|
DIST FEM AUG BLOCK #13/05MM
|
Facility
|
IP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #13/10MM
|
Facility
|
OP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem Medicaid |
$1,734.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Humana KY Medicaid |
$1,734.98
|
| Rate for Payer: Kentucky WC Medicaid |
$1,752.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,769.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #13/10MM
|
Facility
|
IP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #13/15MM
|
Facility
|
OP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem Medicaid |
$1,734.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Humana KY Medicaid |
$1,734.98
|
| Rate for Payer: Kentucky WC Medicaid |
$1,752.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,769.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #13/15MM
|
Facility
|
IP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #3/10MM
|
Facility
|
OP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem Medicaid |
$1,734.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Humana KY Medicaid |
$1,734.98
|
| Rate for Payer: Kentucky WC Medicaid |
$1,752.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,769.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #3/10MM
|
Facility
|
IP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #3/15MM
|
Facility
|
OP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem Medicaid |
$1,734.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Humana KY Medicaid |
$1,734.98
|
| Rate for Payer: Kentucky WC Medicaid |
$1,752.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,769.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #3/15MM
|
Facility
|
IP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #3/5MM
|
Facility
|
OP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem Medicaid |
$1,734.98
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Humana KY Medicaid |
$1,734.98
|
| Rate for Payer: Kentucky WC Medicaid |
$1,752.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,769.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #3/5MM
|
Facility
|
IP
|
$5,045.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,513.50 |
| Max. Negotiated Rate |
$4,843.20 |
| Rate for Payer: Aetna Commercial |
$3,884.65
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,935.10
|
| Rate for Payer: Cash Price |
$2,522.50
|
| Rate for Payer: Cigna Commercial |
$4,187.35
|
| Rate for Payer: First Health Commercial |
$4,792.75
|
| Rate for Payer: Humana Commercial |
$4,288.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,136.90
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,723.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,513.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,439.60
|
| Rate for Payer: Ohio Health Group HMO |
$3,783.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,036.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,389.15
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,481.05
|
| Rate for Payer: PHCS Commercial |
$4,843.20
|
| Rate for Payer: United Healthcare All Payer |
$4,439.60
|
|
|
DIST FEM AUG BLOCK #5/10MM
|
Facility
|
IP
|
$5,618.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,685.40 |
| Max. Negotiated Rate |
$5,393.28 |
| Rate for Payer: Aetna Commercial |
$4,325.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,382.04
|
| Rate for Payer: Cash Price |
$2,809.00
|
| Rate for Payer: Cigna Commercial |
$4,662.94
|
| Rate for Payer: First Health Commercial |
$5,337.10
|
| Rate for Payer: Humana Commercial |
$4,775.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,606.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,146.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,685.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,943.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,213.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,494.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,887.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,876.42
|
| Rate for Payer: PHCS Commercial |
$5,393.28
|
| Rate for Payer: United Healthcare All Payer |
$4,943.84
|
|
|
DIST FEM AUG BLOCK #5/10MM
|
Facility
|
OP
|
$5,618.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,685.40 |
| Max. Negotiated Rate |
$5,393.28 |
| Rate for Payer: Aetna Commercial |
$4,325.86
|
| Rate for Payer: Anthem Medicaid |
$1,932.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,382.04
|
| Rate for Payer: Cash Price |
$2,809.00
|
| Rate for Payer: Cigna Commercial |
$4,662.94
|
| Rate for Payer: First Health Commercial |
$5,337.10
|
| Rate for Payer: Humana Commercial |
$4,775.30
|
| Rate for Payer: Humana KY Medicaid |
$1,932.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,951.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,606.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,146.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,685.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,970.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,943.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,213.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,494.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,887.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,876.42
|
| Rate for Payer: PHCS Commercial |
$5,393.28
|
| Rate for Payer: United Healthcare All Payer |
$4,943.84
|
|
|
DIST FEM AUG BLOCK #5/15MM
|
Facility
|
IP
|
$5,414.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,624.20 |
| Max. Negotiated Rate |
$5,197.44 |
| Rate for Payer: Aetna Commercial |
$4,168.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,222.92
|
| Rate for Payer: Cash Price |
$2,707.00
|
