|
CYTOPATH CELL ENHANCE TECH
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS 88112
|
| Hospital Charge Code |
30001419
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$184.80
|
| Rate for Payer: Anthem Medicaid |
$49.37
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$49.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$192.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$69.12
|
| Rate for Payer: CareSource Just4Me Medicare |
$49.37
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$199.20
|
| Rate for Payer: First Health Commercial |
$228.00
|
| Rate for Payer: Humana Commercial |
$204.00
|
| Rate for Payer: Humana KY Medicaid |
$49.37
|
| Rate for Payer: Humana Medicare Advantage |
$49.37
|
| Rate for Payer: Kentucky WC Medicaid |
$49.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$196.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$177.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$59.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$50.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$211.20
|
| Rate for Payer: Ohio Health Group HMO |
$180.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$192.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$208.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$165.60
|
| Rate for Payer: PHCS Commercial |
$230.40
|
| Rate for Payer: United Healthcare All Payer |
$211.20
|
|
|
CYTOPATH CELL ENHANCE TECH
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS 88112
|
| Hospital Charge Code |
30001419
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$184.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$192.72
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$199.20
|
| Rate for Payer: First Health Commercial |
$228.00
|
| Rate for Payer: Humana Commercial |
$204.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$196.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$177.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$72.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$211.20
|
| Rate for Payer: Ohio Health Group HMO |
$180.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$192.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$208.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$165.60
|
| Rate for Payer: PHCS Commercial |
$230.40
|
| Rate for Payer: United Healthcare All Payer |
$211.20
|
|
|
CYTOPATH CELL ENHANCE TECH
|
Facility
|
OP
|
$251.00
|
|
|
Service Code
|
HCPCS 88112
|
| Hospital Charge Code |
300T2039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$240.96 |
| Rate for Payer: Aetna Commercial |
$193.27
|
| Rate for Payer: Anthem Medicaid |
$49.37
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$49.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$201.55
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$69.12
|
| Rate for Payer: CareSource Just4Me Medicare |
$49.37
|
| Rate for Payer: Cash Price |
$125.50
|
| Rate for Payer: Cash Price |
$125.50
|
| Rate for Payer: Cigna Commercial |
$208.33
|
| Rate for Payer: First Health Commercial |
$238.45
|
| Rate for Payer: Humana Commercial |
$213.35
|
| Rate for Payer: Humana KY Medicaid |
$49.37
|
| Rate for Payer: Humana Medicare Advantage |
$49.37
|
| Rate for Payer: Kentucky WC Medicaid |
$49.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$205.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$185.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$59.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$50.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$220.88
|
| Rate for Payer: Ohio Health Group HMO |
$188.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$200.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$218.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$173.19
|
| Rate for Payer: PHCS Commercial |
$240.96
|
| Rate for Payer: United Healthcare All Payer |
$220.88
|
|
|
CYTOPATH CELL ENHANCE TECH
|
Facility
|
IP
|
$251.00
|
|
|
Service Code
|
HCPCS 88112
|
| Hospital Charge Code |
300T2039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.30 |
| Max. Negotiated Rate |
$240.96 |
| Rate for Payer: Aetna Commercial |
$193.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$201.55
|
| Rate for Payer: Cash Price |
$125.50
|
| Rate for Payer: Cigna Commercial |
$208.33
|
| Rate for Payer: First Health Commercial |
$238.45
|
| Rate for Payer: Humana Commercial |
$213.35
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$205.82
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$185.24
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$75.30
|
| Rate for Payer: Ohio Health Choice Commercial |
$220.88
|
| Rate for Payer: Ohio Health Group HMO |
$188.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$200.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$218.37
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$173.19
|
| Rate for Payer: PHCS Commercial |
$240.96
|
| Rate for Payer: United Healthcare All Payer |
$220.88
|
|
|
CYTOPATH CELL ENHANCE TECH (P
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 88112
|
| Hospital Charge Code |
300P2039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.50 |
| Max. Negotiated Rate |
$155.01 |
| Rate for Payer: Aetna Commercial |
$155.01
|
| Rate for Payer: Ambetter Exchange |
$61.51
|
| Rate for Payer: Buckeye Individual/Medicaid |
$61.51
|
| Rate for Payer: Buckeye Medicare Advantage |
$61.51
|
| Rate for Payer: CareSource Just4Me Medicare |
$73.81
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cigna Commercial |
$72.53
|
| Rate for Payer: Healthspan PPO |
$147.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$30.23
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$61.51
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$61.51
