|
COMPR FX HMRL POS SLV 6*9MM
|
Facility
|
IP
|
$2,208.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$662.46 |
| Max. Negotiated Rate |
$2,119.87 |
| Rate for Payer: Aetna Commercial |
$1,700.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,722.40
|
| Rate for Payer: Cash Price |
$1,104.10
|
| Rate for Payer: Cigna Commercial |
$1,832.81
|
| Rate for Payer: First Health Commercial |
$2,097.79
|
| Rate for Payer: Humana Commercial |
$1,876.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,810.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,629.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$662.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,943.22
|
| Rate for Payer: Ohio Health Group HMO |
$1,656.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,766.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,921.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,523.66
|
| Rate for Payer: PHCS Commercial |
$2,119.87
|
| Rate for Payer: United Healthcare All Payer |
$1,943.22
|
|
|
COMPR FX HMRL POS SLV 8*10MM
|
Facility
|
IP
|
$2,208.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$662.46 |
| Max. Negotiated Rate |
$2,119.87 |
| Rate for Payer: Aetna Commercial |
$1,700.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,722.40
|
| Rate for Payer: Cash Price |
$1,104.10
|
| Rate for Payer: Cigna Commercial |
$1,832.81
|
| Rate for Payer: First Health Commercial |
$2,097.79
|
| Rate for Payer: Humana Commercial |
$1,876.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,810.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,629.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$662.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,943.22
|
| Rate for Payer: Ohio Health Group HMO |
$1,656.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,766.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,921.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,523.66
|
| Rate for Payer: PHCS Commercial |
$2,119.87
|
| Rate for Payer: United Healthcare All Payer |
$1,943.22
|
|
|
COMPR FX HMRL POS SLV 8*10MM
|
Facility
|
OP
|
$2,208.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$662.46 |
| Max. Negotiated Rate |
$2,119.87 |
| Rate for Payer: Aetna Commercial |
$1,700.31
|
| Rate for Payer: Anthem Medicaid |
$759.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,722.40
|
| Rate for Payer: Cash Price |
$1,104.10
|
| Rate for Payer: Cigna Commercial |
$1,832.81
|
| Rate for Payer: First Health Commercial |
$2,097.79
|
| Rate for Payer: Humana Commercial |
$1,876.97
|
| Rate for Payer: Humana KY Medicaid |
$759.40
|
| Rate for Payer: Kentucky WC Medicaid |
$767.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,810.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,629.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$662.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$774.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,943.22
|
| Rate for Payer: Ohio Health Group HMO |
$1,656.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,766.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,921.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,523.66
|
| Rate for Payer: PHCS Commercial |
$2,119.87
|
| Rate for Payer: United Healthcare All Payer |
$1,943.22
|
|
|
COMPR FX HMRL POS SLV 8*11MM
|
Facility
|
IP
|
$2,208.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$662.46 |
| Max. Negotiated Rate |
$2,119.87 |
| Rate for Payer: Aetna Commercial |
$1,700.31
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,722.40
|
| Rate for Payer: Cash Price |
$1,104.10
|
| Rate for Payer: Cigna Commercial |
$1,832.81
|
| Rate for Payer: First Health Commercial |
$2,097.79
|
| Rate for Payer: Humana Commercial |
$1,876.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,810.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,629.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$662.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,943.22
|
| Rate for Payer: Ohio Health Group HMO |
$1,656.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,766.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,921.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,523.66
|
| Rate for Payer: PHCS Commercial |
$2,119.87
|
| Rate for Payer: United Healthcare All Payer |
$1,943.22
|
|
|
COMPR FX HMRL POS SLV 8*11MM
|
Facility
|
OP
|
$2,208.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$662.46 |
| Max. Negotiated Rate |
$2,119.87 |
| Rate for Payer: Aetna Commercial |
$1,700.31
|
| Rate for Payer: Anthem Medicaid |
$759.40
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,722.40
|
| Rate for Payer: Cash Price |
$1,104.10
|
| Rate for Payer: Cigna Commercial |
$1,832.81
|
| Rate for Payer: First Health Commercial |
$2,097.79
|
| Rate for Payer: Humana Commercial |
$1,876.97
|
| Rate for Payer: Humana KY Medicaid |
$759.40
|
| Rate for Payer: Kentucky WC Medicaid |
$767.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,810.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,629.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$662.46
|
| Rate for Payer: Molina Healthcare Medicaid |
$774.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,943.22
|
| Rate for Payer: Ohio Health Group HMO |
$1,656.15
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,766.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,921.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,523.66
|
| Rate for Payer: PHCS Commercial |
$2,119.87
|
| Rate for Payer: United Healthcare All Payer |
$1,943.22
|
|
|
COMPR HMRL FX STEM MACRO 10MM
|
Facility
|
OP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem Medicaid |
$5,764.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Humana KY Medicaid |
$5,764.35
|
| Rate for Payer: Kentucky WC Medicaid |
$5,823.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,880.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 10MM
|
Facility
|
IP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 12MM
|
Facility
|
