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Service Code NDC 93312501
Hospital Charge Code 25000556
Hospital Revenue Code 637
Min. Negotiated Rate $1.22
Max. Negotiated Rate $9.00
Rate for Payer: Aetna Commercial $7.21
Rate for Payer: Anthem Medicaid $3.22
Rate for Payer: Anthem POS/PPO/Traditional $7.31
Rate for Payer: Cash Price $4.68
Rate for Payer: Cigna Commercial $7.78
Rate for Payer: First Health Commercial $8.90
Rate for Payer: Humana Commercial $7.96
Rate for Payer: Humana KY Medicaid $3.22
Rate for Payer: Kentucky WC Medicaid $3.26
Rate for Payer: Medical Mutual Of Ohio HMO $7.68
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6.92
Rate for Payer: Molina Healthcare Benefit Exchange $2.81
Rate for Payer: Molina Healthcare Medicaid $3.29
Rate for Payer: Ohio Health Choice Commercial $8.25
Rate for Payer: Ohio Health Group HMO $7.03
Rate for Payer: Ohio Health Group PPO Differential $1.87
Rate for Payer: Ohio Health Group PPO No Differential $1.22
Rate for Payer: Ohio Health Group PPO SOMC Employees $2.90
Rate for Payer: PHCS Commercial $9.00
Rate for Payer: United Healthcare All Payer $8.25
Service Code NDC 93312501
Hospital Charge Code 25000556
Hospital Revenue Code 637
Min. Negotiated Rate $1.22
Max. Negotiated Rate $9.00
Rate for Payer: Aetna Commercial $7.21
Rate for Payer: Anthem POS/PPO/Traditional $7.31
Rate for Payer: Cash Price $4.68
Rate for Payer: Cigna Commercial $7.78
Rate for Payer: First Health Commercial $8.90
Rate for Payer: Humana Commercial $7.96
Rate for Payer: Medical Mutual Of Ohio HMO $7.68
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6.92
Rate for Payer: Molina Healthcare Benefit Exchange $2.81
Rate for Payer: Ohio Health Choice Commercial $8.25
Rate for Payer: Ohio Health Group HMO $7.03
Rate for Payer: Ohio Health Group PPO Differential $1.87
Rate for Payer: Ohio Health Group PPO No Differential $1.22
Rate for Payer: Ohio Health Group PPO SOMC Employees $2.90
Rate for Payer: PHCS Commercial $9.00
Rate for Payer: United Healthcare All Payer $8.25
Service Code HCPCS 86978
Hospital Charge Code 30001244
Hospital Revenue Code 300
Min. Negotiated Rate $11.83
Max. Negotiated Rate $87.36
Rate for Payer: Aetna Commercial $70.07
Rate for Payer: Anthem Medicaid $31.29
Rate for Payer: Anthem Medicare Advantage/PPO $52.89
Rate for Payer: Anthem POS/PPO/Traditional $73.07
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $74.05
Rate for Payer: CareSource Just4Me Medicare $71.40
Rate for Payer: Cash Price $45.50
Rate for Payer: Cash Price $45.50
Rate for Payer: Cigna Commercial $75.53
Rate for Payer: First Health Commercial $86.45
Rate for Payer: Humana Commercial $77.35
Rate for Payer: Humana KY Medicaid $31.29
Rate for Payer: Humana Medicare Advantage $52.89
Rate for Payer: Kentucky WC Medicaid $31.61
Rate for Payer: Medical Mutual Of Ohio HMO $74.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $67.16
Rate for Payer: Molina Healthcare Benefit Exchange $63.47
Rate for Payer: Molina Healthcare Medicaid $31.92
Rate for Payer: Ohio Health Choice Commercial $80.08
Rate for Payer: Ohio Health Group HMO $68.25
Rate for Payer: Ohio Health Group PPO Differential $18.20
Rate for Payer: Ohio Health Group PPO No Differential $11.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $28.21
Rate for Payer: PHCS Commercial $87.36
Rate for Payer: United Healthcare All Payer $80.08
Service Code HCPCS 86978
