|
COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$1,179.36
|
|
|
Service Code
|
CPT 45378
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$842.40 |
| Max. Negotiated Rate |
$1,179.36 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$842.40
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,179.36
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,137.24
|
| Rate for Payer: Humana Medicare Advantage |
$842.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,010.88
|
|
|
COLONOSCOPY - FLEXIBLE - PRO
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
76101891
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.44 |
| Max. Negotiated Rate |
$480.00 |
| Rate for Payer: Aetna Commercial |
$329.66
|
| Rate for Payer: Ambetter Exchange |
$172.56
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$93.44
|
| Rate for Payer: Anthem Medicaid |
$324.55
|
| Rate for Payer: Buckeye Individual/Medicaid |
$172.56
|
| Rate for Payer: Buckeye Medicare Advantage |
$172.56
|
| Rate for Payer: CareSource Just4Me Medicare |
$207.07
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$299.57
|
| Rate for Payer: Healthspan PPO |
$479.30
|
| Rate for Payer: Humana Medicaid |
$324.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$283.99
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$172.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$172.56
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$331.04
|
| Rate for Payer: Molina Healthcare Passport |
$324.55
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$224.33
|
| Rate for Payer: UHCCP Medicaid |
$98.11
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$327.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$172.56
|
|
|
COLONOSCOPY - FLEXIBLE - PRO
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
76101891
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$768.00 |
| 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 HMO |
$600.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$640.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$696.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$552.00
|
| Rate for Payer: PHCS Commercial |
$768.00
|
| Rate for Payer: United Healthcare All Payer |
$704.00
|
|
|
COLONOSCOPY - FLEXIBLE - PRO
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
76101891
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$275.12 |
| Max. Negotiated Rate |
$1,179.36 |
| Rate for Payer: Aetna Commercial |
$616.00
|
| Rate for Payer: Anthem Medicaid |
$275.12
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$842.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$624.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,179.36
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,137.24
|
| 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 |
$842.40
|
| 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 |
$1,010.88
|
| 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 |
$640.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$696.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$552.00
|
| Rate for Payer: PHCS Commercial |
$768.00
|
| Rate for Payer: United Healthcare All Payer |
$704.00
|
|
|
COLONOSCOPY - FLEXIBLE - PRO(P
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
761P1891
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.44 |
| Max. Negotiated Rate |
$480.00 |
| Rate for Payer: Aetna Commercial |
$329.66
|
| Rate for Payer: Ambetter Exchange |
$172.56
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$93.44
|
| Rate for Payer: Anthem Medicaid |
$324.55
|
| Rate for Payer: Buckeye Individual/Medicaid |
$172.56
|
| Rate for Payer: Buckeye Medicare Advantage |
$172.56
|
| Rate for Payer: CareSource Just4Me Medicare |
$207.07
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cigna Commercial |
$299.57
|
| Rate for Payer: Healthspan PPO |
$479.30
|
| Rate for Payer: Humana Medicaid |
$324.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$283.99
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$172.56
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$172.56
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$331.04
|
| Rate for Payer: Molina Healthcare Passport |
$324.55
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$224.33
|
| Rate for Payer: UHCCP Medicaid |
$98.11
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$327.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$172.56
|
|
|
COLONOSCOPY, FLEXIBLE; WITH BAND LIGATION(S) (EG, HEMORRHOIDS)
|
Facility
|
OP
|
$1,525.23
|
|
|
Service Code
|
CPT 45398
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.45 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| Rate for Payer: Humana Medicare Advantage |
$1,089.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,307.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$1,525.23
|
|
|
Service Code
|
CPT 45380
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.45 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| Rate for Payer: Humana Medicare Advantage |
$1,089.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,307.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY METHOD
|
Facility
|
OP
|
$1,525.23
|
|
|
Service Code
|
CPT 45382
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.45 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| Rate for Payer: Humana Medicare Advantage |
$1,089.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,307.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE
|
Facility
|
OP
|
$1,525.23
|
|
|
Service Code
|
CPT 45381
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.45 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| Rate for Payer: Humana Medicare Advantage |
$1,089.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,307.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$3,547.47
|
|
|
Service Code
|
CPT 45390
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,533.91 |
| Max. Negotiated Rate |
$3,547.47 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,533.91
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,547.47
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,420.78
|
| Rate for Payer: Humana Medicare Advantage |
$2,533.91
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,040.69
|
|
|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
OP
|
$1,525.23
|
|
|
Service Code
|
CPT 45384
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.45 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| Rate for Payer: Humana Medicare Advantage |