OP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem Medicaid |
$5,764.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Humana KY Medicaid |
$5,764.35
|
| Rate for Payer: Kentucky WC Medicaid |
$5,823.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,880.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 12MM
|
Facility
|
IP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 14MM
|
Facility
|
OP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem Medicaid |
$5,764.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Humana KY Medicaid |
$5,764.35
|
| Rate for Payer: Kentucky WC Medicaid |
$5,823.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,880.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 14MM
|
Facility
|
IP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 4MM
|
Facility
|
OP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem Medicaid |
$5,764.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Humana KY Medicaid |
$5,764.35
|
| Rate for Payer: Kentucky WC Medicaid |
$5,823.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,880.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 4MM
|
Facility
|
IP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 6MM
|
Facility
|
IP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 6MM
|
Facility
|
OP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem Medicaid |
$5,764.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Humana KY Medicaid |
$5,764.35
|
| Rate for Payer: Kentucky WC Medicaid |
$5,823.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,880.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 8MM
|
Facility
|
IP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR HMRL FX STEM MACRO 8MM
|
Facility
|
OP
|
$16,761.70
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,028.51 |
| Max. Negotiated Rate |
$16,091.23 |
| Rate for Payer: Aetna Commercial |
$12,906.51
|
| Rate for Payer: Anthem Medicaid |
$5,764.35
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,074.13
|
| Rate for Payer: Cash Price |
$8,380.85
|
| Rate for Payer: Cigna Commercial |
$13,912.21
|
| Rate for Payer: First Health Commercial |
$15,923.61
|
| Rate for Payer: Humana Commercial |
$14,247.44
|
| Rate for Payer: Humana KY Medicaid |
$5,764.35
|
| Rate for Payer: Kentucky WC Medicaid |
$5,823.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$13,744.59
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,370.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,028.51
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,880.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$14,750.30
|
| Rate for Payer: Ohio Health Group HMO |
$12,571.27
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,409.36
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$14,582.68
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,565.57
|
| Rate for Payer: PHCS Commercial |
$16,091.23
|
| Rate for Payer: United Healthcare All Payer |
$14,750.30
|
|
|
COMPR RVS SHLDER GLENSPR 36M+3
|
Facility
|
IP
|
$9,285.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,785.59 |
| Max. Negotiated Rate |
$8,913.89 |
| Rate for Payer: Aetna Commercial |
$7,149.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,242.53
|
| Rate for Payer: Cash Price |
$4,642.65
|
| Rate for Payer: Cigna Commercial |
$7,706.80
|
| Rate for Payer: First Health Commercial |
$8,821.03
|
| Rate for Payer: Humana Commercial |
$7,892.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,613.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,852.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,785.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,171.06
|
| Rate for Payer: Ohio Health Group HMO |
$6,963.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,428.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,078.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,406.86
|
| Rate for Payer: PHCS Commercial |
$8,913.89
|
| Rate for Payer: United Healthcare All Payer |
$8,171.06
|
|
|
COMPR RVS SHLDER GLENSPR 36M+3
|
Facility
|
OP
|
$9,285.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,785.59 |
| Max. Negotiated Rate |
$8,913.89 |
| Rate for Payer: Aetna Commercial |
$7,149.68
|
| Rate for Payer: Anthem Medicaid |
$3,193.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,242.53
|
| Rate for Payer: Cash Price |
$4,642.65
|
| Rate for Payer: Cigna Commercial |
$7,706.80
|
| Rate for Payer: First Health Commercial |
$8,821.03
|
| Rate for Payer: Humana Commercial |
$7,892.51
|
| Rate for Payer: Humana KY Medicaid |
$3,193.21
|
| Rate for Payer: Kentucky WC Medicaid |
$3,225.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,613.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,852.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,785.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,257.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,171.06
|
| Rate for Payer: Ohio Health Group HMO |
$6,963.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,428.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,078.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,406.86
|
| Rate for Payer: PHCS Commercial |
$8,913.89
|
| Rate for Payer: United Healthcare All Payer |
$8,171.06
|
|
|
COMPR RVS SHLDER GLENSPR 36M+6
|
Facility
|
IP
|
$9,285.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,785.59 |
| Max. Negotiated Rate |
$8,913.89 |
| Rate for Payer: Aetna Commercial |
$7,149.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,242.53
|
| Rate for Payer: Cash Price |
$4,642.65
|
| Rate for Payer: Cigna Commercial |
$7,706.80
|
| Rate for Payer: First Health Commercial |
$8,821.03
|
| Rate for Payer: Humana Commercial |
$7,892.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,613.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,852.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,785.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,171.06
|
| Rate for Payer: Ohio Health Group HMO |