Hospital Charge Code 30001244
Hospital Revenue Code 300
Min. Negotiated Rate $11.83
Max. Negotiated Rate $87.36
Rate for Payer: Aetna Commercial $70.07
Rate for Payer: Anthem POS/PPO/Traditional $73.07
Rate for Payer: Cash Price $45.50
Rate for Payer: Cigna Commercial $75.53
Rate for Payer: First Health Commercial $86.45
Rate for Payer: Humana Commercial $77.35
Rate for Payer: Medical Mutual Of Ohio HMO $74.62
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $67.16
Rate for Payer: Molina Healthcare Benefit Exchange $27.30
Rate for Payer: Ohio Health Choice Commercial $80.08
Rate for Payer: Ohio Health Group HMO $68.25
Rate for Payer: Ohio Health Group PPO Differential $18.20
Rate for Payer: Ohio Health Group PPO No Differential $11.83
Rate for Payer: Ohio Health Group PPO SOMC Employees $28.21
Rate for Payer: PHCS Commercial $87.36
Rate for Payer: United Healthcare All Payer $80.08
Service Code NDC 52015070022
Hospital Charge Code 25004135
Hospital Revenue Code 250
Min. Negotiated Rate $46.08
Max. Negotiated Rate $340.29
Rate for Payer: Aetna Commercial $272.94
Rate for Payer: Anthem Medicaid $121.90
Rate for Payer: Anthem POS/PPO/Traditional $276.49
Rate for Payer: Cash Price $177.24
Rate for Payer: Cigna Commercial $294.21
Rate for Payer: First Health Commercial $336.75
Rate for Payer: Humana Commercial $301.30
Rate for Payer: Humana KY Medicaid $121.90
Rate for Payer: Kentucky WC Medicaid $123.14
Rate for Payer: Medical Mutual Of Ohio HMO $290.67
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $261.60
Rate for Payer: Molina Healthcare Benefit Exchange $106.34
Rate for Payer: Molina Healthcare Medicaid $124.35
Rate for Payer: Ohio Health Choice Commercial $311.93
Rate for Payer: Ohio Health Group HMO $265.85
Rate for Payer: Ohio Health Group PPO Differential $70.89
Rate for Payer: Ohio Health Group PPO No Differential $46.08
Rate for Payer: Ohio Health Group PPO SOMC Employees $109.89
Rate for Payer: PHCS Commercial $340.29
Rate for Payer: United Healthcare All Payer $311.93
Service Code NDC 52015070022
Hospital Charge Code 25004135
Hospital Revenue Code 250
Min. Negotiated Rate $46.08
Max. Negotiated Rate $340.29
Rate for Payer: Aetna Commercial $272.94
Rate for Payer: Anthem POS/PPO/Traditional $276.49
Rate for Payer: Cash Price $177.24
Rate for Payer: Cigna Commercial $294.21
Rate for Payer: First Health Commercial $336.75
Rate for Payer: Humana Commercial $301.30
Rate for Payer: Medical Mutual Of Ohio HMO $290.67
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $261.60
Rate for Payer: Molina Healthcare Benefit Exchange $106.34
Rate for Payer: Ohio Health Choice Commercial $311.93
Rate for Payer: Ohio Health Group HMO $265.85
Rate for Payer: Ohio Health Group PPO Differential $70.89
Rate for Payer: Ohio Health Group PPO No Differential $46.08
Rate for Payer: Ohio Health Group PPO SOMC Employees $109.89
Rate for Payer: PHCS Commercial $340.29
Rate for Payer: United Healthcare All Payer $311.93
Service Code NDC 52015008001
Hospital Charge Code 25000558
Hospital Revenue Code 637
Min. Negotiated Rate $54.48
Max. Negotiated Rate $402.28
Rate for Payer: Aetna Commercial $322.66
Rate for Payer: Anthem Medicaid $144.11
Rate for Payer: Anthem POS/PPO/Traditional $326.85
Rate for Payer: Cash Price $209.52
Rate for Payer: Cigna Commercial $347.80
Rate for Payer: First Health Commercial $398.09
Rate for Payer: Humana Commercial $356.18
Rate for Payer: Humana KY Medicaid $144.11