$1,089.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,307.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$1,525.23
|
|
|
Service Code
|
CPT 45385
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.45 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| Rate for Payer: Humana Medicare Advantage |
$1,089.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,307.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC BALLOON DILATION
|
Facility
|
OP
|
$1,525.23
|
|
|
Service Code
|
CPT 45386
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.45 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| Rate for Payer: Humana Medicare Advantage |
$1,089.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,307.34
|
|
|
COLONOSCOPY SUBMUCOUS NJX
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
76101894
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.93 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem Medicaid |
$257.93
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Humana KY Medicaid |
$257.93
|
| Rate for Payer: Humana Medicare Advantage |
$1,089.45
|
| Rate for Payer: Kentucky WC Medicaid |
$260.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,307.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$263.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$652.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$517.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
COLONOSCOPY SUBMUCOUS NJX
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
76101894
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Aetna Commercial |
$577.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$585.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$622.50
|
| Rate for Payer: First Health Commercial |
$712.50
|
| Rate for Payer: Humana Commercial |
$637.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$615.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$553.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$225.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$660.00
|
| Rate for Payer: Ohio Health Group HMO |
$562.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$600.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$652.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$517.50
|
| Rate for Payer: PHCS Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Payer |
$660.00
|
|
|
COLONOSCOPY SUBMUCOUS NJX
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
76101894
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$187.73 |
| Max. Negotiated Rate |
$558.27 |
| Rate for Payer: Aetna Commercial |
$374.58
|
| Rate for Payer: Ambetter Exchange |
$187.73
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$202.79
|
| Rate for Payer: Anthem Medicaid |
$423.63
|
| Rate for Payer: Buckeye Individual/Medicaid |
$187.73
|
| Rate for Payer: Buckeye Medicare Advantage |
$187.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$225.28
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$338.28
|
| Rate for Payer: Healthspan PPO |
$558.27
|
| Rate for Payer: Humana Medicaid |
$423.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$322.39
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$187.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$187.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$432.10
|
| Rate for Payer: Molina Healthcare Passport |
$423.63
|
| Rate for Payer: Multiplan PHCS |
$450.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$244.05
|
| Rate for Payer: UHCCP Medicaid |
$212.93
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$427.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$187.73
|
|
|
COLONOSCOPY SUBMUCOUS NJX(P
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
761P1894
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$187.73 |
| Max. Negotiated Rate |
$558.27 |
| Rate for Payer: Aetna Commercial |
$374.58
|
| Rate for Payer: Ambetter Exchange |
$187.73
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$202.79
|
| Rate for Payer: Anthem Medicaid |
$423.63
|
| Rate for Payer: Buckeye Individual/Medicaid |
$187.73
|
| Rate for Payer: Buckeye Medicare Advantage |
$187.73
|
| Rate for Payer: CareSource Just4Me Medicare |
$225.28
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$338.28
|
| Rate for Payer: Healthspan PPO |
$558.27
|
| Rate for Payer: Humana Medicaid |
$423.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$322.39
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$187.73
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$187.73
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$432.10
|
| Rate for Payer: Molina Healthcare Passport |
$423.63
|
| Rate for Payer: Multiplan PHCS |
$450.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$244.05
|
| Rate for Payer: UHCCP Medicaid |
$212.93
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$427.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$187.73
|
|
|
COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$1,179.36
|
|
|
Service Code
|
CPT 44388
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$842.40 |
| Max. Negotiated Rate |
$1,179.36 |
| Rate for Payer: Anthem Medicare Advantage/PPO |
$842.40
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,179.36
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,137.24
|
| Rate for Payer: Humana Medicare Advantage |
$842.40
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,010.88
|
|
|
COLONOSCOPY W/ABLATION
|
Professional
|
Both
|
$1,300.00
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
76101899
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.98 |
| Max. Negotiated Rate |
$2,474.49 |
| Rate for Payer: Ambetter Exchange |
$251.98
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$254.10
|
| Rate for Payer: Anthem Medicaid |
$2,425.97
|
| Rate for Payer: Buckeye Individual/Medicaid |
$251.98
|
| Rate for Payer: Buckeye Medicare Advantage |
$251.98
|
| Rate for Payer: CareSource Just4Me Medicare |
$302.38
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cigna Commercial |
$889.25
|
| Rate for Payer: Humana Medicaid |
$2,425.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$393.42
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$251.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$251.98
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$2,474.49
|
| Rate for Payer: Molina Healthcare Passport |
$2,425.97
|
| Rate for Payer: Multiplan PHCS |
$780.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$327.57
|
| Rate for Payer: UHCCP Medicaid |
$266.81
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$2,450.23
|
| Rate for Payer: Wellcare Medicare Advantage |
