|
COLONOSCOPY W/DILATION
|
Facility
|
IP
|
$1,250.00
|
|
|
Service Code
|
HCPCS 44405
|
| Hospital Charge Code |
76101852
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.50 |
| Max. Negotiated Rate |
$1,200.00 |
| Rate for Payer: Aetna Commercial |
$962.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$975.00
|
| Rate for Payer: Cash Price |
$625.00
|
| Rate for Payer: Cigna Commercial |
$1,037.50
|
| Rate for Payer: First Health Commercial |
$1,187.50
|
| Rate for Payer: Humana Commercial |
$1,062.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,025.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$922.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$375.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,100.00
|
| Rate for Payer: Ohio Health Group HMO |
$937.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$250.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$162.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$387.50
|
| Rate for Payer: PHCS Commercial |
$1,200.00
|
| Rate for Payer: United Healthcare All Payer |
$1,100.00
|
|
|
COLONOSCOPY W/DILATION(P
|
Professional
|
Both
|
$1,250.00
|
|
|
Service Code
|
HCPCS 44405
|
| Hospital Charge Code |
761P1852
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.07 |
| Max. Negotiated Rate |
$1,250.00 |
| Rate for Payer: Anthem Medicaid |
$155.07
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,250.00
|
| Rate for Payer: Cash Price |
$625.00
|
| Rate for Payer: Cash Price |
$625.00
|
| Rate for Payer: Humana Medicaid |
$155.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$268.56
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$158.17
|
| Rate for Payer: Molina Healthcare Passport |
$155.07
|
| Rate for Payer: Multiplan PHCS |
$750.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$875.00
|
| Rate for Payer: UHCCP Medicaid |
$437.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$156.62
|
|
|
COLONOSCOPY W/FB REMOVAL
|
Facility
|
OP
|
$1,225.00
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
76101892
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.25 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$943.25
|
| Rate for Payer: Anthem Medicaid |
$421.28
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,020.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$955.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,428.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,377.63
|
| Rate for Payer: Cash Price |
$612.50
|
| Rate for Payer: Cash Price |
$612.50
|
| Rate for Payer: Cigna Commercial |
$1,016.75
|
| Rate for Payer: First Health Commercial |
$1,163.75
|
| Rate for Payer: Humana Commercial |
$1,041.25
|
| Rate for Payer: Humana KY Medicaid |
$421.28
|
| Rate for Payer: Humana Medicare Advantage |
$1,020.47
|
| Rate for Payer: Kentucky WC Medicaid |
$425.56
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,004.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$904.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,224.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$429.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,078.00
|
| Rate for Payer: Ohio Health Group HMO |
$918.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$245.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$159.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$379.75
|
| Rate for Payer: PHCS Commercial |
$1,176.00
|
| Rate for Payer: United Healthcare All Payer |
$1,078.00
|
|
|
COLONOSCOPY W/FB REMOVAL
|
Professional
|
Both
|
$1,225.00
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
76101892
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.50 |
| Max. Negotiated Rate |
$1,225.00 |
| Rate for Payer: Aetna Commercial |
$413.56
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$232.50
|
| Rate for Payer: Anthem Medicaid |
$299.16
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,225.00
|
| Rate for Payer: Cash Price |
$612.50
|
| Rate for Payer: Cash Price |
$612.50
|
| Rate for Payer: Cigna Commercial |
$376.53
|
| Rate for Payer: Healthspan PPO |
$608.74
|
| Rate for Payer: Humana Medicaid |
$299.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$355.10
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$305.14
|
| Rate for Payer: Molina Healthcare Passport |
$299.16
|
| Rate for Payer: Multiplan PHCS |
$735.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$857.50
|
| Rate for Payer: UHCCP Medicaid |
$244.12
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$302.15
|
|
|
COLONOSCOPY W/FB REMOVAL
|
Facility
|
IP
|
$1,225.00
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
76101892
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.25 |
| Max. Negotiated Rate |
$1,176.00 |
| Rate for Payer: Aetna Commercial |
$943.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$955.50
|
| Rate for Payer: Cash Price |
$612.50
|
| Rate for Payer: Cigna Commercial |
$1,016.75
|
| Rate for Payer: First Health Commercial |
$1,163.75
|
| Rate for Payer: Humana Commercial |
$1,041.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,004.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$904.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$367.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,078.00
|
| Rate for Payer: Ohio Health Group HMO |
$918.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$245.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$159.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$379.75
