|
COMPR SRS TUMOR BODY 61MM
|
Facility
|
OP
|
$26,455.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,439.21 |
| Max. Negotiated Rate |
$25,397.23 |
| Rate for Payer: Aetna Commercial |
$20,370.70
|
| Rate for Payer: Anthem Medicaid |
$9,098.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,635.25
|
| Rate for Payer: Cash Price |
$13,227.73
|
| Rate for Payer: Cigna Commercial |
$21,958.02
|
| Rate for Payer: First Health Commercial |
$25,132.68
|
| Rate for Payer: Humana Commercial |
$22,487.13
|
| Rate for Payer: Humana KY Medicaid |
$9,098.03
|
| Rate for Payer: Kentucky WC Medicaid |
$9,190.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,693.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,524.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,936.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,280.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,280.80
|
| Rate for Payer: Ohio Health Group HMO |
$19,841.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,291.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,439.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,201.19
|
| Rate for Payer: PHCS Commercial |
$25,397.23
|
| Rate for Payer: United Healthcare All Payer |
$23,280.80
|
|
|
COMPR SRS TUMOR BODY 61MM
|
Facility
|
IP
|
$26,455.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,439.21 |
| Max. Negotiated Rate |
$25,397.23 |
| Rate for Payer: Aetna Commercial |
$20,370.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,635.25
|
| Rate for Payer: Cash Price |
$13,227.73
|
| Rate for Payer: Cigna Commercial |
$21,958.02
|
| Rate for Payer: First Health Commercial |
$25,132.68
|
| Rate for Payer: Humana Commercial |
$22,487.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,693.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,524.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,936.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,280.80
|
| Rate for Payer: Ohio Health Group HMO |
$19,841.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,291.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,439.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,201.19
|
| Rate for Payer: PHCS Commercial |
$25,397.23
|
| Rate for Payer: United Healthcare All Payer |
$23,280.80
|
|
|
COMPR SRS TUMOR BODY 71MM
|
Facility
|
IP
|
$26,455.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,439.21 |
| Max. Negotiated Rate |
$25,397.23 |
| Rate for Payer: Aetna Commercial |
$20,370.70
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,635.25
|
| Rate for Payer: Cash Price |
$13,227.73
|
| Rate for Payer: Cigna Commercial |
$21,958.02
|
| Rate for Payer: First Health Commercial |
$25,132.68
|
| Rate for Payer: Humana Commercial |
$22,487.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,693.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,524.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,936.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,280.80
|
| Rate for Payer: Ohio Health Group HMO |
$19,841.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,291.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,439.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,201.19
|
| Rate for Payer: PHCS Commercial |
$25,397.23
|
| Rate for Payer: United Healthcare All Payer |
$23,280.80
|
|
|
COMPR SRS TUMOR BODY 71MM
|
Facility
|
OP
|
$26,455.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,439.21 |
| Max. Negotiated Rate |
$25,397.23 |
| Rate for Payer: Aetna Commercial |
$20,370.70
|
| Rate for Payer: Anthem Medicaid |
$9,098.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,635.25
|
| Rate for Payer: Cash Price |
$13,227.73
|
| Rate for Payer: Cigna Commercial |
$21,958.02
|
| Rate for Payer: First Health Commercial |
$25,132.68
|
| Rate for Payer: Humana Commercial |
$22,487.13
|
| Rate for Payer: Humana KY Medicaid |
$9,098.03
|
| Rate for Payer: Kentucky WC Medicaid |
$9,190.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,693.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,524.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,936.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,280.57
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,280.80
|
| Rate for Payer: Ohio Health Group HMO |
$19,841.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,291.09
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,439.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$8,201.19
|
| Rate for Payer: PHCS Commercial |
$25,397.23
|
| Rate for Payer: United Healthcare All Payer |
$23,280.80
|
|
|
COMPR STEM 10MM MICRO
|
Facility
|
IP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 10MM MICRO
|
Facility
|
OP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem Medicaid |
$6,698.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Humana KY Medicaid |
$6,698.02
|
| Rate for Payer: Kentucky WC Medicaid |
$6,766.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,832.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 10MM MINI
|
Facility
|
