|
AFX 2 BFMN BDY BEA22-70/I20-30
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA22-70/I20-30
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA22-80/I20-40
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA22-80/I20-40
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA22-90/I16-30
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA22-90/I16-30
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA22-90/I20-30
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA22-90/I20-30
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-60/I16-40
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-60/I16-40
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-70/I16-30
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-70/I16-30
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-70/I20-30
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-70/I20-30
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-80/I13-40
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-80/I13-40
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-80/I16-40
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-80/I16-40
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-80/I16-55
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-80/I16-55
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-90/I16-30
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-90/I16-30
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-90/I20-30
|
Facility
|
OP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem Medicaid |
$28,714.41
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Humana KY Medicaid |
$28,714.41
|
| Rate for Payer: Kentucky WC Medicaid |
$29,006.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Molina Healthcare Medicaid |
$29,290.54
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA25-90/I20-30
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
|
AFX 2 BFMN BDY BEA28-70/I16-30
|
Facility
|
IP
|
$83,496.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,854.53 |
| Max. Negotiated Rate |
$80,156.54 |
| Rate for Payer: Aetna Commercial |
$64,292.23
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$65,127.19
|
| Rate for Payer: Cash Price |
$41,748.20
|
| Rate for Payer: Cigna Commercial |
$69,302.01
|
| Rate for Payer: First Health Commercial |
$79,321.58
|
| Rate for Payer: Humana Commercial |
$70,971.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68,467.05
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61,620.34
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$25,048.92
|
| Rate for Payer: Ohio Health Choice Commercial |
$73,476.83
|
| Rate for Payer: Ohio Health Group HMO |
$62,622.30
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16,699.28
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10,854.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25,883.88
|
| Rate for Payer: PHCS Commercial |
$80,156.54
|
| Rate for Payer: United Healthcare All Payer |
$73,476.83
|
|
