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Service Code HCPCS 53661
Hospital Charge Code 76102121
Hospital Revenue Code 761
Min. Negotiated Rate $24.42
Max. Negotiated Rate $531.00
Rate for Payer: Aetna Commercial $66.53
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $24.42
Rate for Payer: Anthem Medicaid $25.21
Rate for Payer: Buckeye Medicare Advantage $531.00
Rate for Payer: Cash Price $265.50
Rate for Payer: Cash Price $265.50
Rate for Payer: Cigna Commercial $112.90
Rate for Payer: Healthspan PPO $91.71
Rate for Payer: Humana Medicaid $25.21
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $55.05
Rate for Payer: Molina Healthcare CHIP/Medicaid $25.71
Rate for Payer: Molina Healthcare Passport $25.21
Rate for Payer: Multiplan PHCS $318.60
Rate for Payer: Ohio Health Choice Preferred Health Choice $371.70
Rate for Payer: UHCCP Medicaid $25.64
Rate for Payer: Wellcare CHIP/Medicaid $25.46
Service Code HCPCS 53661
Hospital Charge Code 761T2121
Hospital Revenue Code 761
Min. Negotiated Rate $20.28
Max. Negotiated Rate $154.64
Rate for Payer: Aetna Commercial $120.12
Rate for Payer: Anthem Medicaid $53.65
Rate for Payer: Anthem Medicare Advantage/PPO $110.46
Rate for Payer: Anthem POS/PPO/Traditional $121.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $154.64
Rate for Payer: CareSource Just4Me Medicare $149.12
Rate for Payer: Cash Price $78.00
Rate for Payer: Cash Price $78.00
Rate for Payer: Cigna Commercial $129.48
Rate for Payer: First Health Commercial $148.20
Rate for Payer: Humana Commercial $132.60
Rate for Payer: Humana KY Medicaid $53.65
Rate for Payer: Humana Medicare Advantage $110.46
Rate for Payer: Kentucky WC Medicaid $54.19
Rate for Payer: Medical Mutual Of Ohio HMO $127.92
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $115.13
Rate for Payer: Molina Healthcare Benefit Exchange $132.55
Rate for Payer: Molina Healthcare Medicaid $54.72
Rate for Payer: Ohio Health Choice Commercial $137.28
Rate for Payer: Ohio Health Group HMO $117.00
Rate for Payer: Ohio Health Group PPO Differential $31.20
Rate for Payer: Ohio Health Group PPO No Differential $20.28
Rate for Payer: Ohio Health Group PPO SOMC Employees $48.36
Rate for Payer: PHCS Commercial $149.76
Rate for Payer: United Healthcare All Payer $137.28
Service Code HCPCS 53661
Hospital Charge Code 761T2121
Hospital Revenue Code 761
Min. Negotiated Rate $20.28
Max. Negotiated Rate $149.76
Rate for Payer: Aetna Commercial $120.12
Rate for Payer: Anthem POS/PPO/Traditional $121.68
Rate for Payer: Cash Price $78.00
Rate for Payer: Cigna Commercial $129.48
Rate for Payer: First Health Commercial $148.20
Rate for Payer: Humana Commercial $132.60
Rate for Payer: Medical Mutual Of Ohio HMO $127.92
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $115.13
Rate for Payer: Molina Healthcare Benefit Exchange $46.80
Rate for Payer: Ohio Health Choice Commercial $137.28
Rate for Payer: Ohio Health Group HMO $117.00
Rate for Payer: Ohio Health Group PPO Differential $31.20
Rate for Payer: Ohio Health Group PPO No Differential $20.28
Rate for Payer: Ohio Health Group PPO SOMC Employees $48.36
Rate for Payer: PHCS Commercial $149.76
Rate for Payer: United Healthcare All Payer $137.28
Service Code NDC 641601401
Hospital Charge Code 25003022
Hospital Revenue Code 250
Min. Negotiated Rate $10.39
Max. Negotiated Rate $76.70
Rate for Payer: Aetna Commercial $61.52
Rate for Payer: Anthem Medicaid $27.48
Rate for Payer: Anthem POS/PPO/Traditional $62.32
Rate for Payer: Cash Price $39.95
Rate for Payer: Cigna Commercial $66.32
Rate for Payer: First Health Commercial $75.90
Rate for Payer: Humana Commercial $67.92
Rate for Payer: Humana KY Medicaid $27.48
Rate for Payer: Kentucky WC Medicaid $27.76