$251.98
|
|
|
COLONOSCOPY W/ABLATION
|
Facility
|
OP
|
$1,300.00
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
76101899
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$447.07 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Aetna Commercial |
$1,001.00
|
| Rate for Payer: Anthem Medicaid |
$447.07
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,014.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| 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 |
$1,089.45
|
| 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 |
$1,307.34
|
| 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 |
$1,040.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,131.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$897.00
|
| Rate for Payer: PHCS Commercial |
$1,248.00
|
| Rate for Payer: United Healthcare All Payer |
$1,144.00
|
|
|
COLONOSCOPY W/ABLATION
|
Facility
|
IP
|
$1,300.00
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
76101899
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.00 |
| 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 |
$1,040.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,131.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$897.00
|
| Rate for Payer: PHCS Commercial |
$1,248.00
|
| Rate for Payer: United Healthcare All Payer |
$1,144.00
|
|
|
COLONOSCOPY W/ABLATION(P
|
Professional
|
Both
|
$1,300.00
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
761P1899
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.98 |
| Max. Negotiated Rate |
$2,474.49 |
| Rate for Payer: Ambetter Exchange |
$251.98
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$254.10
|
| Rate for Payer: Anthem Medicaid |
$2,425.97
|
| Rate for Payer: Buckeye Individual/Medicaid |
$251.98
|
| Rate for Payer: Buckeye Medicare Advantage |
$251.98
|
| Rate for Payer: CareSource Just4Me Medicare |
$302.38
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cash Price |
$650.00
|
| Rate for Payer: Cigna Commercial |
$889.25
|
| Rate for Payer: Humana Medicaid |
$2,425.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$393.42
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$251.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$251.98
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$2,474.49
|
| Rate for Payer: Molina Healthcare Passport |
$2,425.97
|
| Rate for Payer: Multiplan PHCS |
$780.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$327.57
|
| Rate for Payer: UHCCP Medicaid |
$266.81
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$2,450.23
|
| Rate for Payer: Wellcare Medicare Advantage |
$251.98
|
|
|
COLONOSCOPY W/BALLOON DILAT
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 45386
|
| Hospital Charge Code |
76101898
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$1,440.00 |
| Rate for Payer: Aetna Commercial |
$1,155.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,170.00
|
| Rate for Payer: Cash Price |
$750.00
|
| Rate for Payer: Cigna Commercial |
$1,245.00
|
| Rate for Payer: First Health Commercial |
$1,425.00
|
| Rate for Payer: Humana Commercial |
$1,275.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,230.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,107.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$450.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,320.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,125.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,200.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,305.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,035.00
|
| Rate for Payer: PHCS Commercial |
$1,440.00
|
| Rate for Payer: United Healthcare All Payer |
$1,320.00
|
|
|
COLONOSCOPY W/BALLOON DILAT
|
Professional
|
Both
|
$1,500.00
|
|
|
Service Code
|
HCPCS 45386
|
| Hospital Charge Code |
76101898
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$198.18 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna Commercial |
$406.13
|
| Rate for Payer: Ambetter Exchange |
$198.18
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$213.87
|
| Rate for Payer: Anthem Medicaid |
$584.83
|
| Rate for Payer: Buckeye Individual/Medicaid |
$198.18
|
| Rate for Payer: Buckeye Medicare Advantage |
$198.18
|
| Rate for Payer: CareSource Just4Me Medicare |
$237.82
|
| Rate for Payer: Cash Price |
$750.00
|
| Rate for Payer: Cash Price |
$750.00
|
| Rate for Payer: Cigna Commercial |
$368.97
|
| Rate for Payer: Healthspan PPO |
$792.50
|
| Rate for Payer: Humana Medicaid |
$584.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$348.25
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$198.18
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$198.18
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$596.53
|
| Rate for Payer: Molina Healthcare Passport |
$584.83
|
| Rate for Payer: Multiplan PHCS |
$900.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$257.63
|
| Rate for Payer: UHCCP Medicaid |
$224.56
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$590.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$198.18
|
|
|
COLONOSCOPY W/BALLOON DILAT
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 45386
|
| Hospital Charge Code |
76101898
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$515.85 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Aetna Commercial |
$1,155.00
|
| Rate for Payer: Anthem Medicaid |
$515.85
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,170.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$1,525.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$1,470.76
|
| Rate for Payer: Cash Price |
$750.00
|
| Rate for Payer: Cash Price |
$750.00
|
| Rate for Payer: Cigna Commercial |
$1,245.00
|
| Rate for Payer: First Health Commercial |
$1,425.00
|
| Rate for Payer: Humana Commercial |
$1,275.00
|
| Rate for Payer: Humana KY Medicaid |
$515.85
|
| Rate for Payer: Humana Medicare Advantage |
$1,089.45
|
| Rate for Payer: Kentucky WC Medicaid |
$521.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,230.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,107.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,307.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$526.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,320.00
|
| Rate for Payer: Ohio Health Group HMO |
$1,125.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,200.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,305.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,035.00
|
| Rate for Payer: PHCS Commercial |
$1,440.00
|
| Rate for Payer: United Healthcare All Payer |
$1,320.00
|
|
