for Payer: Kentucky WC Medicaid |
$903.24
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,132.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,918.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$912.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,288.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$520.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$338.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$806.00
|
| Rate for Payer: PHCS Commercial |
$2,496.00
|
| Rate for Payer: United Healthcare All Payer |
$2,288.00
|
|
|
COLECTOMY - PARTIAL; WITH SKI
|
Facility
|
IP
|
$2,600.00
|
|
|
Service Code
|
HCPCS 44141
|
| Hospital Charge Code |
76101815
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$338.00 |
| Max. Negotiated Rate |
$2,496.00 |
| Rate for Payer: Aetna Commercial |
$2,002.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,028.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cigna Commercial |
$2,158.00
|
| Rate for Payer: First Health Commercial |
$2,470.00
|
| Rate for Payer: Humana Commercial |
$2,210.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,132.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,918.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,288.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,950.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$520.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$338.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$806.00
|
| Rate for Payer: PHCS Commercial |
$2,496.00
|
| Rate for Payer: United Healthcare All Payer |
$2,288.00
|
|
|
COLECTOMY - PARTIAL; WITH SKI
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 44141
|
| Hospital Charge Code |
76101815
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$889.47 |
| Max. Negotiated Rate |
$2,600.00 |
| Rate for Payer: Aetna Commercial |
$2,524.88
|
| Rate for Payer: Anthem Medicaid |
$889.47
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,600.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cigna Commercial |
$2,302.85
|
| Rate for Payer: Healthspan PPO |
$2,129.27
|
| Rate for Payer: Humana Medicaid |
$889.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,310.45
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$907.26
|
| Rate for Payer: Molina Healthcare Passport |
$889.47
|
| Rate for Payer: Multiplan PHCS |
$1,560.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,820.00
|
| Rate for Payer: UHCCP Medicaid |
$910.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$898.36
|
|
|
COLECTOMY - PARTIAL; WITH SK(P
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 44141
|
| Hospital Charge Code |
761P1815
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$889.47 |
| Max. Negotiated Rate |
$2,600.00 |
| Rate for Payer: Aetna Commercial |
$2,524.88
|
| Rate for Payer: Anthem Medicaid |
$889.47
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,600.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cigna Commercial |
$2,302.85
|
| Rate for Payer: Healthspan PPO |
$2,129.27
|
| Rate for Payer: Humana Medicaid |
$889.47
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,310.45
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$907.26
|
| Rate for Payer: Molina Healthcare Passport |
$889.47
|
| Rate for Payer: Multiplan PHCS |
$1,560.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,820.00
|
| Rate for Payer: UHCCP Medicaid |
$910.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$898.36
|
|
|
COLECTOMY TOTAL
|
Professional
|
Both
|
$3,350.00
|
|
|
Service Code
|
HCPCS 44151
|
| Hospital Charge Code |
76101822
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$854.51 |
| Max. Negotiated Rate |
$3,350.00 |
| Rate for Payer: Aetna Commercial |
$3,010.76
|
| Rate for Payer: Anthem Medicaid |
$854.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,350.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna Commercial |
$2,790.48
|
| Rate for Payer: Healthspan PPO |
$2,539.03
|
| Rate for Payer: Humana Medicaid |
$854.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,723.68
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$871.60
|
| Rate for Payer: Molina Healthcare Passport |
$854.51
|
| Rate for Payer: Multiplan PHCS |
$2,010.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,345.00
|
| Rate for Payer: UHCCP Medicaid |
$1,172.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$863.06
|
|
|
COLECTOMY TOTAL
|
Facility
|
OP
|
$3,350.00
|
|
|
Service Code
|
HCPCS 44151
|
| Hospital Charge Code |
76101822
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$435.50 |
| Max. Negotiated Rate |
$3,216.00 |
| Rate for Payer: Aetna Commercial |
$2,579.50
|
| Rate for Payer: Anthem Medicaid |
$1,152.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,613.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna Commercial |
$2,780.50
|
| Rate for Payer: First Health Commercial |
$3,182.50
|
| Rate for Payer: Humana Commercial |
$2,847.50
|
| Rate for Payer: Humana KY Medicaid |
$1,152.06
|
| Rate for Payer: Kentucky WC Medicaid |
