|
CORAIL2 STD SIZE 16
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL2 STD SIZE 18
|
Facility
|
IP
|
$20,239.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,631.14 |
| Max. Negotiated Rate |
$19,429.92 |
| Rate for Payer: Aetna Commercial |
$15,584.42
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,786.81
|
| Rate for Payer: Cash Price |
$10,119.75
|
| Rate for Payer: Cigna Commercial |
$16,798.78
|
| Rate for Payer: First Health Commercial |
$19,227.52
|
| Rate for Payer: Humana Commercial |
$17,203.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,596.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,936.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,071.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,810.76
|
| Rate for Payer: Ohio Health Group HMO |
$15,179.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,047.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,631.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,274.24
|
| Rate for Payer: PHCS Commercial |
$19,429.92
|
| Rate for Payer: United Healthcare All Payer |
$17,810.76
|
|
|
CORAIL2 STD SIZE 18
|
Facility
|
OP
|
$20,239.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,631.14 |
| Max. Negotiated Rate |
$19,429.92 |
| Rate for Payer: Aetna Commercial |
$15,584.42
|
| Rate for Payer: Anthem Medicaid |
$6,960.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,786.81
|
| Rate for Payer: Cash Price |
$10,119.75
|
| Rate for Payer: Cigna Commercial |
$16,798.78
|
| Rate for Payer: First Health Commercial |
$19,227.52
|
| Rate for Payer: Humana Commercial |
$17,203.58
|
| Rate for Payer: Humana KY Medicaid |
$6,960.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,031.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,596.39
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,936.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,071.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,100.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,810.76
|
| Rate for Payer: Ohio Health Group HMO |
$15,179.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,047.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,631.14
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,274.24
|
| Rate for Payer: PHCS Commercial |
$19,429.92
|
| Rate for Payer: United Healthcare All Payer |
$17,810.76
|
|
|
CORAIL2 STD SIZE 20
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL2 STD SIZE 20
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL2 STD SIZE 8
|
Facility
|
IP
|
$30,532.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,969.22 |
| Max. Negotiated Rate |
$29,311.20 |
| Rate for Payer: Aetna Commercial |
$23,510.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,815.35
|
| Rate for Payer: Cash Price |
$15,266.25
|
| Rate for Payer: Cigna Commercial |
$25,341.98
|
| Rate for Payer: First Health Commercial |
$29,005.88
|
| Rate for Payer: Humana Commercial |
$25,952.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,036.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,532.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,159.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,868.60
|
| Rate for Payer: Ohio Health Group HMO |
$22,899.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,106.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,969.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,465.08
|
| Rate for Payer: PHCS Commercial |
$29,311.20
|
| Rate for Payer: United Healthcare All Payer |
$26,868.60
|
|
|
CORAIL2 STD SIZE 8
|
Facility
|
OP
|
$30,532.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,969.22 |
| Max. Negotiated Rate |
$29,311.20 |
| Rate for Payer: Aetna Commercial |
$23,510.02
|
| Rate for Payer: Anthem Medicaid |
$10,500.13
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,815.35
|
| Rate for Payer: Cash Price |
$15,266.25
|
| Rate for Payer: Cigna Commercial |
$25,341.98
|
| Rate for Payer: First Health Commercial |
$29,005.88
|
| Rate for Payer: Humana Commercial |
$25,952.62
|
| Rate for Payer: Humana KY Medicaid |
$10,500.13
|
| Rate for Payer: Kentucky WC Medicaid |
$10,606.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,036.65
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,532.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,159.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,710.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,868.60
|
| Rate for Payer: Ohio Health Group HMO |
$22,899.38
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,106.50
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,969.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,465.08
|
| Rate for Payer: PHCS Commercial |
$29,311.20
|
| Rate for Payer: United Healthcare All Payer |
$26,868.60
|
|
|
CORAIL2 STD SIZE 9
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL2 STD SIZE 9
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 10
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 10
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 11
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 11
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 12
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 12
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 13
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 13
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 14
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 14
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 15
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 15
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 16
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 16
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 18
|
Facility
|
OP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem Medicaid |
$7,738.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Humana KY Medicaid |
$7,738.36
|
| Rate for Payer: Kentucky WC Medicaid |
$7,817.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,893.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
|
CORAIL AMT COLLAR SIZE 18
|
Facility
|
IP
|
$22,501.77
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,925.23 |
| Max. Negotiated Rate |
$21,601.70 |
| Rate for Payer: Aetna Commercial |
$17,326.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$17,551.38
|
| Rate for Payer: Cash Price |
$11,250.89
|
| Rate for Payer: Cigna Commercial |
$18,676.47
|
| Rate for Payer: First Health Commercial |
$21,376.68
|
| Rate for Payer: Humana Commercial |
$19,126.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$18,451.45
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$16,606.31
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,750.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$19,801.56
|
| Rate for Payer: Ohio Health Group HMO |
$16,876.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,500.35
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,925.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,975.55
|
| Rate for Payer: PHCS Commercial |
$21,601.70
|
| Rate for Payer: United Healthcare All Payer |
$19,801.56
|
|
