|
COLONOSCOPY WITH BX
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
76101893
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$187.73 |
| Max. Negotiated Rate |
$575.21 |
| Rate for Payer: Aetna Commercial |
$396.81
|
| 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 |
$415.51
|
| 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 |
$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 |
$415.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$339.93
|
| 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 |
$423.82
|
| Rate for Payer: Molina Healthcare Passport |
$415.51
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$244.05
|
| Rate for Payer: UHCCP Medicaid |
$212.93
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$419.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$187.73
|
|
|
COLONOSCOPY WITH BX
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
76101893
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$275.12 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Aetna Commercial |
$616.00
|
| Rate for Payer: Anthem Medicaid |
$275.12
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$624.00
|
| 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 |
$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 |
$1,089.45
|
| 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 |
$1,307.34
|
| 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 WITH BX
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
76101893
|
|
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 WITH BX(P
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
761P1893
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$187.73 |
| Max. Negotiated Rate |
$575.21 |
| Rate for Payer: Aetna Commercial |
$396.81
|
| 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 |
$415.51
|
| 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 |
$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 |
$415.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$339.93
|
| 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 |
$423.82
|
| Rate for Payer: Molina Healthcare Passport |
$415.51
|
| Rate for Payer: Multiplan PHCS |
$480.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$244.05
|
| Rate for Payer: UHCCP Medicaid |
$212.93
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$419.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$187.73
|
|
|
COLONOSCOPY W/POLIPECTOMY
|
Facility
|
OP
|
$1,100.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
76101897
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$378.29 |
| Max. Negotiated Rate |
$1,525.23 |
| Rate for Payer: Aetna Commercial |
$847.00
|
| Rate for Payer: Anthem Medicaid |
$378.29
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,089.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$858.00
|
| 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 |
$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 |
$1,089.45
|
| 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 |
$1,307.34
|
| 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 |
$880.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$957.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$759.00
|
| 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 |
$236.67 |
| Max. Negotiated Rate |
$660.00 |
| Rate for Payer: Aetna Commercial |
$471.28
|
| Rate for Payer: Ambetter Exchange |
$236.67
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$257.82
|
| Rate for Payer: Anthem Medicaid |
$435.84
|
| Rate for Payer: Buckeye Individual/Medicaid |
$236.67
|
| Rate for Payer: Buckeye Medicare Advantage |
$236.67
|
| Rate for Payer: CareSource Just4Me Medicare |
$284.00
|
| 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 |
$435.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$403.33
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$236.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$236.67
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$444.56
|
| Rate for Payer: Molina Healthcare Passport |
$435.84
|
| Rate for Payer: Multiplan PHCS |
$660.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$307.67
|
| Rate for Payer: UHCCP Medicaid |
$270.71
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$440.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$236.67
|
|
|
COLONOSCOPY W/POLIPECTOMY
|
Facility
|
IP
|
$1,100.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
76101897
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$330.00 |
| 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 |
$880.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$957.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$759.00
|
| 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 |
$236.67 |
| Max. Negotiated Rate |
$660.00 |
| Rate for Payer: Aetna Commercial |
$471.28
|
| Rate for Payer: Ambetter Exchange |
$236.67
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$257.82
|
| Rate for Payer: Anthem Medicaid |
$435.84
|
| Rate for Payer: Buckeye Individual/Medicaid |
$236.67
|
| Rate for Payer: Buckeye Medicare Advantage |
$236.67
|
| Rate for Payer: CareSource Just4Me Medicare |
$284.00
|
| 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 |
$435.84
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$403.33
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$236.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$236.67