$1,163.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,747.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,472.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,005.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,175.18
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,948.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,512.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$670.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$435.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,038.50
|
| Rate for Payer: PHCS Commercial |
$3,216.00
|
| Rate for Payer: United Healthcare All Payer |
$2,948.00
|
|
|
COLECTOMY TOTAL
|
Facility
|
IP
|
$3,350.00
|
|
|
Service Code
|
HCPCS 44151
|
| Hospital Charge Code |
76101822
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$435.50 |
| Max. Negotiated Rate |
$3,216.00 |
| Rate for Payer: Aetna Commercial |
$2,579.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,613.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna Commercial |
$2,780.50
|
| Rate for Payer: First Health Commercial |
$3,182.50
|
| Rate for Payer: Humana Commercial |
$2,847.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,747.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,472.30
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,005.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,948.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,512.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$670.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$435.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,038.50
|
| Rate for Payer: PHCS Commercial |
$3,216.00
|
| Rate for Payer: United Healthcare All Payer |
$2,948.00
|
|
|
COLECTOMY TOTAL(P
|
Professional
|
Both
|
$3,350.00
|
|
|
Service Code
|
HCPCS 44151
|
| Hospital Charge Code |
761P1822
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$854.51 |
| Max. Negotiated Rate |
$3,350.00 |
| Rate for Payer: Aetna Commercial |
$3,010.76
|
| Rate for Payer: Anthem Medicaid |
$854.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,350.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna Commercial |
$2,790.48
|
| Rate for Payer: Healthspan PPO |
$2,539.03
|
| Rate for Payer: Humana Medicaid |
$854.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,723.68
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$871.60
|
| Rate for Payer: Molina Healthcare Passport |
$854.51
|
| Rate for Payer: Multiplan PHCS |
$2,010.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,345.00
|
| Rate for Payer: UHCCP Medicaid |
$1,172.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$863.06
|
|
|
COLECTOMY TOTAL W ILEOSTOMY
|
Facility
|
OP
|
$3,050.00
|
|
|
Service Code
|
HCPCS 44150
|
| Hospital Charge Code |
76101821
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$396.50 |
| Max. Negotiated Rate |
$2,928.00 |
| Rate for Payer: Aetna Commercial |
$2,348.50
|
| Rate for Payer: Anthem Medicaid |
$1,048.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,379.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cigna Commercial |
$2,531.50
|
| Rate for Payer: First Health Commercial |
$2,897.50
|
| Rate for Payer: Humana Commercial |
$2,592.50
|
| Rate for Payer: Humana KY Medicaid |
$1,048.90
|
| Rate for Payer: Kentucky WC Medicaid |
$1,059.57
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,501.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,250.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$915.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,069.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,684.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,287.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$610.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$396.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$945.50
|
| Rate for Payer: PHCS Commercial |
$2,928.00
|
| Rate for Payer: United Healthcare All Payer |
$2,684.00
|
|
|
COLECTOMY TOTAL W ILEOSTOMY
|
Facility
|
IP
|
$3,050.00
|
|
|
Service Code
|
HCPCS 44150
|
| Hospital Charge Code |
76101821
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$396.50 |
| Max. Negotiated Rate |
$2,928.00 |
| Rate for Payer: Aetna Commercial |
$2,348.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,379.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cigna Commercial |
$2,531.50
|
| Rate for Payer: First Health Commercial |
$2,897.50
|
| Rate for Payer: Humana Commercial |
$2,592.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,501.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,250.90
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$915.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,684.00
|
| Rate for Payer: Ohio Health Group HMO |
$2,287.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$610.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$396.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$945.50
|
| Rate for Payer: PHCS Commercial |
$2,928.00
|
| Rate for Payer: United Healthcare All Payer |
$2,684.00
|
|
|
COLECTOMY TOTAL W ILEOSTOMY