Rate for Payer: Medical Mutual Of Ohio HMO $65.52
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $58.97
Rate for Payer: Molina Healthcare Benefit Exchange $23.97
Rate for Payer: Molina Healthcare Medicaid $28.03
Rate for Payer: Ohio Health Choice Commercial $70.31
Rate for Payer: Ohio Health Group HMO $59.92
Rate for Payer: Ohio Health Group PPO Differential $15.98
Rate for Payer: Ohio Health Group PPO No Differential $10.39
Rate for Payer: Ohio Health Group PPO SOMC Employees $24.77
Rate for Payer: PHCS Commercial $76.70
Rate for Payer: United Healthcare All Payer $70.31
Service Code NDC 641601401
Hospital Charge Code 25003022
Hospital Revenue Code 250
Min. Negotiated Rate $10.39
Max. Negotiated Rate $76.70
Rate for Payer: Aetna Commercial $61.52
Rate for Payer: Anthem POS/PPO/Traditional $62.32
Rate for Payer: Cash Price $39.95
Rate for Payer: Cigna Commercial $66.32
Rate for Payer: First Health Commercial $75.90
Rate for Payer: Humana Commercial $67.92
Rate for Payer: Medical Mutual Of Ohio HMO $65.52
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $58.97
Rate for Payer: Molina Healthcare Benefit Exchange $23.97
Rate for Payer: Ohio Health Choice Commercial $70.31
Rate for Payer: Ohio Health Group HMO $59.92
Rate for Payer: Ohio Health Group PPO Differential $15.98
Rate for Payer: Ohio Health Group PPO No Differential $10.39
Rate for Payer: Ohio Health Group PPO SOMC Employees $24.77
Rate for Payer: PHCS Commercial $76.70
Rate for Payer: United Healthcare All Payer $70.31
Service Code HCPCS 53605
Hospital Charge Code 76102118
Hospital Revenue Code 761
Min. Negotiated Rate $51.11
Max. Negotiated Rate $5,352.50
Rate for Payer: Aetna Commercial $107.61
Rate for Payer: Anthem Medicaid $51.11
Rate for Payer: Buckeye Medicare Advantage $5,352.50
Rate for Payer: Cash Price $2,676.25
Rate for Payer: Cash Price $2,676.25
Rate for Payer: Cigna Commercial $97.27
Rate for Payer: Healthspan PPO $86.04
Rate for Payer: Humana Medicaid $51.11
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $88.08
Rate for Payer: Molina Healthcare CHIP/Medicaid $52.13
Rate for Payer: Molina Healthcare Passport $51.11
Rate for Payer: Multiplan PHCS $3,211.50
Rate for Payer: Ohio Health Choice Preferred Health Choice $3,746.75
Rate for Payer: UHCCP Medicaid $1,873.38
Rate for Payer: Wellcare CHIP/Medicaid $51.62
Service Code HCPCS 53605
Hospital Charge Code 76102118
Hospital Revenue Code 761
Min. Negotiated Rate $695.82
Max. Negotiated Rate $5,138.40
Rate for Payer: Aetna Commercial $4,121.42
Rate for Payer: Anthem Medicaid $1,840.72
Rate for Payer: Anthem Medicare Advantage/PPO $3,014.67
Rate for Payer: Anthem POS/PPO/Traditional $4,174.95
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $4,220.54
Rate for Payer: CareSource Just4Me Medicare $4,069.80
Rate for Payer: Cash Price $2,676.25
Rate for Payer: Cash Price $2,676.25
Rate for Payer: Cigna Commercial $4,442.58
Rate for Payer: First Health Commercial $5,084.88
Rate for Payer: Humana Commercial $4,549.62
Rate for Payer: Humana KY Medicaid $1,840.72
Rate for Payer: Humana Medicare Advantage $3,014.67
Rate for Payer: Kentucky WC Medicaid $1,859.46
Rate for Payer: Medical Mutual Of Ohio HMO $4,389.05
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,950.14
Rate for Payer: Molina Healthcare Benefit Exchange $3,617.60
Rate for Payer: Molina Healthcare Medicaid $1,877.66
Rate for Payer: Ohio Health Choice Commercial $4,710.20
Rate for Payer: Ohio Health Group HMO $4,014.38
Rate for Payer: Ohio Health Group PPO Differential $1,070.50
Rate for Payer: Ohio Health Group PPO No Differential $695.82
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,659.28
Rate for Payer: PHCS Commercial $5,138.40