OP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem Medicaid |
$6,698.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Humana KY Medicaid |
$6,698.02
|
| Rate for Payer: Kentucky WC Medicaid |
$6,766.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,832.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 10MM MINI
|
Facility
|
IP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 10MM STD
|
Facility
|
OP
|
$16,926.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,200.38 |
| Max. Negotiated Rate |
$16,248.96 |
| Rate for Payer: Aetna Commercial |
$13,033.02
|
| Rate for Payer: Anthem Medicaid |
$5,820.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,202.28
|
| Rate for Payer: Cash Price |
$8,463.00
|
| Rate for Payer: Cigna Commercial |
$14,048.58
|
| Rate for Payer: First Health Commercial |
$16,079.70
|
| Rate for Payer: Humana Commercial |
$14,387.10
|
| Rate for Payer: Humana KY Medicaid |
$5,820.85
|
| Rate for Payer: Kentucky WC Medicaid |
$5,880.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,879.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,491.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,077.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,937.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,894.88
|
| Rate for Payer: Ohio Health Group HMO |
$12,694.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,200.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,247.06
|
| Rate for Payer: PHCS Commercial |
$16,248.96
|
| Rate for Payer: United Healthcare All Payer |
$14,894.88
|
|
|
COMPR STEM 10MM STD
|
Facility
|
IP
|
$16,926.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,200.38 |
| Max. Negotiated Rate |
$16,248.96 |
| Rate for Payer: Aetna Commercial |
$13,033.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,202.28
|
| Rate for Payer: Cash Price |
$8,463.00
|
| Rate for Payer: Cigna Commercial |
$14,048.58
|
| Rate for Payer: First Health Commercial |
$16,079.70
|
| Rate for Payer: Humana Commercial |
$14,387.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,879.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,491.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,077.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,894.88
|
| Rate for Payer: Ohio Health Group HMO |
$12,694.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,200.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,247.06
|
| Rate for Payer: PHCS Commercial |
$16,248.96
|
| Rate for Payer: United Healthcare All Payer |
$14,894.88
|
|
|
COMPR STEM 11MM MICRO
|
Facility
|
IP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 11MM MICRO
|
Facility
|
OP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem Medicaid |
$6,698.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Humana KY Medicaid |
$6,698.02
|
| Rate for Payer: Kentucky WC Medicaid |
$6,766.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,832.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 11MM MINI
|
Facility
|
IP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 11MM MINI
|
Facility
|
OP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem Medicaid |
$6,698.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Humana KY Medicaid |
$6,698.02
|
| Rate for Payer: Kentucky WC Medicaid |
$6,766.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,832.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 11MM STD
|
Facility
|
IP
|
$16,926.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,200.38 |
| Max. Negotiated Rate |
$16,248.96 |
| Rate for Payer: Aetna Commercial |
$13,033.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,202.28
|
| Rate for Payer: Cash Price |
$8,463.00
|
| Rate for Payer: Cigna Commercial |
$14,048.58
|
| Rate for Payer: First Health Commercial |
$16,079.70
|
| Rate for Payer: Humana Commercial |
$14,387.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,879.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,491.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,077.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,894.88
|
| Rate for Payer: Ohio Health Group HMO |
$12,694.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,200.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,247.06
|
| Rate for Payer: PHCS Commercial |
$16,248.96
|
| Rate for Payer: United Healthcare All Payer |
$14,894.88
|
|
|
COMPR STEM 11MM STD
|
Facility
|
OP
|
$16,926.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,200.38 |
| Max. Negotiated Rate |
$16,248.96 |
| Rate for Payer: Aetna Commercial |
$13,033.02
|
| Rate for Payer: Anthem Medicaid |
$5,820.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,202.28
|
| Rate for Payer: Cash Price |
$8,463.00
|
| Rate for Payer: Cigna Commercial |
$14,048.58
|
| Rate for Payer: First Health Commercial |
$16,079.70
|
| Rate for Payer: Humana Commercial |
$14,387.10
|
| Rate for Payer: Humana KY Medicaid |
$5,820.85
|
| Rate for Payer: Kentucky WC Medicaid |