|
| Rate for Payer: Multiplan PHCS |
$30.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$79.96
|
| Rate for Payer: UHCCP Medicaid |
$17.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$52.59
|
| Rate for Payer: Wellcare Medicare Advantage |
$61.51
|
|
|
CYTOPATH C/V AUTO FLUID REDO
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
HCPCS 88175
|
| Hospital Charge Code |
30001426
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.61 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Aetna Commercial |
$207.90
|
| Rate for Payer: Anthem Medicaid |
$26.61
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$26.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$216.81
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$37.25
|
| Rate for Payer: CareSource Just4Me Medicare |
$26.61
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna Commercial |
$224.10
|
| Rate for Payer: First Health Commercial |
$256.50
|
| Rate for Payer: Humana Commercial |
$229.50
|
| Rate for Payer: Humana KY Medicaid |
$26.61
|
| Rate for Payer: Humana Medicare Advantage |
$26.61
|
| Rate for Payer: Kentucky WC Medicaid |
$26.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$221.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$199.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$31.93
|
| Rate for Payer: Molina Healthcare Medicaid |
$27.14
|
| Rate for Payer: Ohio Health Choice Commercial |
$237.60
|
| Rate for Payer: Ohio Health Group HMO |
$202.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$216.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$234.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$186.30
|
| Rate for Payer: PHCS Commercial |
$259.20
|
| Rate for Payer: United Healthcare All Payer |
$237.60
|
|
|
CYTOPATH C/V AUTO FLUID REDO
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
HCPCS 88175
|
| Hospital Charge Code |
30001426
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Aetna Commercial |
$207.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$216.81
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna Commercial |
$224.10
|
| Rate for Payer: First Health Commercial |
$256.50
|
| Rate for Payer: Humana Commercial |
$229.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$221.40
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$199.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$81.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$237.60
|
| Rate for Payer: Ohio Health Group HMO |
$202.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$216.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$234.90
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$186.30
|
| Rate for Payer: PHCS Commercial |
$259.20
|
| Rate for Payer: United Healthcare All Payer |
$237.60
|
|
|
CYTOPATH C/V AUTO IN FLUID
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 88174
|
| Hospital Charge Code |
30001580
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$24.68
|
| Rate for Payer: Ambetter Exchange |
$25.37
|
| Rate for Payer: Buckeye Individual/Medicaid |
$25.37
|
| Rate for Payer: Buckeye Medicare Advantage |
$25.37
|
| Rate for Payer: CareSource Just4Me Medicare |
$30.44
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$18.94
|
| Rate for Payer: Healthspan PPO |
$36.00
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$25.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25.37
|
| Rate for Payer: Multiplan PHCS |
$144.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$32.98
|
| Rate for Payer: UHCCP Medicaid |
$84.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$15.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$25.37
|
|
|
CYTOPATH C/V AUTO IN FLUID
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS 88174
|
| Hospital Charge Code |
30001580
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.37 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$184.80
|
| Rate for Payer: Anthem Medicaid |
$25.37
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$25.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$192.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$35.52
|
| Rate for Payer: CareSource Just4Me Medicare |
$25.37
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$199.20
|
| Rate for Payer: First Health Commercial |
$228.00
|
| Rate for Payer: Humana Commercial |
$204.00
|
| Rate for Payer: Humana KY Medicaid |
$25.37
|
| Rate for Payer: Humana Medicare Advantage |
$25.37
|
| Rate for Payer: Kentucky WC Medicaid |
$25.62
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$196.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$177.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$30.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$25.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$211.20
|
| Rate for Payer: Ohio Health Group HMO |
$180.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$192.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$208.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$165.60
|
| Rate for Payer: PHCS Commercial |
$230.40
|
| Rate for Payer: United Healthcare All Payer |
$211.20
|
|
|
CYTOPATH C/V AUTO IN FLUID
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS 88174
|
| Hospital Charge Code |
30001580
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$184.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$192.72
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$199.20
|
| Rate for Payer: First Health Commercial |
$228.00
|
| Rate for Payer: Humana Commercial |
$204.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$196.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$177.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$72.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$211.20