Rate for Payer: United Healthcare All Payer $4,710.20
Service Code HCPCS 53605
Hospital Charge Code 76102118
Hospital Revenue Code 761
Min. Negotiated Rate $695.82
Max. Negotiated Rate $5,138.40
Rate for Payer: Aetna Commercial $4,121.42
Rate for Payer: Anthem POS/PPO/Traditional $4,174.95
Rate for Payer: Cash Price $2,676.25
Rate for Payer: Cigna Commercial $4,442.58
Rate for Payer: First Health Commercial $5,084.88
Rate for Payer: Humana Commercial $4,549.62
Rate for Payer: Medical Mutual Of Ohio HMO $4,389.05
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,950.14
Rate for Payer: Molina Healthcare Benefit Exchange $1,605.75
Rate for Payer: Ohio Health Choice Commercial $4,710.20
Rate for Payer: Ohio Health Group HMO $4,014.38
Rate for Payer: Ohio Health Group PPO Differential $1,070.50
Rate for Payer: Ohio Health Group PPO No Differential $695.82
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,659.28
Rate for Payer: PHCS Commercial $5,138.40
Rate for Payer: United Healthcare All Payer $4,710.20
Service Code HCPCS 53605
Hospital Charge Code 761T2118
Hospital Revenue Code 761
Min. Negotiated Rate $661.38
Max. Negotiated Rate $4,884.00
Rate for Payer: Aetna Commercial $3,917.38
Rate for Payer: Anthem Medicaid $1,749.59
Rate for Payer: Anthem Medicare Advantage/PPO $3,014.67
Rate for Payer: Anthem POS/PPO/Traditional $3,968.25
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $4,220.54
Rate for Payer: CareSource Just4Me Medicare $4,069.80
Rate for Payer: Cash Price $2,543.75
Rate for Payer: Cash Price $2,543.75
Rate for Payer: Cigna Commercial $4,222.62
Rate for Payer: First Health Commercial $4,833.12
Rate for Payer: Humana Commercial $4,324.38
Rate for Payer: Humana KY Medicaid $1,749.59
Rate for Payer: Humana Medicare Advantage $3,014.67
Rate for Payer: Kentucky WC Medicaid $1,767.40
Rate for Payer: Medical Mutual Of Ohio HMO $4,171.75
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,754.58
Rate for Payer: Molina Healthcare Benefit Exchange $3,617.60
Rate for Payer: Molina Healthcare Medicaid $1,784.70
Rate for Payer: Ohio Health Choice Commercial $4,477.00
Rate for Payer: Ohio Health Group HMO $3,815.62
Rate for Payer: Ohio Health Group PPO Differential $1,017.50
Rate for Payer: Ohio Health Group PPO No Differential $661.38
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,577.12
Rate for Payer: PHCS Commercial $4,884.00
Rate for Payer: United Healthcare All Payer $4,477.00
Service Code HCPCS 53605
Hospital Charge Code 761P2118
Hospital Revenue Code 761
Min. Negotiated Rate $51.11
Max. Negotiated Rate $265.00
Rate for Payer: Aetna Commercial $107.61
Rate for Payer: Anthem Medicaid $51.11
Rate for Payer: Buckeye Medicare Advantage $265.00
Rate for Payer: Cash Price $132.50
Rate for Payer: Cash Price $132.50
Rate for Payer: Cigna Commercial $97.27
Rate for Payer: Healthspan PPO $86.04
Rate for Payer: Humana Medicaid $51.11
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $88.08
Rate for Payer: Molina Healthcare CHIP/Medicaid $52.13
Rate for Payer: Molina Healthcare Passport $51.11
Rate for Payer: Multiplan PHCS $159.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $185.50
Rate for Payer: UHCCP Medicaid $92.75
Rate for Payer: Wellcare CHIP/Medicaid $51.62
Service Code HCPCS 53605
Hospital Charge Code 761T2118
Hospital Revenue Code 761
Min. Negotiated Rate $661.38
Max. Negotiated Rate $4,884.00
Rate for Payer: Aetna Commercial $3,917.38
Rate for Payer: Anthem POS/PPO/Traditional $3,968.25
Rate for Payer: Cash Price $2,543.75
Rate for Payer: Cigna Commercial $4,222.62
Rate for Payer: First Health Commercial $4,833.12
Rate for Payer: Humana Commercial $4,324.38
Rate for Payer: Medical Mutual Of Ohio HMO $4,171.75