Rate for Payer: Kentucky WC Medicaid $145.57
Rate for Payer: Medical Mutual Of Ohio HMO $343.61
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $309.25
Rate for Payer: Molina Healthcare Benefit Exchange $125.71
Rate for Payer: Molina Healthcare Medicaid $147.00
Rate for Payer: Ohio Health Choice Commercial $368.76
Rate for Payer: Ohio Health Group HMO $314.28
Rate for Payer: Ohio Health Group PPO Differential $83.81
Rate for Payer: Ohio Health Group PPO No Differential $54.48
Rate for Payer: Ohio Health Group PPO SOMC Employees $129.90
Rate for Payer: PHCS Commercial $402.28
Rate for Payer: United Healthcare All Payer $368.76
Service Code NDC 52015008001
Hospital Charge Code 25000558
Hospital Revenue Code 637
Min. Negotiated Rate $54.48
Max. Negotiated Rate $402.28
Rate for Payer: Aetna Commercial $322.66
Rate for Payer: Anthem POS/PPO/Traditional $326.85
Rate for Payer: Cash Price $209.52
Rate for Payer: Cigna Commercial $347.80
Rate for Payer: First Health Commercial $398.09
Rate for Payer: Humana Commercial $356.18
Rate for Payer: Medical Mutual Of Ohio HMO $343.61
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $309.25
Rate for Payer: Molina Healthcare Benefit Exchange $125.71
Rate for Payer: Ohio Health Choice Commercial $368.76
Rate for Payer: Ohio Health Group HMO $314.28
Rate for Payer: Ohio Health Group PPO Differential $83.81
Rate for Payer: Ohio Health Group PPO No Differential $54.48
Rate for Payer: Ohio Health Group PPO SOMC Employees $129.90
Rate for Payer: PHCS Commercial $402.28
Rate for Payer: United Healthcare All Payer $368.76
Service Code HCPCS J1450
Hospital Charge Code 25002063
Hospital Revenue Code 636
Min. Negotiated Rate $15.08
Max. Negotiated Rate $111.36
Rate for Payer: Aetna Commercial $89.32
Rate for Payer: Anthem Medicaid $39.89
Rate for Payer: Anthem POS/PPO/Traditional $90.48
Rate for Payer: Cash Price $58.00
Rate for Payer: Cigna Commercial $96.28
Rate for Payer: First Health Commercial $110.20
Rate for Payer: Humana Commercial $98.60
Rate for Payer: Humana KY Medicaid $39.89
Rate for Payer: Kentucky WC Medicaid $40.30
Rate for Payer: Medical Mutual Of Ohio HMO $95.12
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $85.61
Rate for Payer: Molina Healthcare Benefit Exchange $34.80
Rate for Payer: Molina Healthcare Medicaid $40.69
Rate for Payer: Ohio Health Choice Commercial $102.08
Rate for Payer: Ohio Health Group HMO $87.00
Rate for Payer: Ohio Health Group PPO Differential $23.20
Rate for Payer: Ohio Health Group PPO No Differential $15.08
Rate for Payer: Ohio Health Group PPO SOMC Employees $35.96
Rate for Payer: PHCS Commercial $111.36
Rate for Payer: United Healthcare All Payer $102.08
Service Code HCPCS J1450
Hospital Charge Code 25002063
Hospital Revenue Code 636
Min. Negotiated Rate $15.08
Max. Negotiated Rate $111.36
Rate for Payer: Aetna Commercial $89.32
Rate for Payer: Anthem POS/PPO/Traditional $90.48
Rate for Payer: Cash Price $58.00
Rate for Payer: Cigna Commercial $96.28
Rate for Payer: First Health Commercial $110.20
Rate for Payer: Humana Commercial $98.60
Rate for Payer: Medical Mutual Of Ohio HMO $95.12
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $85.61
Rate for Payer: Molina Healthcare Benefit Exchange $34.80
Rate for Payer: Ohio Health Choice Commercial $102.08
Rate for Payer: Ohio Health Group HMO $87.00
Rate for Payer: Ohio Health Group PPO Differential $23.20