| Rate for Payer: Cigna Commercial |
$4,493.62
|
| Rate for Payer: First Health Commercial |
$5,143.30
|
| Rate for Payer: Humana Commercial |
$4,601.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,439.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,995.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,624.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,764.32
|
| Rate for Payer: Ohio Health Group HMO |
$4,060.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,331.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,710.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,735.66
|
| Rate for Payer: PHCS Commercial |
$5,197.44
|
| Rate for Payer: United Healthcare All Payer |
$4,764.32
|
|
|
DIST FEM AUG BLOCK #5/15MM
|
Facility
|
OP
|
$5,414.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,624.20 |
| Max. Negotiated Rate |
$5,197.44 |
| Rate for Payer: Aetna Commercial |
$4,168.78
|
| Rate for Payer: Anthem Medicaid |
$1,861.87
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,222.92
|
| Rate for Payer: Cash Price |
$2,707.00
|
| Rate for Payer: Cigna Commercial |
$4,493.62
|
| Rate for Payer: First Health Commercial |
$5,143.30
|
| Rate for Payer: Humana Commercial |
$4,601.90
|
| Rate for Payer: Humana KY Medicaid |
$1,861.87
|
| Rate for Payer: Kentucky WC Medicaid |
$1,880.82
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,439.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,995.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,624.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,899.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,764.32
|
| Rate for Payer: Ohio Health Group HMO |
$4,060.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,331.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,710.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,735.66
|
| Rate for Payer: PHCS Commercial |
$5,197.44
|
| Rate for Payer: United Healthcare All Payer |
$4,764.32
|
|
|
DIST FEM AUG BLOCK #5/5MM
|
Facility
|
IP
|
$5,618.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,685.40 |
| Max. Negotiated Rate |
$5,393.28 |
| Rate for Payer: Aetna Commercial |
$4,325.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,382.04
|
| Rate for Payer: Cash Price |
$2,809.00
|
| Rate for Payer: Cigna Commercial |
$4,662.94
|
| Rate for Payer: First Health Commercial |
$5,337.10
|
| Rate for Payer: Humana Commercial |
$4,775.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,606.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,146.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,685.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,943.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,213.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,494.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,887.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,876.42
|
| Rate for Payer: PHCS Commercial |
$5,393.28
|
| Rate for Payer: United Healthcare All Payer |
$4,943.84
|
|
|
DIST FEM AUG BLOCK #5/5MM
|
Facility
|
OP
|
$5,618.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,685.40 |
| Max. Negotiated Rate |
$5,393.28 |
| Rate for Payer: Aetna Commercial |
$4,325.86
|
| Rate for Payer: Anthem Medicaid |
$1,932.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,382.04
|
| Rate for Payer: Cash Price |
$2,809.00
|
| Rate for Payer: Cigna Commercial |
$4,662.94
|
| Rate for Payer: First Health Commercial |
$5,337.10
|
| Rate for Payer: Humana Commercial |
$4,775.30
|
| Rate for Payer: Humana KY Medicaid |
$1,932.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,951.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,606.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,146.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,685.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,970.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,943.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,213.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,494.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,887.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,876.42
|
| Rate for Payer: PHCS Commercial |
$5,393.28
|
| Rate for Payer: United Healthcare All Payer |
$4,943.84
|
|
|
DIST FEM AUG BLOCK #7/10MM
|
Facility
|
OP
|
$6,731.76
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,019.53 |
| Max. Negotiated Rate |
$6,462.49 |
| Rate for Payer: Aetna Commercial |
$5,183.46
|
| Rate for Payer: Anthem Medicaid |
$2,315.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,250.77
|
| Rate for Payer: Cash Price |
$3,365.88
|
| Rate for Payer: Cigna Commercial |
$5,587.36
|
| Rate for Payer: First Health Commercial |
$6,395.17
|
| Rate for Payer: Humana Commercial |
$5,722.00
|
| Rate for Payer: Humana KY Medicaid |
$2,315.05
|
| Rate for Payer: Kentucky WC Medicaid |
$2,338.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,520.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,968.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,019.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,361.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,923.95
|
| Rate for Payer: Ohio Health Group HMO |
$5,048.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,385.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,856.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,644.91
|
| Rate for Payer: PHCS Commercial |
$6,462.49
|
| Rate for Payer: United Healthcare All Payer |
$5,923.95
|
|
|
DIST FEM AUG BLOCK #7/10MM
|
Facility
|
IP
|
$6,731.76
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,019.53 |
| Max. Negotiated Rate |
$6,462.49 |
| Rate for Payer: Aetna Commercial |
$5,183.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,250.77