|
Professional
|
Both
|
$3,050.00
|
|
|
Service Code
|
HCPCS 44150
|
| Hospital Charge Code |
76101821
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,033.77 |
| Max. Negotiated Rate |
$3,050.00 |
| Rate for Payer: Aetna Commercial |
$2,631.75
|
| Rate for Payer: Anthem Medicaid |
$1,033.77
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,050.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cigna Commercial |
$2,436.77
|
| Rate for Payer: Healthspan PPO |
$2,219.40
|
| Rate for Payer: Humana Medicaid |
$1,033.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,370.22
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,054.45
|
| Rate for Payer: Molina Healthcare Passport |
$1,033.77
|
| Rate for Payer: Multiplan PHCS |
$1,830.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,135.00
|
| Rate for Payer: UHCCP Medicaid |
$1,067.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,044.11
|
|
|
COLECTOMY TOTAL W ILEOSTOMY(P
|
Professional
|
Both
|
$3,050.00
|
|
|
Service Code
|
HCPCS 44150
|
| Hospital Charge Code |
761P1821
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,033.77 |
| Max. Negotiated Rate |
$3,050.00 |
| Rate for Payer: Aetna Commercial |
$2,631.75
|
| Rate for Payer: Anthem Medicaid |
$1,033.77
|
| Rate for Payer: Buckeye Medicare Advantage |
$3,050.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cash Price |
$1,525.00
|
| Rate for Payer: Cigna Commercial |
$2,436.77
|
| Rate for Payer: Healthspan PPO |
$2,219.40
|
| Rate for Payer: Humana Medicaid |
$1,033.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$2,370.22
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$1,054.45
|
| Rate for Payer: Molina Healthcare Passport |
$1,033.77
|
| Rate for Payer: Multiplan PHCS |
$1,830.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$2,135.00
|
| Rate for Payer: UHCCP Medicaid |
$1,067.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$1,044.11
|
|
|
COLESTID(COLESTIPOL) 1GRAM TAB
|
Facility
|
IP
|
$9.05
|
|
|
Service Code
|
NDC 59762045001
|
| Hospital Charge Code |
25000445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$8.69 |
| Rate for Payer: Aetna Commercial |
$6.97
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7.06
|
| Rate for Payer: Cash Price |
$4.53
|
| Rate for Payer: Cigna Commercial |
$7.51
|
| Rate for Payer: First Health Commercial |
$8.60
|
| Rate for Payer: Humana Commercial |
$7.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2.72
|
| Rate for Payer: Ohio Health Choice Commercial |
$7.96
|
| Rate for Payer: Ohio Health Group HMO |
$6.79
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.81
|
| Rate for Payer: PHCS Commercial |
$8.69
|
| Rate for Payer: United Healthcare All Payer |
$7.96
|
|
|
COLESTID(COLESTIPOL) 1GRAM TAB
|
Facility
|
OP
|
$9.05
|
|
|
Service Code
|
NDC 59762045001
|
| Hospital Charge Code |
25000445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$8.69 |
| Rate for Payer: Aetna Commercial |
$6.97
|
| Rate for Payer: Anthem Medicaid |
$3.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7.06
|
| Rate for Payer: Cash Price |
$4.53
|
| Rate for Payer: Cigna Commercial |
$7.51
|
| Rate for Payer: First Health Commercial |
$8.60
|
| Rate for Payer: Humana Commercial |
$7.69
|
| Rate for Payer: Humana KY Medicaid |
$3.11
|
| Rate for Payer: Kentucky WC Medicaid |
$3.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2.72
|
| Rate for Payer: Molina Healthcare Medicaid |
$3.17
|
| Rate for Payer: Ohio Health Choice Commercial |
$7.96
|
| Rate for Payer: Ohio Health Group HMO |
$6.79
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1.81
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2.81
|
| Rate for Payer: PHCS Commercial |
$8.69
|
| Rate for Payer: United Healthcare All Payer |
$7.96
|
|
|
COLISTIMETHATE SOD 150MG/2ML
|
Facility
|
OP
|
$183.99
|
|
|
Service Code
|
HCPCS J0770
|
| Hospital Charge Code |
25001967
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.92 |
| Max. Negotiated Rate |
$176.63 |
| Rate for Payer: Aetna Commercial |
$141.67
|
| Rate for Payer: Anthem Medicaid |
$63.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$143.51
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cigna Commercial |
$152.71
|
| Rate for Payer: First Health Commercial |
$174.79
|
| Rate for Payer: Humana Commercial |
$156.39
|
| Rate for Payer: Humana KY Medicaid |
$63.27
|
| Rate for Payer: Kentucky WC Medicaid |
$63.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$150.87
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$135.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$55.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$64.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$161.91
|
| Rate for Payer: Ohio Health Group HMO |
$137.99
|
| Rate for Payer: Ohio Health Group PPO Differential |
$36.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$23.92
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$57.04
|
| Rate for Payer: PHCS Commercial |
$176.63
|
| Rate for Payer: United Healthcare All Payer |
$161.91
|
|