Rate for Payer: Ohio Health Group PPO No Differential $15.08
Rate for Payer: Ohio Health Group PPO SOMC Employees $35.96
Rate for Payer: PHCS Commercial $111.36
Rate for Payer: United Healthcare All Payer $102.08
Service Code NDC 68001025204
Hospital Charge Code 25000559
Hospital Revenue Code 637
Min. Negotiated Rate $1.24
Max. Negotiated Rate $9.12
Rate for Payer: Aetna Commercial $7.32
Rate for Payer: Anthem Medicaid $3.27
Rate for Payer: Anthem POS/PPO/Traditional $7.41
Rate for Payer: Cash Price $4.75
Rate for Payer: Cigna Commercial $7.88
Rate for Payer: First Health Commercial $9.02
Rate for Payer: Humana Commercial $8.08
Rate for Payer: Humana KY Medicaid $3.27
Rate for Payer: Kentucky WC Medicaid $3.30
Rate for Payer: Medical Mutual Of Ohio HMO $7.79
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7.01
Rate for Payer: Molina Healthcare Benefit Exchange $2.85
Rate for Payer: Molina Healthcare Medicaid $3.33
Rate for Payer: Ohio Health Choice Commercial $8.36
Rate for Payer: Ohio Health Group HMO $7.12
Rate for Payer: Ohio Health Group PPO Differential $1.90
Rate for Payer: Ohio Health Group PPO No Differential $1.24
Rate for Payer: Ohio Health Group PPO SOMC Employees $2.94
Rate for Payer: PHCS Commercial $9.12
Rate for Payer: United Healthcare All Payer $8.36
Service Code NDC 68001025204
Hospital Charge Code 25000559
Hospital Revenue Code 637
Min. Negotiated Rate $1.24
Max. Negotiated Rate $9.12
Rate for Payer: Aetna Commercial $7.32
Rate for Payer: Anthem POS/PPO/Traditional $7.41
Rate for Payer: Cash Price $4.75
Rate for Payer: Cigna Commercial $7.88
Rate for Payer: First Health Commercial $9.02
Rate for Payer: Humana Commercial $8.08
Rate for Payer: Medical Mutual Of Ohio HMO $7.79
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $7.01
Rate for Payer: Molina Healthcare Benefit Exchange $2.85
Rate for Payer: Ohio Health Choice Commercial $8.36
Rate for Payer: Ohio Health Group HMO $7.12
Rate for Payer: Ohio Health Group PPO Differential $1.90
Rate for Payer: Ohio Health Group PPO No Differential $1.24
Rate for Payer: Ohio Health Group PPO SOMC Employees $2.94
Rate for Payer: PHCS Commercial $9.12
Rate for Payer: United Healthcare All Payer $8.36
Service Code NDC 57237000630
Hospital Charge Code 25000560
Hospital Revenue Code 637
Min. Negotiated Rate $0.63
Max. Negotiated Rate $4.68
Rate for Payer: Aetna Commercial $3.75
Rate for Payer: Anthem Medicaid $1.67
Rate for Payer: Anthem POS/PPO/Traditional $3.80
Rate for Payer: Cash Price $2.44
Rate for Payer: Cigna Commercial $4.04
Rate for Payer: First Health Commercial $4.63
Rate for Payer: Humana Commercial $4.14
Rate for Payer: Humana KY Medicaid $1.67
Rate for Payer: Kentucky WC Medicaid $1.69
Rate for Payer: Medical Mutual Of Ohio HMO $3.99
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.59
Rate for Payer: Molina Healthcare Benefit Exchange $1.46
Rate for Payer: Molina Healthcare Medicaid $1.71
Rate for Payer: Ohio Health Choice Commercial $4.29
Rate for Payer: Ohio Health Group HMO $3.65
Rate for Payer: Ohio Health Group PPO Differential $0.97
Rate for Payer: Ohio Health Group PPO No Differential $0.63
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.51
Rate for Payer: PHCS Commercial $4.68
Rate for Payer: United Healthcare All Payer $4.29
Service Code NDC 57237000630
Hospital Charge Code 25000560
Hospital Revenue Code 637
Min. Negotiated Rate $0.63
Max. Negotiated Rate $4.68
