|
CORAIL2 STD SIZE 15
|
Facility
|
IP
|
$20,862.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,258.75 |
| Max. Negotiated Rate |
$20,028.00 |
| Rate for Payer: Aetna Commercial |
$16,064.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,272.75
|
| Rate for Payer: Cash Price |
$10,431.25
|
| Rate for Payer: Cigna Commercial |
$17,315.88
|
| Rate for Payer: First Health Commercial |
$19,819.38
|
| Rate for Payer: Humana Commercial |
$17,733.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,107.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,396.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,258.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,359.00
|
| Rate for Payer: Ohio Health Group HMO |
$15,646.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,690.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,150.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$14,395.12
|
| Rate for Payer: PHCS Commercial |
$20,028.00
|
| Rate for Payer: United Healthcare All Payer |
$18,359.00
|
|
|
CORAIL2 STD SIZE 15
|
Facility
|
OP
|
$20,862.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,258.75 |
| Max. Negotiated Rate |
$20,028.00 |
| Rate for Payer: Aetna Commercial |
$16,064.12
|
| Rate for Payer: Anthem Medicaid |
$7,174.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,272.75
|
| Rate for Payer: Cash Price |
$10,431.25
|
| Rate for Payer: Cigna Commercial |
$17,315.88
|
| Rate for Payer: First Health Commercial |
$19,819.38
|
| Rate for Payer: Humana Commercial |
$17,733.12
|
| Rate for Payer: Humana KY Medicaid |
$7,174.61
|
| Rate for Payer: Kentucky WC Medicaid |
$7,247.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,107.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,396.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,258.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,318.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,359.00
|
| Rate for Payer: Ohio Health Group HMO |
$15,646.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,690.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,150.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$14,395.12
|
| Rate for Payer: PHCS Commercial |
$20,028.00
|
| Rate for Payer: United Healthcare All Payer |
$18,359.00
|
|
|
CORAIL2 STD SIZE 16
|
Facility
|
OP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem Medicaid |
$7,973.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Humana KY Medicaid |
$7,973.92
|
| Rate for Payer: Kentucky WC Medicaid |
$8,055.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,133.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL2 STD SIZE 16
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL2 STD SIZE 18
|
Facility
|
IP
|
$20,862.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,258.75 |
| Max. Negotiated Rate |
$20,028.00 |
| Rate for Payer: Aetna Commercial |
$16,064.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,272.75
|
| Rate for Payer: Cash Price |
$10,431.25
|
| Rate for Payer: Cigna Commercial |
$17,315.88
|
| Rate for Payer: First Health Commercial |
$19,819.38
|
| Rate for Payer: Humana Commercial |
$17,733.12
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,107.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,396.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,258.75
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,359.00
|
| Rate for Payer: Ohio Health Group HMO |
$15,646.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,690.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,150.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$14,395.12
|
| Rate for Payer: PHCS Commercial |
$20,028.00
|
| Rate for Payer: United Healthcare All Payer |
$18,359.00
|
|
|
CORAIL2 STD SIZE 18
|
Facility
|
OP
|
$20,862.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,258.75 |
| Max. Negotiated Rate |
$20,028.00 |
| Rate for Payer: Aetna Commercial |
$16,064.12
|
| Rate for Payer: Anthem Medicaid |
$7,174.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$16,272.75
|
| Rate for Payer: Cash Price |
$10,431.25
|
| Rate for Payer: Cigna Commercial |
$17,315.88
|
| Rate for Payer: First Health Commercial |
$19,819.38
|
| Rate for Payer: Humana Commercial |
$17,733.12
|
| Rate for Payer: Humana KY Medicaid |
$7,174.61
|
| Rate for Payer: Kentucky WC Medicaid |
$7,247.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$17,107.25
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$15,396.52
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,258.75
|
| Rate for Payer: Molina Healthcare Medicaid |
$7,318.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$18,359.00
|
| Rate for Payer: Ohio Health Group HMO |
$15,646.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,690.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$18,150.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$14,395.12
|
| Rate for Payer: PHCS Commercial |
$20,028.00
|
| Rate for Payer: United Healthcare All Payer |
$18,359.00
|
|
|
CORAIL2 STD SIZE 20
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL2 STD SIZE 20
|
Facility
|
OP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem Medicaid |
$7,973.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Humana KY Medicaid |
$7,973.92
|
| Rate for Payer: Kentucky WC Medicaid |
$8,055.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,133.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL2 STD SIZE 8
|
Facility
|
IP
|
$31,437.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,431.25 |
| Max. Negotiated Rate |
$30,180.00 |
| Rate for Payer: Aetna Commercial |
$24,206.88
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,521.25
|
| Rate for Payer: Cash Price |
$15,718.75
|
| Rate for Payer: Cigna Commercial |
$26,093.12
|