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$444.56
|
| Rate for Payer: Molina Healthcare Passport |
$435.84
|
| Rate for Payer: Multiplan PHCS |
$660.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$307.67
|
| Rate for Payer: UHCCP Medicaid |
$270.71
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$440.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$236.67
|
|
|
COLONOSCOPY W/RESECTION
|
Facility
|
OP
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
76101901
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$386.89 |
| Max. Negotiated Rate |
$3,547.47 |
| Rate for Payer: Aetna Commercial |
$866.25
|
| Rate for Payer: Anthem Medicaid |
$386.89
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,533.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$877.50
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,547.47
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,420.78
|
| 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 |
$2,533.91
|
| 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 |
$3,040.69
|
| 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 |
$900.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$978.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$776.25
|
| Rate for Payer: PHCS Commercial |
$1,080.00
|
| Rate for Payer: United Healthcare All Payer |
$990.00
|
|
|
COLONOSCOPY W/RESECTION
|
Facility
|
IP
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
76101901
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$337.50 |
| 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 |
$900.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$978.75
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$776.25
|
| 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 |
$675.00 |
| Rate for Payer: Ambetter Exchange |
$308.97
|
| Rate for Payer: Anthem Medicaid |
$277.89
|
| Rate for Payer: Buckeye Individual/Medicaid |
$308.97
|
| Rate for Payer: Buckeye Medicare Advantage |
$308.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$370.76
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$308.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$308.97
|
| 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 |
$401.66
|
| Rate for Payer: UHCCP Medicaid |
$393.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$280.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$308.97
|
|
|
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 |
$675.00 |
| Rate for Payer: Ambetter Exchange |
$308.97
|
| Rate for Payer: Anthem Medicaid |
$277.89
|
| Rate for Payer: Buckeye Individual/Medicaid |
$308.97
|
| Rate for Payer: Buckeye Medicare Advantage |
$308.97
|
| Rate for Payer: CareSource Just4Me Medicare |
$370.76
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$308.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$308.97
|
| 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 |
$401.66
|
| Rate for Payer: UHCCP Medicaid |
$393.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$280.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$308.97
|
|
|
COLONOSCOPY W/SNARE
|
Professional
|
Both
|
$1,300.00
|
|
|
Service Code
|
HCPCS 44394
|
| Hospital Charge Code |
76101851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.28 |
| Max. Negotiated Rate |
$780.00 |
| Rate for Payer: Aetna Commercial |
$392.47
|
| Rate for Payer: Ambetter Exchange |
$210.28
|
| 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 Individual/Medicaid |
$210.28
|
| Rate for Payer: Buckeye Medicare Advantage |
$210.28
|
| Rate for Payer: CareSource Just4Me Medicare |
$252.34
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$210.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$210.28
|
| 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 |
$273.36
|
| Rate for Payer: UHCCP Medicaid |
$231.69
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$288.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.28
|
|
|
COLONOSCOPY W/SNARE
|
Facility
|
OP
|
$1,300.00
|
|
|
Service Code
|
HCPCS 44394
|
| Hospital Charge Code |
76101851
|
|
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/SNARE
|
Facility
|
IP
|
$1,300.00
|
|
|
Service Code
|
HCPCS 44394
|
| Hospital Charge Code |
76101851
|
|
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/SNARE(P
|
Professional
|
Both
|
$1,300.00
|
|
|
Service Code
|
HCPCS 44394
|
| Hospital Charge Code |
761P1851
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.28 |
| Max. Negotiated Rate |
$780.00 |
| Rate for Payer: Aetna Commercial |
$392.47
|
| Rate for Payer: Ambetter Exchange |
$210.28
|
| 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 Individual/Medicaid |
$210.28
|
| Rate for Payer: Buckeye Medicare Advantage |
$210.28
|
| Rate for Payer: CareSource Just4Me Medicare |
$252.34
|
| 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: Medical Mutual Of Ohio Medicare Advantage |
$210.28
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$210.28
|
| 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 |
$273.36
|
| Rate for Payer: UHCCP Medicaid |
$231.69
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$288.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.28
|
|
|
COLONOSCOPY W/STENT PLCMT
|
Professional
|
Both
|
$600.00
|
|
|
Service Code
|
HCPCS 45389
|
| Hospital Charge Code |
76101900
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$547.25 |
| Rate for Payer: Ambetter Exchange |
$269.23
|
| Rate for Payer: Anthem Medicaid |