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,754.58
Rate for Payer: Molina Healthcare Benefit Exchange $1,526.25
Rate for Payer: Ohio Health Choice Commercial $4,477.00
Rate for Payer: Ohio Health Group HMO $3,815.62
Rate for Payer: Ohio Health Group PPO Differential $1,017.50
Rate for Payer: Ohio Health Group PPO No Differential $661.38
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,577.12
Rate for Payer: PHCS Commercial $4,884.00
Rate for Payer: United Healthcare All Payer $4,477.00
Service Code HCPCS 53620
Hospital Charge Code 76102119
Hospital Revenue Code 761
Min. Negotiated Rate $321.42
Max. Negotiated Rate $2,373.57
Rate for Payer: Aetna Commercial $1,903.80
Rate for Payer: Anthem Medicaid $850.28
Rate for Payer: Anthem Medicare Advantage/PPO $590.72
Rate for Payer: Anthem POS/PPO/Traditional $1,928.53
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $827.01
Rate for Payer: CareSource Just4Me Medicare $797.47
Rate for Payer: Cash Price $1,236.23
Rate for Payer: Cash Price $1,236.23
Rate for Payer: Cigna Commercial $2,052.15
Rate for Payer: First Health Commercial $2,348.85
Rate for Payer: Humana Commercial $2,101.60
Rate for Payer: Humana KY Medicaid $850.28
Rate for Payer: Humana Medicare Advantage $590.72
Rate for Payer: Kentucky WC Medicaid $858.94
Rate for Payer: Medical Mutual Of Ohio HMO $2,027.43
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,824.68
Rate for Payer: Molina Healthcare Benefit Exchange $708.86
Rate for Payer: Molina Healthcare Medicaid $867.34
Rate for Payer: Ohio Health Choice Commercial $2,175.77
Rate for Payer: Ohio Health Group HMO $1,854.35
Rate for Payer: Ohio Health Group PPO Differential $494.49
Rate for Payer: Ohio Health Group PPO No Differential $321.42
Rate for Payer: Ohio Health Group PPO SOMC Employees $766.47
Rate for Payer: PHCS Commercial $2,373.57
Rate for Payer: United Healthcare All Payer $2,175.77
Service Code HCPCS 53620
Hospital Charge Code 76102119
Hospital Revenue Code 761
Min. Negotiated Rate $55.05
Max. Negotiated Rate $2,472.47
Rate for Payer: Aetna Commercial $144.71
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $55.47
Rate for Payer: Anthem Medicaid $55.05
Rate for Payer: Buckeye Medicare Advantage $2,472.47
Rate for Payer: Cash Price $1,236.23
Rate for Payer: Cash Price $1,236.23
Rate for Payer: Cigna Commercial $198.31
Rate for Payer: Healthspan PPO $158.08
Rate for Payer: Humana Medicaid $55.05
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $119.73
Rate for Payer: Molina Healthcare CHIP/Medicaid $56.15
Rate for Payer: Molina Healthcare Passport $55.05
Rate for Payer: Multiplan PHCS $1,483.48
Rate for Payer: Ohio Health Choice Preferred Health Choice $1,730.73
Rate for Payer: UHCCP Medicaid $58.24
Rate for Payer: Wellcare CHIP/Medicaid $55.60
Service Code HCPCS 53620
Hospital Charge Code 761T2119
Hospital Revenue Code 761
Min. Negotiated Rate $256.42
Max. Negotiated Rate $1,893.57
Rate for Payer: Aetna Commercial $1,518.80
Rate for Payer: Anthem POS/PPO/Traditional $1,538.53
Rate for Payer: Cash Price $986.24
Rate for Payer: Cigna Commercial $1,637.15
Rate for Payer: First Health Commercial $1,873.85
Rate for Payer: Humana Commercial $1,676.60
Rate for Payer: Medical Mutual Of Ohio HMO $1,617.43
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,455.68
Rate for Payer: Molina Healthcare Benefit Exchange $591.74
Rate for Payer: Ohio Health Choice Commercial $1,735.77
Rate for Payer: Ohio Health Group HMO $1,479.35
Rate for Payer: Ohio Health Group PPO Differential $394.49
Rate for Payer: Ohio Health Group PPO No Differential $256.42
Rate for Payer: Ohio Health Group PPO SOMC Employees $611.47
Rate for Payer: PHCS Commercial $1,893.57
Rate for Payer: United Healthcare All Payer $1,735.77