|
| Rate for Payer: PHCS Commercial |
$1,176.00
|
| Rate for Payer: United Healthcare All Payer |
$1,078.00
|
|
|
COLONOSCOPY W/FB REMOVAL(P
|
Professional
|
Both
|
$1,225.00
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
761P1892
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.50 |
| Max. Negotiated Rate |
$1,225.00 |
| Rate for Payer: Aetna Commercial |
$413.56
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$232.50
|
| Rate for Payer: Anthem Medicaid |
$299.16
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,225.00
|
| Rate for Payer: Cash Price |
$612.50
|
| Rate for Payer: Cash Price |
$612.50
|
| Rate for Payer: Cigna Commercial |
$376.53
|
| Rate for Payer: Healthspan PPO |
$608.74
|
| Rate for Payer: Humana Medicaid |
$299.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$355.10
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$305.14
|
| Rate for Payer: Molina Healthcare Passport |
$299.16
|
| Rate for Payer: Multiplan PHCS |
$735.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$857.50
|
| Rate for Payer: UHCCP Medicaid |
$244.12
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$302.15
|
|
|
COLONOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$1,080.00
|
|
|
Service Code
|
HCPCS 44389
|
| Hospital Charge Code |
76101850
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.40 |
| Max. Negotiated Rate |
$1,036.80 |
| Rate for Payer: Aetna Commercial |
$831.60
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$842.40
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cigna Commercial |
$896.40
|
| Rate for Payer: First Health Commercial |
$1,026.00
|
| Rate for Payer: Humana Commercial |
$918.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$885.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$797.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$324.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$950.40
|
| Rate for Payer: Ohio Health Group HMO |
$810.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$216.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$140.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$334.80
|
| Rate for Payer: PHCS Commercial |
$1,036.80
|
| Rate for Payer: United Healthcare All Payer |
$950.40
|
|
|
COLONOSCOPY WITH BIOPSY
|
Professional
|
Both
|
$1,080.00
|
|
|
Service Code
|
HCPCS 44389
|
| Hospital Charge Code |
76101850
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.44 |
| Max. Negotiated Rate |
$1,080.00 |
| Rate for Payer: Aetna Commercial |
$281.81
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$158.44
|
| Rate for Payer: Anthem Medicaid |
$210.07
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,080.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cigna Commercial |
$256.24
|
| Rate for Payer: Healthspan PPO |
$478.22
|
| Rate for Payer: Humana Medicaid |
$210.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$241.85
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$214.27
|
| Rate for Payer: Molina Healthcare Passport |
$210.07
|
| Rate for Payer: Multiplan PHCS |
$648.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$756.00
|
| Rate for Payer: UHCCP Medicaid |
$166.36
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$212.17
|
|
|
COLONOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$1,080.00
|
|
|
Service Code
|
HCPCS 44389
|
| Hospital Charge Code |
76101850
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.40 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$831.60
|
| Rate for Payer: Anthem Medicaid |
$371.41
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,020.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$842.40
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,428.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,377.63
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cigna Commercial |
$896.40
|
| Rate for Payer: First Health Commercial |
$1,026.00
|
| Rate for Payer: Humana Commercial |
$918.00
|
| Rate for Payer: Humana KY Medicaid |
$371.41
|
| Rate for Payer: Humana Medicare Advantage |
$1,020.47
|
| Rate for Payer: Kentucky WC Medicaid |
$375.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$885.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$797.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,224.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$378.86
|
| Rate for Payer: Ohio Health Choice Commercial |
$950.40
|
| Rate for Payer: Ohio Health Group HMO |
$810.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$216.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$140.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$334.80
|
| Rate for Payer: PHCS Commercial |
$1,036.80
|
| Rate for Payer: United Healthcare All Payer |
$950.40
|
|
|
COLONOSCOPY WITH BIOPSY(P
|
Professional
|
Both
|
$1,080.00
|
|
|
Service Code
|
HCPCS 44389
|
| Hospital Charge Code |
761P1850
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.44 |
| Max. Negotiated Rate |
$1,080.00 |
| Rate for Payer: Aetna Commercial |
$281.81
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$158.44
|
| Rate for Payer: Anthem Medicaid |
$210.07
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,080.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cigna Commercial |
$256.24
|
| Rate for Payer: Healthspan PPO |
$478.22
|
| Rate for Payer: Humana Medicaid |
$210.07
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$241.85
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$214.27