$243.40
|
| Rate for Payer: Buckeye Individual/Medicaid |
$269.23
|
| Rate for Payer: Buckeye Medicare Advantage |
$269.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$323.08
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$547.25
|
| Rate for Payer: Humana Medicaid |
$243.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$421.03
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$269.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$269.23
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$248.27
|
| Rate for Payer: Molina Healthcare Passport |
$243.40
|
| Rate for Payer: Multiplan PHCS |
$360.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$350.00
|
| Rate for Payer: UHCCP Medicaid |
$210.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$245.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$269.23
|
|
|
COLONOSCOPY W/STENT PLCMT
|
Facility
|
OP
|
$600.00
|
|
|
Service Code
|
HCPCS 45389
|
| Hospital Charge Code |
76101900
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$206.34 |
| Max. Negotiated Rate |
$7,700.39 |
| Rate for Payer: Aetna Commercial |
$462.00
|
| Rate for Payer: Anthem Medicaid |
$206.34
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$5,500.28
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$468.00
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$7,700.39
|
| Rate for Payer: CareSource Just4Me Medicare |
$7,425.38
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$498.00
|
| Rate for Payer: First Health Commercial |
$570.00
|
| Rate for Payer: Humana Commercial |
$510.00
|
| Rate for Payer: Humana KY Medicaid |
$206.34
|
| Rate for Payer: Humana Medicare Advantage |
$5,500.28
|
| Rate for Payer: Kentucky WC Medicaid |
$208.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$492.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$442.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,600.34
|
| Rate for Payer: Molina Healthcare Medicaid |
$210.48
|
| Rate for Payer: Ohio Health Choice Commercial |
$528.00
|
| Rate for Payer: Ohio Health Group HMO |
$450.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$480.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$522.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$414.00
|
| Rate for Payer: PHCS Commercial |
$576.00
|
| Rate for Payer: United Healthcare All Payer |
$528.00
|
|
|
COLONOSCOPY W/STENT PLCMT
|
Facility
|
IP
|
$600.00
|
|
|
Service Code
|
HCPCS 45389
|
| Hospital Charge Code |
76101900
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$576.00 |
| Rate for Payer: Aetna Commercial |
$462.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$468.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$498.00
|
| Rate for Payer: First Health Commercial |
$570.00
|
| Rate for Payer: Humana Commercial |
$510.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$492.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$442.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$180.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$528.00
|
| Rate for Payer: Ohio Health Group HMO |
$450.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$480.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$522.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$414.00
|
| Rate for Payer: PHCS Commercial |
$576.00
|
| Rate for Payer: United Healthcare All Payer |
$528.00
|
|
|
COLONOSCOPY W/STENT PLCMT(P
|
Professional
|
Both
|
$600.00
|
|
|
Service Code
|
HCPCS 45389
|
| Hospital Charge Code |
761P1900
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$547.25 |
| Rate for Payer: Ambetter Exchange |
$269.23
|
| Rate for Payer: Anthem Medicaid |
$243.40
|
| Rate for Payer: Buckeye Individual/Medicaid |
$269.23
|
| Rate for Payer: Buckeye Medicare Advantage |
$269.23
|
| Rate for Payer: CareSource Just4Me Medicare |
$323.08
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$547.25
|
| Rate for Payer: Humana Medicaid |
$243.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$421.03
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$269.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$269.23
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$248.27
|
| Rate for Payer: Molina Healthcare Passport |
$243.40
|
| Rate for Payer: Multiplan PHCS |
$360.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$350.00
|
| Rate for Payer: UHCCP Medicaid |
$210.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$245.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$269.23
|
|
|
COLONSCPY STMA WWO COL SPEC PX
|
Facility
|
OP
|
$950.00
|
|
|
Service Code
|
HCPCS 44388
|
| Hospital Charge Code |
76101849
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.70 |
| Max. Negotiated Rate |
$1,179.36 |
| Rate for Payer: Aetna Commercial |
$731.50
|
| Rate for Payer: Anthem Medicaid |
$326.70
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$842.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$741.00
|
| 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 |
$475.00
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cigna Commercial |
$788.50
|
| Rate for Payer: First Health Commercial |
$902.50
|
| Rate for Payer: Humana Commercial |
$807.50
|
| Rate for Payer: Humana KY Medicaid |
$326.70
|
| Rate for Payer: Humana Medicare Advantage |
$842.40
|
| Rate for Payer: Kentucky WC Medicaid |
$330.03