| Rate for Payer: First Health Commercial |
$29,865.62
|
| Rate for Payer: Humana Commercial |
$26,721.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,778.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,200.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,431.25
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,665.00
|
| Rate for Payer: Ohio Health Group HMO |
$23,578.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,150.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,350.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,691.88
|
| Rate for Payer: PHCS Commercial |
$30,180.00
|
| Rate for Payer: United Healthcare All Payer |
$27,665.00
|
|
|
CORAIL2 STD SIZE 8
|
Facility
|
OP
|
$31,437.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,431.25 |
| Max. Negotiated Rate |
$30,180.00 |
| Rate for Payer: Aetna Commercial |
$24,206.88
|
| Rate for Payer: Anthem Medicaid |
$10,811.36
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,521.25
|
| Rate for Payer: Cash Price |
$15,718.75
|
| Rate for Payer: Cigna Commercial |
$26,093.12
|
| Rate for Payer: First Health Commercial |
$29,865.62
|
| Rate for Payer: Humana Commercial |
$26,721.88
|
| Rate for Payer: Humana KY Medicaid |
$10,811.36
|
| Rate for Payer: Kentucky WC Medicaid |
$10,921.39
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,778.75
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,200.88
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,431.25
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,028.27
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,665.00
|
| Rate for Payer: Ohio Health Group HMO |
$23,578.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,150.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,350.62
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,691.88
|
| Rate for Payer: PHCS Commercial |
$30,180.00
|
| Rate for Payer: United Healthcare All Payer |
$27,665.00
|
|
|
CORAIL2 STD SIZE 9
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL2 STD SIZE 9
|
Facility
|
OP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem Medicaid |
$7,973.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Humana KY Medicaid |
$7,973.92
|
| Rate for Payer: Kentucky WC Medicaid |
$8,055.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,133.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 10
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 10
|
Facility
|
OP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem Medicaid |
$7,973.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Humana KY Medicaid |
$7,973.92
|
| Rate for Payer: Kentucky WC Medicaid |
$8,055.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,133.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 11
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 11
|
Facility
|
OP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem Medicaid |
$7,973.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Humana KY Medicaid |
$7,973.92
|
| Rate for Payer: Kentucky WC Medicaid |
$8,055.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,133.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 12
|
Facility
|
OP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem Medicaid |
$7,973.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Humana KY Medicaid |
$7,973.92
|
| Rate for Payer: Kentucky WC Medicaid |
$8,055.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,133.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 12
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 13
|
Facility
|
OP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem Medicaid |
$7,973.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Humana KY Medicaid |
$7,973.92
|
| Rate for Payer: Kentucky WC Medicaid |
$8,055.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,133.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 13
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 14
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 14
|
Facility
|
OP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem Medicaid |
$7,973.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Humana KY Medicaid |
$7,973.92
|
| Rate for Payer: Kentucky WC Medicaid |
$8,055.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,133.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 15
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 15
|
Facility
|
OP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem Medicaid |
$7,973.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Humana KY Medicaid |
$7,973.92
|
| Rate for Payer: Kentucky WC Medicaid |
$8,055.08
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,133.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
|
CORAIL AMT COLLAR SIZE 16
|
Facility
|
IP
|
$23,186.75
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,956.02 |
| Max. Negotiated Rate |
$22,259.28 |
| Rate for Payer: Aetna Commercial |
$17,853.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,085.67
|
| Rate for Payer: Cash Price |
$11,593.38
|
| Rate for Payer: Cigna Commercial |
$19,245.00
|
| Rate for Payer: First Health Commercial |
$22,027.41
|
| Rate for Payer: Humana Commercial |
$19,708.74
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,013.13
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,111.82
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$6,956.02
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,404.34
|
| Rate for Payer: Ohio Health Group HMO |
$17,390.06
|
| Rate for Payer: Ohio Health Group PPO Differential |
$18,549.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$20,172.47
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$15,998.86
|
| Rate for Payer: PHCS Commercial |
$22,259.28
|
| Rate for Payer: United Healthcare All Payer |
$20,404.34
|
|