|
| Rate for Payer: Molina Healthcare Passport |
$210.07
|
| Rate for Payer: Multiplan PHCS |
$648.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$756.00
|
| Rate for Payer: UHCCP Medicaid |
$166.36
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$212.17
|
|
|
COLONOSCOPY WITH BX
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
76101893
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$616.00
|
| Rate for Payer: Anthem Medicaid |
$275.12
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,020.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$624.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,428.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,377.63
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$664.00
|
| Rate for Payer: First Health Commercial |
$760.00
|
| Rate for Payer: Humana Commercial |
$680.00
|
| Rate for Payer: Humana KY Medicaid |
$275.12
|
| Rate for Payer: Humana Medicare Advantage |
$1,020.47
|
| Rate for Payer: Kentucky WC Medicaid |
$277.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$656.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$590.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,224.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$280.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$704.00
|
| Rate for Payer: Ohio Health Group HMO |
$600.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$160.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$104.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$248.00
|
| Rate for Payer: PHCS Commercial |
$768.00
|
| Rate for Payer: United Healthcare All Payer |
$704.00
|
|
|
COLONOSCOPY WITH BX
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
76101893
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$191.77 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Aetna Commercial |
$396.81
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$202.79
|
| Rate for Payer: Anthem Medicaid |
$191.77
|
| Rate for Payer: Buckeye Medicare Advantage |
$800.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$357.92
|
| Rate for Payer: Healthspan PPO |
$575.21
|
| Rate for Payer: Humana Medicaid |
$191.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$339.93
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$195.61
|
| Rate for Payer: Molina Healthcare Passport |
$191.77
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$560.00
|
| Rate for Payer: UHCCP Medicaid |
$212.93
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$193.69
|
|
|
COLONOSCOPY WITH BX
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
76101893
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$768.00 |
| Rate for Payer: Ohio Health Group HMO |
$600.00
|
| Rate for Payer: Aetna Commercial |
$616.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$624.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$664.00
|
| Rate for Payer: First Health Commercial |
$760.00
|
| Rate for Payer: Humana Commercial |
$680.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$656.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$590.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$240.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$704.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$160.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$104.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$248.00
|
| Rate for Payer: PHCS Commercial |
$768.00
|
| Rate for Payer: United Healthcare All Payer |
$704.00
|
|
|
COLONOSCOPY WITH BX(P
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
761P1893
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$191.77 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Aetna Commercial |
$396.81
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$202.79
|
| Rate for Payer: Anthem Medicaid |
$191.77
|
| Rate for Payer: Buckeye Medicare Advantage |
$800.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$357.92
|
| Rate for Payer: Healthspan PPO |
$575.21
|
| Rate for Payer: Humana Medicaid |
$191.77
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$339.93
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$195.61
|
| Rate for Payer: Molina Healthcare Passport |
$191.77
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$560.00
|
| Rate for Payer: UHCCP Medicaid |
$212.93
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$193.69
|
|
|
COLONOSCOPY W/POLIPECTOMY
|
Facility
|
IP
|
$1,100.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
76101897
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$1,056.00 |
| Rate for Payer: Aetna Commercial |
$847.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$858.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cigna Commercial |
$913.00
|
| Rate for Payer: First Health Commercial |
$1,045.00
|
| Rate for Payer: Humana Commercial |
$935.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$902.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$811.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$330.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$968.00
|
| Rate for Payer: Ohio Health Group HMO |
$825.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$220.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$143.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$341.00
|
| Rate for Payer: PHCS Commercial |
$1,056.00
|
| Rate for Payer: United Healthcare All Payer |
$968.00
|
|
|