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$779.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$701.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,010.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$333.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$836.00
|
| Rate for Payer: Ohio Health Group HMO |
$712.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$760.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$826.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$655.50
|
| Rate for Payer: PHCS Commercial |
$912.00
|
| Rate for Payer: United Healthcare All Payer |
$836.00
|
|
|
COLONSCPY STMA WWO COL SPEC PX
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 44388
|
| Hospital Charge Code |
761P1849
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.25 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Ambetter Exchange |
$146.51
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$79.25
|
| Rate for Payer: Anthem Medicaid |
$191.73
|
| Rate for Payer: Buckeye Individual/Medicaid |
$146.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$146.51
|
| Rate for Payer: CareSource Just4Me Medicare |
$175.81
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cigna Commercial |
$231.43
|
| Rate for Payer: Healthspan PPO |
$412.88
|
| Rate for Payer: Humana Medicaid |
$191.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$216.71
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$146.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$146.51
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$195.56
|
| Rate for Payer: Molina Healthcare Passport |
$191.73
|
| Rate for Payer: Multiplan PHCS |
$570.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$190.46
|
| Rate for Payer: UHCCP Medicaid |
$83.21
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$193.65
|
| Rate for Payer: Wellcare Medicare Advantage |
$146.51
|
|
|
COLONSCPY STMA WWO COL SPEC PX
|
Facility
|
IP
|
$950.00
|
|
|
Service Code
|
HCPCS 44388
|
| Hospital Charge Code |
76101849
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$912.00 |
| Rate for Payer: Aetna Commercial |
$731.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$741.00
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cigna Commercial |
$788.50
|
| Rate for Payer: First Health Commercial |
$902.50
|
| Rate for Payer: Humana Commercial |
$807.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$779.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$701.10
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$285.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$836.00
|
| Rate for Payer: Ohio Health Group HMO |
$712.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$760.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$826.50
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$655.50
|
| Rate for Payer: PHCS Commercial |
$912.00
|
| Rate for Payer: United Healthcare All Payer |
$836.00
|
|
|
COLONSCPY STMA WWO COL SPEC PX
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 44388
|
| Hospital Charge Code |
76101849
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.25 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Ambetter Exchange |
$146.51
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$79.25
|
| Rate for Payer: Anthem Medicaid |
$191.73
|
| Rate for Payer: Buckeye Individual/Medicaid |
$146.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$146.51
|
| Rate for Payer: CareSource Just4Me Medicare |
$175.81
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cash Price |
$475.00
|
| Rate for Payer: Cigna Commercial |
$231.43
|
| Rate for Payer: Healthspan PPO |
$412.88
|
| Rate for Payer: Humana Medicaid |
$191.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$216.71
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$146.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$146.51
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$195.56
|
| Rate for Payer: Molina Healthcare Passport |
$191.73
|
| Rate for Payer: Multiplan PHCS |
$570.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$190.46
|
| Rate for Payer: UHCCP Medicaid |
$83.21
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$193.65
|
| Rate for Payer: Wellcare Medicare Advantage |
$146.51
|
|
|
COLOR DOPPLER SMA AND CELIAC
|
Professional
|
Both
|
$905.00
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$81.02 |
| Max. Negotiated Rate |
$543.00 |
| Rate for Payer: Aetna Commercial |
$329.00
|
| Rate for Payer: Ambetter Exchange |
$141.96
|
| Rate for Payer: Anthem Medicaid |
$132.20
|
| Rate for Payer: Buckeye Individual/Medicaid |
$141.96
|
| Rate for Payer: Buckeye Medicare Advantage |
$141.96
|
| Rate for Payer: CareSource Just4Me Medicare |
$170.35
|
| Rate for Payer: Cash Price |
$452.50
|
| Rate for Payer: Cash Price |
$452.50
|
| Rate for Payer: Cigna Commercial |
$280.84
|
| Rate for Payer: Healthspan PPO |
$351.44
|
| Rate for Payer: Humana Medicaid |
$132.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$81.02
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$141.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$141.96
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$134.84
|
| Rate for Payer: Molina Healthcare Passport |
$132.20
|
| Rate for Payer: Multiplan PHCS |
$543.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$184.55
|
| Rate for Payer: UHCCP Medicaid |
$316.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$133.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$141.96
|
|