Rate for Payer: Humana Commercial $4.14
Rate for Payer: Medical Mutual Of Ohio HMO $3.99
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.59
Rate for Payer: Molina Healthcare Benefit Exchange $1.46
Rate for Payer: Ohio Health Choice Commercial $4.29
Rate for Payer: Ohio Health Group HMO $3.65
Rate for Payer: Ohio Health Group PPO Differential $0.97
Rate for Payer: Ohio Health Group PPO No Differential $0.63
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.51
Rate for Payer: PHCS Commercial $4.68
Rate for Payer: United Healthcare All Payer $4.29
Rate for Payer: Aetna Commercial $3.75
Rate for Payer: Anthem POS/PPO/Traditional $3.80
Rate for Payer: Cash Price $2.44
Rate for Payer: Cigna Commercial $4.04
Rate for Payer: First Health Commercial $4.63
Service Code NDC 68001025104
Hospital Charge Code 25000562
Hospital Revenue Code 637
Min. Negotiated Rate $1.19
Max. Negotiated Rate $8.76
Rate for Payer: Aetna Commercial $7.02
Rate for Payer: Anthem Medicaid $3.14
Rate for Payer: Anthem POS/PPO/Traditional $7.11
Rate for Payer: Cash Price $4.56
Rate for Payer: Cigna Commercial $7.57
Rate for Payer: First Health Commercial $8.66
Rate for Payer: Humana Commercial $7.75
Rate for Payer: Humana KY Medicaid $3.14
Rate for Payer: Kentucky WC Medicaid $3.17
Rate for Payer: Medical Mutual Of Ohio HMO $7.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6.73
Rate for Payer: Molina Healthcare Benefit Exchange $2.74
Rate for Payer: Molina Healthcare Medicaid $3.20
Rate for Payer: Ohio Health Choice Commercial $8.03
Rate for Payer: Ohio Health Group HMO $6.84
Rate for Payer: Ohio Health Group PPO Differential $1.82
Rate for Payer: Ohio Health Group PPO No Differential $1.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $2.83
Rate for Payer: PHCS Commercial $8.76
Rate for Payer: United Healthcare All Payer $8.03
Service Code NDC 68001025104
Hospital Charge Code 25000562
Hospital Revenue Code 637
Min. Negotiated Rate $1.19
Max. Negotiated Rate $8.76
Rate for Payer: Aetna Commercial $7.02
Rate for Payer: Anthem POS/PPO/Traditional $7.11
Rate for Payer: Cash Price $4.56
Rate for Payer: Cigna Commercial $7.57
Rate for Payer: First Health Commercial $8.66
Rate for Payer: Humana Commercial $7.75
Rate for Payer: Medical Mutual Of Ohio HMO $7.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6.73
Rate for Payer: Molina Healthcare Benefit Exchange $2.74
Rate for Payer: Ohio Health Choice Commercial $8.03
Rate for Payer: Ohio Health Group HMO $6.84
Rate for Payer: Ohio Health Group PPO Differential $1.82
Rate for Payer: Ohio Health Group PPO No Differential $1.19
Rate for Payer: Ohio Health Group PPO SOMC Employees $2.83
Rate for Payer: PHCS Commercial $8.76
Rate for Payer: United Healthcare All Payer $8.03
Service Code MSDRG 375
Min. Negotiated Rate $9,512.18
Max. Negotiated Rate $14,017.95
Rate for Payer: Anthem Medicaid $9,512.18
Rate for Payer: Anthem Medicare Advantage/PPO $10,012.82
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $14,017.95
Rate for Payer: CareSource Just4Me Medicare $13,517.31
Rate for Payer: Humana KY Medicaid $9,512.18
Rate for Payer: Humana Medicare Advantage $10,012.82
Rate for Payer: Kentucky WC Medicaid $9,607.30
Rate for Payer: Molina Healthcare Benefit Exchange $12,015.38
Rate for Payer: Molina Healthcare Medicaid $9,702.42
Service Code MSDRG 374
Min. Negotiated Rate $16,662.01
Max. Negotiated Rate $24,554.54