COLONOSCOPY W/POLIPECTOMY
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
76101897
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$243.98 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Aetna Commercial |
$471.28
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$257.82
|
| Rate for Payer: Anthem Medicaid |
$243.98
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,100.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cigna Commercial |
$425.63
|
| Rate for Payer: Healthspan PPO |
$650.20
|
| Rate for Payer: Humana Medicaid |
$243.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$403.33
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$248.86
|
| Rate for Payer: Molina Healthcare Passport |
$243.98
|
| Rate for Payer: Multiplan PHCS |
$660.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$770.00
|
| Rate for Payer: UHCCP Medicaid |
$270.71
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$246.42
|
|
|
COLONOSCOPY W/POLIPECTOMY
|
Facility
|
OP
|
$1,100.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
76101897
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$847.00
|
| Rate for Payer: Anthem Medicaid |
$378.29
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,020.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$858.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,428.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,377.63
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cigna Commercial |
$913.00
|
| Rate for Payer: First Health Commercial |
$1,045.00
|
| Rate for Payer: Humana Commercial |
$935.00
|
| Rate for Payer: Humana KY Medicaid |
$378.29
|
| Rate for Payer: Humana Medicare Advantage |
$1,020.47
|
| Rate for Payer: Kentucky WC Medicaid |
$382.14
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$902.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$811.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,224.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$385.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$968.00
|
| Rate for Payer: Ohio Health Group HMO |
$825.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$220.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$143.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$341.00
|
| Rate for Payer: PHCS Commercial |
$1,056.00
|
| Rate for Payer: United Healthcare All Payer |
$968.00
|
|
|
COLONOSCOPY W/POLIPECTOMY(P
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
761P1897
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$243.98 |
| Max. Negotiated Rate |
$1,100.00 |
| Rate for Payer: Aetna Commercial |
$471.28
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$257.82
|
| Rate for Payer: Anthem Medicaid |
$243.98
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,100.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cash Price |
$550.00
|
| Rate for Payer: Cigna Commercial |
$425.63
|
| Rate for Payer: Healthspan PPO |
$650.20
|
| Rate for Payer: Humana Medicaid |
$243.98
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$403.33
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$248.86
|
| Rate for Payer: Molina Healthcare Passport |
$243.98
|
| Rate for Payer: Multiplan PHCS |
$660.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$770.00
|
| Rate for Payer: UHCCP Medicaid |
$270.71
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$246.42
|
|
|
COLONOSCOPY W/RESECTION
|
Facility
|
IP
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
76101901
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$1,080.00 |
| Rate for Payer: Aetna Commercial |
$866.25
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$877.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$933.75
|
| Rate for Payer: First Health Commercial |
$1,068.75
|
| Rate for Payer: Humana Commercial |
$956.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$922.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$830.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$337.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$990.00
|
| Rate for Payer: Ohio Health Group HMO |
$843.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$225.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$146.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$348.75
|
| Rate for Payer: PHCS Commercial |
$1,080.00
|
| Rate for Payer: United Healthcare All Payer |
$990.00
|
|
|
COLONOSCOPY W/RESECTION
|
Facility
|
OP
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
76101901
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$3,399.27 |
| Rate for Payer: Aetna Commercial |
$866.25
|
| Rate for Payer: Anthem Medicaid |
$386.89
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,428.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$877.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,399.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,277.87
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cigna Commercial |
$933.75
|
| Rate for Payer: First Health Commercial |
$1,068.75
|
| Rate for Payer: Humana Commercial |
$956.25
|
| Rate for Payer: Humana KY Medicaid |
$386.89
|
| Rate for Payer: Humana Medicare Advantage |
$2,428.05
|
| Rate for Payer: Kentucky WC Medicaid |
$390.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$922.50
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$830.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,913.66
|
| Rate for Payer: Molina Healthcare Medicaid |