Service Code HCPCS 53620
Hospital Charge Code 76102119
Hospital Revenue Code 761
Min. Negotiated Rate $321.42
Max. Negotiated Rate $2,373.57
Rate for Payer: Aetna Commercial $1,903.80
Rate for Payer: Anthem POS/PPO/Traditional $1,928.53
Rate for Payer: Cash Price $1,236.23
Rate for Payer: Cigna Commercial $2,052.15
Rate for Payer: First Health Commercial $2,348.85
Rate for Payer: Humana Commercial $2,101.60
Rate for Payer: Medical Mutual Of Ohio HMO $2,027.43
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,824.68
Rate for Payer: Molina Healthcare Benefit Exchange $741.74
Rate for Payer: Ohio Health Choice Commercial $2,175.77
Rate for Payer: Ohio Health Group HMO $1,854.35
Rate for Payer: Ohio Health Group PPO Differential $494.49
Rate for Payer: Ohio Health Group PPO No Differential $321.42
Rate for Payer: Ohio Health Group PPO SOMC Employees $766.47
Rate for Payer: PHCS Commercial $2,373.57
Rate for Payer: United Healthcare All Payer $2,175.77
Service Code HCPCS 53620
Hospital Charge Code 761T2119
Hospital Revenue Code 761
Min. Negotiated Rate $256.42
Max. Negotiated Rate $1,893.57
Rate for Payer: Aetna Commercial $1,518.80
Rate for Payer: Anthem Medicaid $678.33
Rate for Payer: Anthem Medicare Advantage/PPO $590.72
Rate for Payer: Anthem POS/PPO/Traditional $1,538.53
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $827.01
Rate for Payer: CareSource Just4Me Medicare $797.47
Rate for Payer: Cash Price $986.24
Rate for Payer: Cash Price $986.24
Rate for Payer: Cigna Commercial $1,637.15
Rate for Payer: First Health Commercial $1,873.85
Rate for Payer: Humana Commercial $1,676.60
Rate for Payer: Humana KY Medicaid $678.33
Rate for Payer: Humana Medicare Advantage $590.72
Rate for Payer: Kentucky WC Medicaid $685.24
Rate for Payer: Medical Mutual Of Ohio HMO $1,617.43
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,455.68
Rate for Payer: Molina Healthcare Benefit Exchange $708.86
Rate for Payer: Molina Healthcare Medicaid $691.94
Rate for Payer: Ohio Health Choice Commercial $1,735.77
Rate for Payer: Ohio Health Group HMO $1,479.35
Rate for Payer: Ohio Health Group PPO Differential $394.49
Rate for Payer: Ohio Health Group PPO No Differential $256.42
Rate for Payer: Ohio Health Group PPO SOMC Employees $611.47
Rate for Payer: PHCS Commercial $1,893.57
Rate for Payer: United Healthcare All Payer $1,735.77
Service Code HCPCS 53620
Hospital Charge Code 761P2119
Hospital Revenue Code 761
Min. Negotiated Rate $55.05
Max. Negotiated Rate $500.00
Rate for Payer: Aetna Commercial $144.71
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $55.47
Rate for Payer: Anthem Medicaid $55.05
Rate for Payer: Buckeye Medicare Advantage $500.00
Rate for Payer: Cash Price $250.00
Rate for Payer: Cash Price $250.00
Rate for Payer: Cigna Commercial $198.31
Rate for Payer: Healthspan PPO $158.08
Rate for Payer: Humana Medicaid $55.05
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $119.73
Rate for Payer: Molina Healthcare CHIP/Medicaid $56.15
Rate for Payer: Molina Healthcare Passport $55.05
Rate for Payer: Multiplan PHCS $300.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $350.00
Rate for Payer: UHCCP Medicaid $58.24
Rate for Payer: Wellcare CHIP/Medicaid $55.60
Service Code NDC 53329002144
Hospital Charge Code 25004442
Hospital Revenue Code 250
Min. Negotiated Rate $0.44
Max. Negotiated Rate $3.28
Rate for Payer: Aetna Commercial $2.63
Rate for Payer: Anthem POS/PPO/Traditional $2.67
Rate for Payer: Cash Price $1.71
Rate for Payer: Cigna Commercial $2.84
Rate for Payer: First Health Commercial $3.25
Rate for Payer: Humana Commercial $2.91
Rate for Payer: Medical Mutual Of Ohio HMO $2.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2.52