$6,963.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,428.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,078.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,406.86
|
| Rate for Payer: PHCS Commercial |
$8,913.89
|
| Rate for Payer: United Healthcare All Payer |
$8,171.06
|
|
|
COMPR RVS SHLDER GLENSPR 36M+6
|
Facility
|
OP
|
$9,285.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,785.59 |
| Max. Negotiated Rate |
$8,913.89 |
| Rate for Payer: Aetna Commercial |
$7,149.68
|
| Rate for Payer: Anthem Medicaid |
$3,193.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,242.53
|
| Rate for Payer: Cash Price |
$4,642.65
|
| Rate for Payer: Cigna Commercial |
$7,706.80
|
| Rate for Payer: First Health Commercial |
$8,821.03
|
| Rate for Payer: Humana Commercial |
$7,892.51
|
| Rate for Payer: Humana KY Medicaid |
$3,193.21
|
| Rate for Payer: Kentucky WC Medicaid |
$3,225.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,613.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,852.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,785.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,257.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,171.06
|
| Rate for Payer: Ohio Health Group HMO |
$6,963.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,428.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,078.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,406.86
|
| Rate for Payer: PHCS Commercial |
$8,913.89
|
| Rate for Payer: United Healthcare All Payer |
$8,171.06
|
|
|
COMPR RVS SHLDER GLENSPR 41M+3
|
Facility
|
OP
|
$9,285.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,785.59 |
| Max. Negotiated Rate |
$8,913.89 |
| Rate for Payer: Aetna Commercial |
$7,149.68
|
| Rate for Payer: Anthem Medicaid |
$3,193.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,242.53
|
| Rate for Payer: Cash Price |
$4,642.65
|
| Rate for Payer: Cigna Commercial |
$7,706.80
|
| Rate for Payer: First Health Commercial |
$8,821.03
|
| Rate for Payer: Humana Commercial |
$7,892.51
|
| Rate for Payer: Humana KY Medicaid |
$3,193.21
|
| Rate for Payer: Kentucky WC Medicaid |
$3,225.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,613.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,852.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,785.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,257.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,171.06
|
| Rate for Payer: Ohio Health Group HMO |
$6,963.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,428.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,078.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,406.86
|
| Rate for Payer: PHCS Commercial |
$8,913.89
|
| Rate for Payer: United Healthcare All Payer |
$8,171.06
|
|
|
COMPR RVS SHLDER GLENSPR 41M+3
|
Facility
|
IP
|
$9,285.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,785.59 |
| Max. Negotiated Rate |
$8,913.89 |
| Rate for Payer: Aetna Commercial |
$7,149.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,242.53
|
| Rate for Payer: Cash Price |
$4,642.65
|
| Rate for Payer: Cigna Commercial |
$7,706.80
|
| Rate for Payer: First Health Commercial |
$8,821.03
|
| Rate for Payer: Humana Commercial |
$7,892.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,613.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,852.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,785.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,171.06
|
| Rate for Payer: Ohio Health Group HMO |
$6,963.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,428.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,078.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,406.86
|
| Rate for Payer: PHCS Commercial |
$8,913.89
|
| Rate for Payer: United Healthcare All Payer |
$8,171.06
|
|
|
COMPR RVS SHLDER GLENSPR 41M+6
|
Facility
|
OP
|
$9,285.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,785.59 |
| Max. Negotiated Rate |
$8,913.89 |
| Rate for Payer: Aetna Commercial |
$7,149.68
|
| Rate for Payer: Anthem Medicaid |
$3,193.21
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,242.53
|
| Rate for Payer: Cash Price |
$4,642.65
|
| Rate for Payer: Cigna Commercial |
$7,706.80
|
| Rate for Payer: First Health Commercial |
$8,821.03
|
| Rate for Payer: Humana Commercial |
$7,892.51
|
| Rate for Payer: Humana KY Medicaid |
$3,193.21
|
| Rate for Payer: Kentucky WC Medicaid |
$3,225.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,613.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,852.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,785.59
|
| Rate for Payer: Molina Healthcare Medicaid |
$3,257.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,171.06
|
| Rate for Payer: Ohio Health Group HMO |
$6,963.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,428.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,078.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,406.86
|
| Rate for Payer: PHCS Commercial |
$8,913.89
|
| Rate for Payer: United Healthcare All Payer |
$8,171.06
|
|
|
COMPR RVS SHLDER GLENSPR 41M+6
|
Facility
|
IP
|
$9,285.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,785.59 |
| Max. Negotiated Rate |
$8,913.89 |
| Rate for Payer: Aetna Commercial |
$7,149.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$7,242.53
|
| Rate for Payer: Cash Price |
$4,642.65
|
| Rate for Payer: Cigna Commercial |
$7,706.80
|
| Rate for Payer: First Health Commercial |
$8,821.03
|
| Rate for Payer: Humana Commercial |
$7,892.51
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$7,613.95
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,852.55
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,785.59
|
| Rate for Payer: Ohio Health Choice Commercial |
$8,171.06
|
| Rate for Payer: Ohio Health Group HMO |
$6,963.98
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,428.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8,078.21
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$6,406.86
|
| Rate for Payer: PHCS Commercial |
$8,913.89
|
| Rate for Payer: United Healthcare All Payer |
$8,171.06
|
|