Rate for Payer: Anthem Medicaid $16,662.01
Rate for Payer: Anthem Medicare Advantage/PPO $17,538.96
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $24,554.54
Rate for Payer: CareSource Just4Me Medicare $23,677.60
Rate for Payer: Humana KY Medicaid $16,662.01
Rate for Payer: Humana Medicare Advantage $17,538.96
Rate for Payer: Kentucky WC Medicaid $16,828.63
Rate for Payer: Molina Healthcare Benefit Exchange $21,046.75
Rate for Payer: Molina Healthcare Medicaid $16,995.25
Service Code MSDRG 376
Min. Negotiated Rate $7,075.98
Max. Negotiated Rate $10,427.76
Rate for Payer: Anthem Medicaid $7,075.98
Rate for Payer: Anthem Medicare Advantage/PPO $7,448.40
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $10,427.76
Rate for Payer: CareSource Just4Me Medicare $10,055.34
Rate for Payer: Humana KY Medicaid $7,075.98
Rate for Payer: Humana Medicare Advantage $7,448.40
Rate for Payer: Kentucky WC Medicaid $7,146.74
Rate for Payer: Molina Healthcare Benefit Exchange $8,938.08
Rate for Payer: Molina Healthcare Medicaid $7,217.50
Service Code HCPCS G0102
Hospital Charge Code 51000132
Hospital Revenue Code 510
Min. Negotiated Rate $3.90
Max. Negotiated Rate $28.80
Rate for Payer: Aetna Commercial $23.10
Rate for Payer: Anthem POS/PPO/Traditional $23.40
Rate for Payer: Cash Price $15.00
Rate for Payer: Cigna Commercial $24.90
Rate for Payer: First Health Commercial $28.50
Rate for Payer: Humana Commercial $25.50
Rate for Payer: Medical Mutual Of Ohio HMO $24.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $22.14
Rate for Payer: Molina Healthcare Benefit Exchange $9.00
Rate for Payer: Ohio Health Choice Commercial $26.40
Rate for Payer: Ohio Health Group HMO $22.50
Rate for Payer: Ohio Health Group PPO Differential $6.00
Rate for Payer: Ohio Health Group PPO No Differential $3.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $9.30
Rate for Payer: PHCS Commercial $28.80
Rate for Payer: United Healthcare All Payer $26.40
Service Code HCPCS G0102
Hospital Charge Code 51000132
Hospital Revenue Code 510
Min. Negotiated Rate $10.50
Max. Negotiated Rate $30.00
Rate for Payer: Aetna Commercial $13.74
Rate for Payer: Buckeye Medicare Advantage $30.00
Rate for Payer: Cash Price $15.00
Rate for Payer: Cash Price $15.00
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $11.49
Rate for Payer: Multiplan PHCS $18.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $21.00
Rate for Payer: UHCCP Medicaid $10.50
Service Code HCPCS G0102
Hospital Charge Code 51000132
Hospital Revenue Code 510
Min. Negotiated Rate $3.90
Max. Negotiated Rate $28.80
Rate for Payer: Aetna Commercial $23.10
Rate for Payer: Anthem Medicaid $10.32
Rate for Payer: Anthem POS/PPO/Traditional $23.40
Rate for Payer: Cash Price $15.00
Rate for Payer: Cigna Commercial $24.90
Rate for Payer: First Health Commercial $28.50
Rate for Payer: Humana Commercial $25.50
Rate for Payer: Humana KY Medicaid $10.32
Rate for Payer: Kentucky WC Medicaid $10.42
Rate for Payer: Medical Mutual Of Ohio HMO $24.60
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $22.14
Rate for Payer: Molina Healthcare Benefit Exchange $9.00
Rate for Payer: Molina Healthcare Medicaid $10.52
Rate for Payer: Ohio Health Choice Commercial $26.40
Rate for Payer: Ohio Health Group HMO $22.50
Rate for Payer: Ohio Health Group PPO Differential $6.00
Rate for Payer: Ohio Health Group PPO No Differential $3.90
Rate for Payer: Ohio Health Group PPO SOMC Employees $9.30