Rate for Payer: Molina Healthcare Benefit Exchange $1.03
Rate for Payer: Ohio Health Choice Commercial $3.01
Rate for Payer: Ohio Health Group HMO $2.56
Rate for Payer: Ohio Health Group PPO Differential $0.68
Rate for Payer: Ohio Health Group PPO No Differential $0.44
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.06
Rate for Payer: PHCS Commercial $3.28
Rate for Payer: United Healthcare All Payer $3.01
Service Code NDC 53329002144
Hospital Charge Code 25004442
Hospital Revenue Code 250
Min. Negotiated Rate $0.44
Max. Negotiated Rate $3.28
Rate for Payer: Aetna Commercial $2.63
Rate for Payer: Anthem Medicaid $1.18
Rate for Payer: Anthem POS/PPO/Traditional $2.67
Rate for Payer: Cash Price $1.71
Rate for Payer: Cigna Commercial $2.84
Rate for Payer: First Health Commercial $3.25
Rate for Payer: Humana Commercial $2.91
Rate for Payer: Humana KY Medicaid $1.18
Rate for Payer: Kentucky WC Medicaid $1.19
Rate for Payer: Medical Mutual Of Ohio HMO $2.80
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2.52
Rate for Payer: Molina Healthcare Benefit Exchange $1.03
Rate for Payer: Molina Healthcare Medicaid $1.20
Rate for Payer: Ohio Health Choice Commercial $3.01
Rate for Payer: Ohio Health Group HMO $2.56
Rate for Payer: Ohio Health Group PPO Differential $0.68
Rate for Payer: Ohio Health Group PPO No Differential $0.44
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.06
Rate for Payer: PHCS Commercial $3.28
Rate for Payer: United Healthcare All Payer $3.01
Service Code NDC 378580793
Hospital Charge Code 25000568
Hospital Revenue Code 637
Min. Negotiated Rate $0.58
Max. Negotiated Rate $4.29
Rate for Payer: Aetna Commercial $3.44
Rate for Payer: Anthem POS/PPO/Traditional $3.49
Rate for Payer: Cash Price $2.23
Rate for Payer: Cigna Commercial $3.71
Rate for Payer: First Health Commercial $4.25
Rate for Payer: Humana Commercial $3.80
Rate for Payer: Medical Mutual Of Ohio HMO $3.67
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.30
Rate for Payer: Molina Healthcare Benefit Exchange $1.34
Rate for Payer: Ohio Health Choice Commercial $3.93
Rate for Payer: Ohio Health Group HMO $3.35
Rate for Payer: Ohio Health Group PPO Differential $0.89
Rate for Payer: Ohio Health Group PPO No Differential $0.58
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.39
Rate for Payer: PHCS Commercial $4.29
Rate for Payer: United Healthcare All Payer $3.93
Service Code NDC 378580793
Hospital Charge Code 25000568
Hospital Revenue Code 637
Min. Negotiated Rate $0.58
Max. Negotiated Rate $4.29
Rate for Payer: Aetna Commercial $3.44
Rate for Payer: Anthem Medicaid $1.54
Rate for Payer: Anthem POS/PPO/Traditional $3.49
Rate for Payer: Cash Price $2.23
Rate for Payer: Cigna Commercial $3.71
Rate for Payer: First Health Commercial $4.25
Rate for Payer: Humana Commercial $3.80
Rate for Payer: Humana KY Medicaid $1.54
Rate for Payer: Kentucky WC Medicaid $1.55
Rate for Payer: Medical Mutual Of Ohio HMO $3.67
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.30
Rate for Payer: Molina Healthcare Benefit Exchange $1.34
Rate for Payer: Molina Healthcare Medicaid $1.57
Rate for Payer: Ohio Health Choice Commercial $3.93
Rate for Payer: Ohio Health Group HMO $3.35
Rate for Payer: Ohio Health Group PPO Differential $0.89
Rate for Payer: Ohio Health Group PPO No Differential $0.58
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.39
Rate for Payer: PHCS Commercial $4.29
Rate for Payer: United Healthcare All Payer $3.93
Service Code NDC 378581377
Hospital Charge Code 25000569
Hospital Revenue Code 637
Min. Negotiated Rate $0.59
Max. Negotiated Rate $4.35
Rate for Payer: Aetna Commercial $3.49
Rate for Payer: Anthem Medicaid $1.56
Rate for Payer: Anthem POS/PPO/Traditional $3.53