|
| Rate for Payer: Ohio Health Group HMO |
$180.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$192.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$208.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$165.60
|
| Rate for Payer: PHCS Commercial |
$230.40
|
| Rate for Payer: United Healthcare All Payer |
$211.20
|
|
|
CYTOPATH C/V INTERPRET
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS 88141
|
| Hospital Charge Code |
30001578
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$184.80
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$192.72
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$199.20
|
| Rate for Payer: First Health Commercial |
$228.00
|
| Rate for Payer: Humana Commercial |
$204.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$196.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$177.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$72.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$211.20
|
| Rate for Payer: Ohio Health Group HMO |
$180.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$192.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$208.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$165.60
|
| Rate for Payer: PHCS Commercial |
$230.40
|
| Rate for Payer: United Healthcare All Payer |
$211.20
|
|
|
CYTOPATH C/V INTERPRET
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS 88141
|
| Hospital Charge Code |
30001578
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$184.80
|
| Rate for Payer: Anthem Medicaid |
$82.54
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$192.72
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$199.20
|
| Rate for Payer: First Health Commercial |
$228.00
|
| Rate for Payer: Humana Commercial |
$204.00
|
| Rate for Payer: Humana KY Medicaid |
$82.54
|
| Rate for Payer: Kentucky WC Medicaid |
$83.38
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$196.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$177.12
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$72.00
|
| Rate for Payer: Molina Healthcare Medicaid |
$84.19
|
| Rate for Payer: Ohio Health Choice Commercial |
$211.20
|
| Rate for Payer: Ohio Health Group HMO |
$180.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$192.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$208.80
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$165.60
|
| Rate for Payer: PHCS Commercial |
$230.40
|
| Rate for Payer: United Healthcare All Payer |
$211.20
|
|
|
CYTOPATH C/V INTERPRET
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 88141
|
| Hospital Charge Code |
30001578
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.81 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$42.26
|
| Rate for Payer: Ambetter Exchange |
$22.89
|
| Rate for Payer: Buckeye Individual/Medicaid |
$22.89
|
| Rate for Payer: Buckeye Medicare Advantage |
$22.89
|
| Rate for Payer: CareSource Just4Me Medicare |
$27.47
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$15.28
|
| Rate for Payer: Healthspan PPO |
$40.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$15.40
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$22.89
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22.89
|
| Rate for Payer: Multiplan PHCS |
$144.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$29.76
|
| Rate for Payer: UHCCP Medicaid |
$84.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$10.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$22.89
|
|
|
CYTOPATH EVAL FNA REPORT
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
HCPCS 88173
|
| Hospital Charge Code |
30001424
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$276.48 |
| Rate for Payer: Aetna Commercial |
$221.76
|
| Rate for Payer: Anthem Medicaid |
$49.37
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$49.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$231.26
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$69.12
|
| Rate for Payer: CareSource Just4Me Medicare |
$49.37
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$239.04
|
| Rate for Payer: First Health Commercial |
$273.60
|
| Rate for Payer: Humana Commercial |
$244.80
|
| Rate for Payer: Humana KY Medicaid |
$49.37
|
| Rate for Payer: Humana Medicare Advantage |
$49.37
|
| Rate for Payer: Kentucky WC Medicaid |
$49.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$236.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$212.54
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$59.24
|
| Rate for Payer: Molina Healthcare Medicaid |
$50.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$253.44
|
| Rate for Payer: Ohio Health Group HMO |
$216.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$230.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$250.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$198.72
|
| Rate for Payer: PHCS Commercial |
$276.48
|
| Rate for Payer: United Healthcare All Payer |
$253.44
|
|
|
CYTOPATH EVAL FNA REPORT
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
HCPCS 88173
|
| Hospital Charge Code |
30001424
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$36.54 |
| Max. Negotiated Rate |
$202.44 |
| Rate for Payer: Aetna Commercial |
$202.44
|
| Rate for Payer: Ambetter Exchange |
$155.70
|
| Rate for Payer: Anthem Medicaid |
$97.13
|
| Rate for Payer: Buckeye Individual/Medicaid |
$155.70
|
| Rate for Payer: Buckeye Medicare Advantage |
$155.70
|
| Rate for Payer: CareSource Just4Me Medicare |
$186.84
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$86.08
|
| Rate for Payer: Healthspan PPO |
$192.22
|
| Rate for Payer: Humana Medicaid |
$97.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$36.54
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$155.70