Rate for Payer: PHCS Commercial $28.80
Rate for Payer: United Healthcare All Payer $26.40
Service Code HCPCS J1162
Hospital Charge Code 25002021
Hospital Revenue Code 636
Min. Negotiated Rate $849.29
Max. Negotiated Rate $6,688.42
Rate for Payer: Aetna Commercial $5,030.41
Rate for Payer: Anthem Medicaid $2,246.70
Rate for Payer: Anthem Medicare Advantage/PPO $4,777.44
Rate for Payer: Anthem POS/PPO/Traditional $5,095.74
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $6,688.42
Rate for Payer: CareSource Just4Me Medicare $6,449.55
Rate for Payer: Cash Price $3,266.50
Rate for Payer: Cash Price $3,266.50
Rate for Payer: Cigna Commercial $5,422.39
Rate for Payer: First Health Commercial $6,206.35
Rate for Payer: Humana Commercial $5,553.05
Rate for Payer: Humana KY Medicaid $2,246.70
Rate for Payer: Humana Medicare Advantage $4,777.44
Rate for Payer: Kentucky WC Medicaid $2,269.56
Rate for Payer: Medical Mutual Of Ohio HMO $5,357.06
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,821.35
Rate for Payer: Molina Healthcare Benefit Exchange $5,732.93
Rate for Payer: Molina Healthcare Medicaid $2,291.78
Rate for Payer: Ohio Health Choice Commercial $5,749.04
Rate for Payer: Ohio Health Group HMO $4,899.75
Rate for Payer: Ohio Health Group PPO Differential $1,306.60
Rate for Payer: Ohio Health Group PPO No Differential $849.29
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,025.23
Rate for Payer: PHCS Commercial $6,271.68
Rate for Payer: United Healthcare All Payer $5,749.04
Service Code HCPCS J1162
Hospital Charge Code 25002021
Hospital Revenue Code 636
Min. Negotiated Rate $849.29
Max. Negotiated Rate $6,271.68
Rate for Payer: Humana Commercial $5,553.05
Rate for Payer: Medical Mutual Of Ohio HMO $5,357.06
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,821.35
Rate for Payer: Molina Healthcare Benefit Exchange $1,959.90
Rate for Payer: Ohio Health Choice Commercial $5,749.04
Rate for Payer: Ohio Health Group HMO $4,899.75
Rate for Payer: Ohio Health Group PPO Differential $1,306.60
Rate for Payer: Ohio Health Group PPO No Differential $849.29
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,025.23
Rate for Payer: PHCS Commercial $6,271.68
Rate for Payer: United Healthcare All Payer $5,749.04
Rate for Payer: Aetna Commercial $5,030.41
Rate for Payer: Anthem POS/PPO/Traditional $5,095.74
Rate for Payer: Cash Price $3,266.50
Rate for Payer: Cigna Commercial $5,422.39
Rate for Payer: First Health Commercial $6,206.35
Service Code HCPCS 80162
Hospital Charge Code 30000025
Hospital Revenue Code 300
Min. Negotiated Rate $9.75
Max. Negotiated Rate $72.00
Rate for Payer: Aetna Commercial $57.75
Rate for Payer: Anthem POS/PPO/Traditional $60.22
Rate for Payer: Cash Price $37.50
Rate for Payer: Cigna Commercial $62.25
Rate for Payer: First Health Commercial $71.25
Rate for Payer: Humana Commercial $63.75
Rate for Payer: Medical Mutual Of Ohio HMO $61.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $55.35
Rate for Payer: Molina Healthcare Benefit Exchange $22.50
Rate for Payer: Ohio Health Choice Commercial $66.00
Rate for Payer: Ohio Health Group HMO $56.25
Rate for Payer: Ohio Health Group PPO Differential $15.00
Rate for Payer: Ohio Health Group PPO No Differential $9.75
Rate for Payer: Ohio Health Group PPO SOMC Employees $23.25
Rate for Payer: PHCS Commercial $72.00
Rate for Payer: United Healthcare All Payer $66.00