Rate for Payer: Cash Price $2.27
Rate for Payer: Cigna Commercial $3.76
Rate for Payer: First Health Commercial $4.30
Rate for Payer: Humana Commercial $3.85
Rate for Payer: Humana KY Medicaid $1.56
Rate for Payer: Kentucky WC Medicaid $1.57
Rate for Payer: Medical Mutual Of Ohio HMO $3.71
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.34
Rate for Payer: Molina Healthcare Benefit Exchange $1.36
Rate for Payer: Molina Healthcare Medicaid $1.59
Rate for Payer: Ohio Health Choice Commercial $3.99
Rate for Payer: Ohio Health Group HMO $3.40
Rate for Payer: Ohio Health Group PPO Differential $0.91
Rate for Payer: Ohio Health Group PPO No Differential $0.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.40
Rate for Payer: PHCS Commercial $4.35
Rate for Payer: United Healthcare All Payer $3.99
Service Code NDC 378581377
Hospital Charge Code 25000569
Hospital Revenue Code 637
Min. Negotiated Rate $0.59
Max. Negotiated Rate $4.35
Rate for Payer: Aetna Commercial $3.49
Rate for Payer: Anthem POS/PPO/Traditional $3.53
Rate for Payer: Cash Price $2.27
Rate for Payer: Cigna Commercial $3.76
Rate for Payer: First Health Commercial $4.30
Rate for Payer: Humana Commercial $3.85
Rate for Payer: Medical Mutual Of Ohio HMO $3.71
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.34
Rate for Payer: Molina Healthcare Benefit Exchange $1.36
Rate for Payer: Ohio Health Choice Commercial $3.99
Rate for Payer: Ohio Health Group HMO $3.40
Rate for Payer: Ohio Health Group PPO Differential $0.91
Rate for Payer: Ohio Health Group PPO No Differential $0.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.40
Rate for Payer: PHCS Commercial $4.35
Rate for Payer: United Healthcare All Payer $3.99
Service Code NDC 12547017162
Hospital Charge Code 25000314
Hospital Revenue Code 637
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.12
Rate for Payer: Humana Commercial $0.11
Rate for Payer: Humana KY Medicaid $0.04
Rate for Payer: Kentucky WC Medicaid $0.05
Rate for Payer: Medical Mutual Of Ohio HMO $0.11
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $0.10
Rate for Payer: Molina Healthcare Benefit Exchange $0.04
Rate for Payer: Molina Healthcare Medicaid $0.05
Rate for Payer: Ohio Health Choice Commercial $0.11
Rate for Payer: Ohio Health Group HMO $0.10
Rate for Payer: Ohio Health Group PPO Differential $0.03
Rate for Payer: Ohio Health Group PPO No Differential $0.02
Rate for Payer: Ohio Health Group PPO SOMC Employees $0.04
Rate for Payer: PHCS Commercial $0.12
Rate for Payer: United Healthcare All Payer $0.11
Rate for Payer: Aetna Commercial $0.10
Rate for Payer: Anthem Medicaid $0.04
Rate for Payer: Anthem POS/PPO/Traditional $0.10
Rate for Payer: Cash Price $0.06
Rate for Payer: Cigna Commercial $0.11
Rate for Payer: First Health Commercial $0.12
Service Code NDC 12547017162
Hospital Charge Code 25000314
Hospital Revenue Code 637
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.12
Rate for Payer: Aetna Commercial $0.10
Rate for Payer: Anthem POS/PPO/Traditional $0.10
Rate for Payer: Cash Price $0.06
Rate for Payer: Cigna Commercial $0.11
Rate for Payer: First Health Commercial $0.12
Rate for Payer: Humana Commercial $0.11
Rate for Payer: Medical Mutual Of Ohio HMO $0.11
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $0.10
Rate for Payer: Molina Healthcare Benefit Exchange $0.04
Rate for Payer: Ohio Health Choice Commercial $0.11
Rate for Payer: Ohio Health Group HMO $0.10
Rate for Payer: Ohio Health Group PPO Differential $0.03
Rate for Payer: Ohio Health Group PPO No Differential $0.02
Rate for Payer: Ohio Health Group PPO SOMC Employees $0.04
Rate for Payer: PHCS Commercial $0.12
Rate for Payer: United Healthcare All Payer $0.11