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$155.70
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$99.07
|
| Rate for Payer: Molina Healthcare Passport |
$97.13
|
| Rate for Payer: Multiplan PHCS |
$172.80
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$202.41
|
| Rate for Payer: UHCCP Medicaid |
$100.80
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$98.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$155.70
|
|
|
CYTOPATH EVAL FNA REPORT
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
HCPCS 88173
|
| Hospital Charge Code |
30001424
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$276.48 |
| Rate for Payer: Aetna Commercial |
$221.76
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$231.26
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial |
$239.04
|
| Rate for Payer: First Health Commercial |
$273.60
|
| Rate for Payer: Humana Commercial |
$244.80
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$236.16
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$212.54
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$86.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$253.44
|
| Rate for Payer: Ohio Health Group HMO |
$216.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$230.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$250.56
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$198.72
|
| Rate for Payer: PHCS Commercial |
$276.48
|
| Rate for Payer: United Healthcare All Payer |
$253.44
|
|
|
CYTOPATH FL NONGYN SMEARS
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 88104
|
| Hospital Charge Code |
30001416
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$147.00 |
| Rate for Payer: Aetna Commercial |
$92.98
|
| Rate for Payer: Ambetter Exchange |
$72.45
|
| Rate for Payer: Buckeye Individual/Medicaid |
$72.45
|
| Rate for Payer: Buckeye Medicare Advantage |
$72.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$86.94
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$36.12
|
| Rate for Payer: Healthspan PPO |
$88.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$14.69
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$72.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$72.45
|
| Rate for Payer: Multiplan PHCS |
$147.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$94.19
|
| Rate for Payer: UHCCP Medicaid |
$85.75
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$21.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$72.45
|
|
|
CYTOPATH FL NONGYN SMEARS
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
HCPCS 88104
|
| Hospital Charge Code |
30001416
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$36.27 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem Medicaid |
$36.27
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$36.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$50.78
|
| Rate for Payer: CareSource Just4Me Medicare |
$36.27
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Humana KY Medicaid |
$36.27
|
| Rate for Payer: Humana Medicare Advantage |
$36.27
|
| Rate for Payer: Kentucky WC Medicaid |
$36.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$43.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$37.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$196.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$213.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$169.05
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
CYTOPATH FL NONGYN SMEARS
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
HCPCS 88104
|
| Hospital Charge Code |
30002032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$293.76 |
| Rate for Payer: Aetna Commercial |
$235.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$245.72
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cigna Commercial |
$253.98
|
| Rate for Payer: First Health Commercial |
$290.70
|
| Rate for Payer: Humana Commercial |
$260.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$250.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$225.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$91.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$269.28
|
| Rate for Payer: Ohio Health Group HMO |
$229.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$244.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$266.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$211.14
|
| Rate for Payer: PHCS Commercial |
$293.76
|
| Rate for Payer: United Healthcare All Payer |
$269.28
|
|
|
CYTOPATH FL NONGYN SMEARS
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
HCPCS 88104
|
| Hospital Charge Code |
30001416
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$196.74
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cigna Commercial |
$203.35
|
| Rate for Payer: First Health Commercial |
$232.75
|
| Rate for Payer: Humana Commercial |
$208.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$200.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$180.81
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$73.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$215.60
|
| Rate for Payer: Ohio Health Group HMO |
$183.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$196.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$213.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$169.05
|
| Rate for Payer: PHCS Commercial |
$235.20
|
| Rate for Payer: United Healthcare All Payer |
$215.60
|
|
|
CYTOPATH FL NONGYN SMEARS
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 88104
|
| Hospital Charge Code |
30002032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna Commercial |
$92.98
|
| Rate for Payer: Ambetter Exchange |
$72.45
|
| Rate for Payer: Buckeye Individual/Medicaid |
$72.45
|