$5,880.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,879.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,491.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,077.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,937.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,894.88
|
| Rate for Payer: Ohio Health Group HMO |
$12,694.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,200.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,247.06
|
| Rate for Payer: PHCS Commercial |
$16,248.96
|
| Rate for Payer: United Healthcare All Payer |
$14,894.88
|
|
|
COMPR STEM 12MM MICRO
|
Facility
|
OP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem Medicaid |
$6,698.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Humana KY Medicaid |
$6,698.02
|
| Rate for Payer: Kentucky WC Medicaid |
$6,766.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,832.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 12MM MICRO
|
Facility
|
IP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 12MM MINI
|
Facility
|
OP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem Medicaid |
$6,698.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Humana KY Medicaid |
$6,698.02
|
| Rate for Payer: Kentucky WC Medicaid |
$6,766.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,832.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 12MM MINI
|
Facility
|
IP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 12MM STD
|
Facility
|
OP
|
$16,926.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,200.38 |
| Max. Negotiated Rate |
$16,248.96 |
| Rate for Payer: Aetna Commercial |
$13,033.02
|
| Rate for Payer: Anthem Medicaid |
$5,820.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,202.28
|
| Rate for Payer: Cash Price |
$8,463.00
|
| Rate for Payer: Cigna Commercial |
$14,048.58
|
| Rate for Payer: First Health Commercial |
$16,079.70
|
| Rate for Payer: Humana Commercial |
$14,387.10
|
| Rate for Payer: Humana KY Medicaid |
$5,820.85
|
| Rate for Payer: Kentucky WC Medicaid |
$5,880.09
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,879.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,491.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,077.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,937.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,894.88
|
| Rate for Payer: Ohio Health Group HMO |
$12,694.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,200.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,247.06
|
| Rate for Payer: PHCS Commercial |
$16,248.96
|
| Rate for Payer: United Healthcare All Payer |
$14,894.88
|
|
|
COMPR STEM 12MM STD
|
Facility
|
IP
|
$16,926.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,200.38 |
| Max. Negotiated Rate |
$16,248.96 |
| Rate for Payer: Aetna Commercial |
$13,033.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,202.28
|
| Rate for Payer: Cash Price |
$8,463.00
|
| Rate for Payer: Cigna Commercial |
$14,048.58
|
| Rate for Payer: First Health Commercial |
$16,079.70
|
| Rate for Payer: Humana Commercial |
$14,387.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,879.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,491.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,077.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,894.88
|
| Rate for Payer: Ohio Health Group HMO |
$12,694.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,385.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,200.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,247.06
|
| Rate for Payer: PHCS Commercial |
$16,248.96
|
| Rate for Payer: United Healthcare All Payer |
$14,894.88
|
|
|
COMPR STEM 13MM MICRO
|
Facility
|
OP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem Medicaid |
$6,698.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Humana KY Medicaid |
$6,698.02
|
| Rate for Payer: Kentucky WC Medicaid |
$6,766.19
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,832.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 13MM MICRO
|
Facility
|
IP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
|
COMPR STEM 13MM MINI
|
Facility
|
IP
|
$19,476.65
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,531.96 |
| Max. Negotiated Rate |
$18,697.58 |
| Rate for Payer: Aetna Commercial |
$14,997.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,191.79
|
| Rate for Payer: Cash Price |
$9,738.33
|
| Rate for Payer: Cigna Commercial |
$16,165.62
|
| Rate for Payer: First Health Commercial |
$18,502.82
|
| Rate for Payer: Humana Commercial |
$16,555.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$15,970.85
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,373.77
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,843.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,139.45
|
| Rate for Payer: Ohio Health Group HMO |
$14,607.49
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,895.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,531.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,037.76
|
| Rate for Payer: PHCS Commercial |
$18,697.58
|
| Rate for Payer: United Healthcare All Payer |
$17,139.45
|
|
