|
COMPR STEM 20MM MINI
|
Facility
|
OP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem Medicaid |
$6,905.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Humana KY Medicaid |
$6,905.08
|
| Rate for Payer: Kentucky WC Medicaid |
$6,975.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 20MM MINI
|
Facility
|
IP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 20MM STD
|
Facility
|
OP
|
$17,479.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,243.85 |
| Max. Negotiated Rate |
$16,780.32 |
| Rate for Payer: Aetna Commercial |
$13,459.22
|
| Rate for Payer: Anthem Medicaid |
$6,011.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,634.01
|
| Rate for Payer: Cash Price |
$8,739.75
|
| Rate for Payer: Cigna Commercial |
$14,507.99
|
| Rate for Payer: First Health Commercial |
$16,605.53
|
| Rate for Payer: Humana Commercial |
$14,857.58
|
| Rate for Payer: Humana KY Medicaid |
$6,011.20
|
| Rate for Payer: Kentucky WC Medicaid |
$6,072.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,333.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,899.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,243.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,131.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,381.96
|
| Rate for Payer: Ohio Health Group HMO |
$13,109.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,983.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,207.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,060.85
|
| Rate for Payer: PHCS Commercial |
$16,780.32
|
| Rate for Payer: United Healthcare All Payer |
$15,381.96
|
|
|
COMPR STEM 20MM STD
|
Facility
|
IP
|
$17,479.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,243.85 |
| Max. Negotiated Rate |
$16,780.32 |
| Rate for Payer: Aetna Commercial |
$13,459.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,634.01
|
| Rate for Payer: Cash Price |
$8,739.75
|
| Rate for Payer: Cigna Commercial |
$14,507.99
|
| Rate for Payer: First Health Commercial |
$16,605.53
|
| Rate for Payer: Humana Commercial |
$14,857.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,333.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,899.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,243.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,381.96
|
| Rate for Payer: Ohio Health Group HMO |
$13,109.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,983.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,207.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,060.85
|
| Rate for Payer: PHCS Commercial |
$16,780.32
|
| Rate for Payer: United Healthcare All Payer |
$15,381.96
|
|
|
COMPR STEM 4MM MICRO
|
Facility
|
IP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 4MM MICRO
|
Facility
|
OP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem Medicaid |
$6,905.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Humana KY Medicaid |
$6,905.08
|
| Rate for Payer: Kentucky WC Medicaid |
$6,975.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 4MM MINI
|
Facility
|
OP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem Medicaid |
$6,905.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Humana KY Medicaid |
$6,905.08
|
| Rate for Payer: Kentucky WC Medicaid |
$6,975.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 4MM MINI
|
Facility
|
IP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 5MM MICRO
|
Facility
|
IP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 5MM MICRO
|
Facility
|
OP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem Medicaid |
$6,905.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Humana KY Medicaid |
$6,905.08
|
| Rate for Payer: Kentucky WC Medicaid |
$6,975.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 5MM MINI
|
Facility
|
OP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem Medicaid |
$6,905.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Humana KY Medicaid |
$6,905.08
|
| Rate for Payer: Kentucky WC Medicaid |
$6,975.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 5MM MINI
|
Facility
|
IP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 5MM STD
|
Facility
|
IP
|
$17,479.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,243.85 |
| Max. Negotiated Rate |
$16,780.32 |
| Rate for Payer: Aetna Commercial |
$13,459.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,634.01
|
| Rate for Payer: Cash Price |
$8,739.75
|
| Rate for Payer: Cigna Commercial |
$14,507.99
|
| Rate for Payer: First Health Commercial |
$16,605.53
|
| Rate for Payer: Humana Commercial |
$14,857.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,333.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,899.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,243.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,381.96
|
| Rate for Payer: Ohio Health Group HMO |
$13,109.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,983.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,207.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,060.85
|
| Rate for Payer: PHCS Commercial |
$16,780.32
|
| Rate for Payer: United Healthcare All Payer |
$15,381.96
|
|
|
COMPR STEM 5MM STD
|
Facility
|
OP
|
$17,479.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,243.85 |
| Max. Negotiated Rate |
$16,780.32 |
| Rate for Payer: Aetna Commercial |
$13,459.22
|
| Rate for Payer: Anthem Medicaid |
$6,011.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,634.01
|
| Rate for Payer: Cash Price |
$8,739.75
|
| Rate for Payer: Cigna Commercial |
$14,507.99
|
| Rate for Payer: First Health Commercial |
$16,605.53
|
| Rate for Payer: Humana Commercial |
$14,857.58
|
| Rate for Payer: Humana KY Medicaid |
$6,011.20
|
| Rate for Payer: Kentucky WC Medicaid |
$6,072.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,333.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,899.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,243.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,131.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,381.96
|
| Rate for Payer: Ohio Health Group HMO |
$13,109.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,983.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,207.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,060.85