| Rate for Payer: Buckeye Medicare Advantage |
$72.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$86.94
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cigna Commercial |
$36.12
|
| Rate for Payer: Healthspan PPO |
$88.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$14.69
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$72.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$72.45
|
| Rate for Payer: Multiplan PHCS |
$183.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$94.19
|
| Rate for Payer: UHCCP Medicaid |
$107.10
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$21.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$72.45
|
|
|
CYTOPATH FL NONGYN SMEARS
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
HCPCS 88104
|
| Hospital Charge Code |
30002032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.27 |
| Max. Negotiated Rate |
$293.76 |
| Rate for Payer: Aetna Commercial |
$235.62
|
| Rate for Payer: Anthem Medicaid |
$36.27
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$36.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$245.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$50.78
|
| Rate for Payer: CareSource Just4Me Medicare |
$36.27
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cigna Commercial |
$253.98
|
| Rate for Payer: First Health Commercial |
$290.70
|
| Rate for Payer: Humana Commercial |
$260.10
|
| Rate for Payer: Humana KY Medicaid |
$36.27
|
| Rate for Payer: Humana Medicare Advantage |
$36.27
|
| Rate for Payer: Kentucky WC Medicaid |
$36.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$250.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$225.83
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$43.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$37.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$269.28
|
| Rate for Payer: Ohio Health Group HMO |
$229.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$244.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$266.22
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$211.14
|
| Rate for Payer: PHCS Commercial |
$293.76
|
| Rate for Payer: United Healthcare All Payer |
$269.28
|
|
|
CYTOPATH FL NONGYN SMEARS (P
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 88104
|
| Hospital Charge Code |
300P2032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$94.19 |
| Rate for Payer: Aetna Commercial |
$92.98
|
| Rate for Payer: Ambetter Exchange |
$72.45
|
| Rate for Payer: Buckeye Individual/Medicaid |
$72.45
|
| Rate for Payer: Buckeye Medicare Advantage |
$72.45
|
| Rate for Payer: CareSource Just4Me Medicare |
$86.94
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cigna Commercial |
$36.12
|
| Rate for Payer: Healthspan PPO |
$88.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$14.69
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$72.45
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$72.45
|
| Rate for Payer: Multiplan PHCS |
$30.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$94.19
|
| Rate for Payer: UHCCP Medicaid |
$17.50
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$21.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$72.45
|
|
|
CYTOPATH FL NONGYN SMEARS (T
|
Facility
|
OP
|
$256.00
|
|
|
Service Code
|
HCPCS 88104
|
| Hospital Charge Code |
300T2032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.27 |
| Max. Negotiated Rate |
$245.76 |
| Rate for Payer: Aetna Commercial |
$197.12
|
| Rate for Payer: Anthem Medicaid |
$36.27
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$36.27
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$205.57
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$50.78
|
| Rate for Payer: CareSource Just4Me Medicare |
$36.27
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cigna Commercial |
$212.48
|
| Rate for Payer: First Health Commercial |
$243.20
|
| Rate for Payer: Humana Commercial |
$217.60
|
| Rate for Payer: Humana KY Medicaid |
$36.27
|
| Rate for Payer: Humana Medicare Advantage |
$36.27
|
| Rate for Payer: Kentucky WC Medicaid |
$36.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$209.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$188.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$43.52
|
| Rate for Payer: Molina Healthcare Medicaid |
$37.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$225.28
|
| Rate for Payer: Ohio Health Group HMO |
$192.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$204.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$222.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$176.64
|
| Rate for Payer: PHCS Commercial |
$245.76
|
| Rate for Payer: United Healthcare All Payer |
$225.28
|
|
|
CYTOPATH FL NONGYN SMEARS (T
|
Facility
|
IP
|
$256.00
|
|
|
Service Code
|
HCPCS 88104
|
| Hospital Charge Code |
300T2032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$76.80 |
| Max. Negotiated Rate |
$245.76 |
| Rate for Payer: Aetna Commercial |
$197.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$205.57
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cigna Commercial |
$212.48
|
| Rate for Payer: First Health Commercial |
$243.20
|
| Rate for Payer: Humana Commercial |
$217.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$209.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$188.93
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$76.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$225.28
|
| Rate for Payer: Ohio Health Group HMO |
$192.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$204.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$222.72
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$176.64
|
| Rate for Payer: PHCS Commercial |
$245.76
|
| Rate for Payer: United Healthcare All Payer |
$225.28
|
|