$394.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$990.00
|
| Rate for Payer: Ohio Health Group HMO |
$843.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$225.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$146.25
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$348.75
|
| Rate for Payer: PHCS Commercial |
$1,080.00
|
| Rate for Payer: United Healthcare All Payer |
$990.00
|
|
|
COLONOSCOPY W/RESECTION
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
76101901
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$277.89 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Anthem Medicaid |
$277.89
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,125.00
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Humana Medicaid |
$277.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$481.09
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$283.45
|
| Rate for Payer: Molina Healthcare Passport |
$277.89
|
| Rate for Payer: Multiplan PHCS |
$675.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$787.50
|
| Rate for Payer: UHCCP Medicaid |
$393.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$280.67
|
|
|
COLONOSCOPY W/RESECTION(P
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
761P1901
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$277.89 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Anthem Medicaid |
$277.89
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,125.00
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Humana Medicaid |
$277.89
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$481.09
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$283.45
|
| Rate for Payer: Molina Healthcare Passport |
$277.89
|
| Rate for Payer: Multiplan PHCS |
$675.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$787.50
|
| Rate for Payer: UHCCP Medicaid |
$393.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$280.67
|
|
|
COLONOSCOPY W/SNARE
|
Facility
|
IP
|
$1,300.00
|
|
|
Service Code
|
HCPCS 44394
|
| Hospital Charge Code |
76101851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$169.00 |
| Max. Negotiated Rate |
$1,248.00 |
| Rate for Payer: Aetna Commercial |
$1,001.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,014.00
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cigna Commercial |
$1,079.00
|
| Rate for Payer: First Health Commercial |
$1,235.00
|
| Rate for Payer: Humana Commercial |
$1,105.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,066.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$959.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$390.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,144.00
|
| Rate for Payer: Ohio Health Group HMO |
$975.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$260.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$169.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$403.00
|
| Rate for Payer: PHCS Commercial |
$1,248.00
|
| Rate for Payer: United Healthcare All Payer |
$1,144.00
|
|
|
COLONOSCOPY W/SNARE
|
Professional
|
Both
|
$1,300.00
|
|
|
Service Code
|
HCPCS 44394
|
| Hospital Charge Code |
76101851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$220.66 |
| Max. Negotiated Rate |
$1,300.00 |
| Rate for Payer: Aetna Commercial |
$392.47
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$220.66
|
| Rate for Payer: Anthem Medicaid |
$285.40
|
| Rate for Payer: Buckeye Medicare Advantage |
$1,300.00
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cigna Commercial |
$356.33
|
| Rate for Payer: Healthspan PPO |
$609.01
|
| Rate for Payer: Humana Medicaid |
$285.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$335.56
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$291.11
|
| Rate for Payer: Molina Healthcare Passport |
$285.40
|
| Rate for Payer: Multiplan PHCS |
$780.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$910.00
|
| Rate for Payer: UHCCP Medicaid |
$231.69
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$288.25
|
|
|
COLONOSCOPY W/SNARE
|
Facility
|
OP
|
$1,300.00
|
|
|
Service Code
|
HCPCS 44394
|
| Hospital Charge Code |
76101851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$169.00 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$1,001.00
|
| Rate for Payer: Anthem Medicaid |
$447.07
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,020.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,014.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,428.66
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,377.63
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cigna Commercial |
$1,079.00
|
| Rate for Payer: First Health Commercial |
$1,235.00
|
| Rate for Payer: Humana Commercial |
$1,105.00
|
| Rate for Payer: Humana KY Medicaid |
$447.07
|
| Rate for Payer: Humana Medicare Advantage |
$1,020.47
|
| Rate for Payer: Kentucky WC Medicaid |
$451.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,066.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$959.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,224.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$456.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,144.00
|
| Rate for Payer: Ohio Health Group HMO |
$975.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$260.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$169.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$403.00
|
| Rate for Payer: PHCS Commercial |
$1,248.00
|
| Rate for Payer: United Healthcare All Payer |
$1,144.00
|
|