|
| Rate for Payer: PHCS Commercial |
$16,780.32
|
| Rate for Payer: United Healthcare All Payer |
$15,381.96
|
|
|
COMPR STEM 6MM MICRO
|
Facility
|
OP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem Medicaid |
$6,905.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Humana KY Medicaid |
$6,905.08
|
| Rate for Payer: Kentucky WC Medicaid |
$6,975.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 6MM MICRO
|
Facility
|
IP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 6MM MINI
|
Facility
|
IP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 6MM MINI
|
Facility
|
OP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem Medicaid |
$6,905.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Humana KY Medicaid |
$6,905.08
|
| Rate for Payer: Kentucky WC Medicaid |
$6,975.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 6MM STD
|
Facility
|
OP
|
$17,479.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,243.85 |
| Max. Negotiated Rate |
$16,780.32 |
| Rate for Payer: Aetna Commercial |
$13,459.22
|
| Rate for Payer: Anthem Medicaid |
$6,011.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,634.01
|
| Rate for Payer: Cash Price |
$8,739.75
|
| Rate for Payer: Cigna Commercial |
$14,507.99
|
| Rate for Payer: First Health Commercial |
$16,605.53
|
| Rate for Payer: Humana Commercial |
$14,857.58
|
| Rate for Payer: Humana KY Medicaid |
$6,011.20
|
| Rate for Payer: Kentucky WC Medicaid |
$6,072.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,333.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,899.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,243.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,131.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,381.96
|
| Rate for Payer: Ohio Health Group HMO |
$13,109.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,983.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,207.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,060.85
|
| Rate for Payer: PHCS Commercial |
$16,780.32
|
| Rate for Payer: United Healthcare All Payer |
$15,381.96
|
|
|
COMPR STEM 6MM STD
|
Facility
|
IP
|
$17,479.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,243.85 |
| Max. Negotiated Rate |
$16,780.32 |
| Rate for Payer: Aetna Commercial |
$13,459.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,634.01
|
| Rate for Payer: Cash Price |
$8,739.75
|
| Rate for Payer: Cigna Commercial |
$14,507.99
|
| Rate for Payer: First Health Commercial |
$16,605.53
|
| Rate for Payer: Humana Commercial |
$14,857.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,333.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,899.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,243.85
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,381.96
|
| Rate for Payer: Ohio Health Group HMO |
$13,109.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,983.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,207.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,060.85
|
| Rate for Payer: PHCS Commercial |
$16,780.32
|
| Rate for Payer: United Healthcare All Payer |
$15,381.96
|
|
|
COMPR STEM 7MM MICRO
|
Facility
|
OP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem Medicaid |
$6,905.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Humana KY Medicaid |
$6,905.08
|
| Rate for Payer: Kentucky WC Medicaid |
$6,975.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 7MM MICRO
|
Facility
|
IP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 7MM MINI
|
Facility
|
OP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem Medicaid |
$6,905.08
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Humana KY Medicaid |
$6,905.08
|
| Rate for Payer: Kentucky WC Medicaid |
$6,975.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,043.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 7MM MINI
|
Facility
|
IP
|
$20,078.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,023.62 |
| Max. Negotiated Rate |
$19,275.60 |
| Rate for Payer: Aetna Commercial |
$15,460.64
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$15,661.42
|
| Rate for Payer: Cash Price |
$10,039.38
|
| Rate for Payer: Cigna Commercial |
$16,665.36
|
| Rate for Payer: First Health Commercial |
$19,074.81
|
| Rate for Payer: Humana Commercial |
$17,066.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$16,464.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$14,818.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,023.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$17,669.30
|
| Rate for Payer: Ohio Health Group HMO |
$15,059.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,063.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$17,468.51
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$13,854.34
|
| Rate for Payer: PHCS Commercial |
$19,275.60
|
| Rate for Payer: United Healthcare All Payer |
$17,669.30
|
|
|
COMPR STEM 7MM STD
|
Facility
|
OP
|
$17,479.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,243.85 |
| Max. Negotiated Rate |
$16,780.32 |
| Rate for Payer: Aetna Commercial |
$13,459.22
|
| Rate for Payer: Anthem Medicaid |
$6,011.20
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$13,634.01
|
| Rate for Payer: Cash Price |
$8,739.75
|
| Rate for Payer: Cigna Commercial |
$14,507.99
|
| Rate for Payer: First Health Commercial |
$16,605.53
|
| Rate for Payer: Humana Commercial |
$14,857.58
|
| Rate for Payer: Humana KY Medicaid |
$6,011.20
|
| Rate for Payer: Kentucky WC Medicaid |
$6,072.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$14,333.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$12,899.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$5,243.85
|
| Rate for Payer: Molina Healthcare Medicaid |
$6,131.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$15,381.96
|
| Rate for Payer: Ohio Health Group HMO |
$13,109.62
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13,983.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$15,207.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$12,060.85
|
| Rate for Payer: PHCS Commercial |
$16,780.32
|
| Rate for Payer: United Healthcare All Payer |
$15,381.96
|
|