|
| Rate for Payer: Cash Price |
$3,365.88
|
| Rate for Payer: Cigna Commercial |
$5,587.36
|
| Rate for Payer: First Health Commercial |
$6,395.17
|
| Rate for Payer: Humana Commercial |
$5,722.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,520.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,968.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,019.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,923.95
|
| Rate for Payer: Ohio Health Group HMO |
$5,048.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,385.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,856.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,644.91
|
| Rate for Payer: PHCS Commercial |
$6,462.49
|
| Rate for Payer: United Healthcare All Payer |
$5,923.95
|
|
|
DIST FEM AUG BLOCK #7/15MM
|
Facility
|
OP
|
$6,731.76
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,019.53 |
| Max. Negotiated Rate |
$6,462.49 |
| Rate for Payer: Aetna Commercial |
$5,183.46
|
| Rate for Payer: Anthem Medicaid |
$2,315.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,250.77
|
| Rate for Payer: Cash Price |
$3,365.88
|
| Rate for Payer: Cigna Commercial |
$5,587.36
|
| Rate for Payer: First Health Commercial |
$6,395.17
|
| Rate for Payer: Humana Commercial |
$5,722.00
|
| Rate for Payer: Humana KY Medicaid |
$2,315.05
|
| Rate for Payer: Kentucky WC Medicaid |
$2,338.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,520.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,968.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,019.53
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,361.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,923.95
|
| Rate for Payer: Ohio Health Group HMO |
$5,048.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,385.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,856.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,644.91
|
| Rate for Payer: PHCS Commercial |
$6,462.49
|
| Rate for Payer: United Healthcare All Payer |
$5,923.95
|
|
|
DIST FEM AUG BLOCK #7/15MM
|
Facility
|
IP
|
$6,731.76
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,019.53 |
| Max. Negotiated Rate |
$6,462.49 |
| Rate for Payer: Aetna Commercial |
$5,183.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$5,250.77
|
| Rate for Payer: Cash Price |
$3,365.88
|
| Rate for Payer: Cigna Commercial |
$5,587.36
|
| Rate for Payer: First Health Commercial |
$6,395.17
|
| Rate for Payer: Humana Commercial |
$5,722.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$5,520.04
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,968.04
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,019.53
|
| Rate for Payer: Ohio Health Choice Commercial |
$5,923.95
|
| Rate for Payer: Ohio Health Group HMO |
$5,048.82
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,385.41
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$5,856.63
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,644.91
|
| Rate for Payer: PHCS Commercial |
$6,462.49
|
| Rate for Payer: United Healthcare All Payer |
$5,923.95
|
|
|
DIST FEM AUG BLOCK #7/5MM
|
Facility
|
IP
|
$5,618.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,685.40 |
| Max. Negotiated Rate |
$5,393.28 |
| Rate for Payer: Aetna Commercial |
$4,325.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,382.04
|
| Rate for Payer: Cash Price |
$2,809.00
|
| Rate for Payer: Cigna Commercial |
$4,662.94
|
| Rate for Payer: First Health Commercial |
$5,337.10
|
| Rate for Payer: Humana Commercial |
$4,775.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,606.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,146.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,685.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,943.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,213.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,494.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,887.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,876.42
|
| Rate for Payer: PHCS Commercial |
$5,393.28
|
| Rate for Payer: United Healthcare All Payer |
$4,943.84
|
|
|
DIST FEM AUG BLOCK #7/5MM
|
Facility
|
OP
|
$5,618.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,685.40 |
| Max. Negotiated Rate |
$5,393.28 |
| Rate for Payer: Aetna Commercial |
$4,325.86
|
| Rate for Payer: Anthem Medicaid |
$1,932.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,382.04
|
| Rate for Payer: Cash Price |
$2,809.00
|
| Rate for Payer: Cigna Commercial |
$4,662.94
|
| Rate for Payer: First Health Commercial |
$5,337.10
|
| Rate for Payer: Humana Commercial |
$4,775.30
|
| Rate for Payer: Humana KY Medicaid |
$1,932.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,951.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,606.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,146.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,685.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,970.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,943.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,213.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,494.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,887.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,876.42
|
| Rate for Payer: PHCS Commercial |
$5,393.28
|
| Rate for Payer: United Healthcare All Payer |
$4,943.84
|
|
|
DIST FEM AUG BLOCK #9/10MM
|
Facility
|
OP
|
$5,618.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,685.40 |
| Max. Negotiated Rate |
$5,393.28 |
| Rate for Payer: Aetna Commercial |
$4,325.86
|
| Rate for Payer: Anthem Medicaid |
$1,932.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,382.04
|
| Rate for Payer: Cash Price |
$2,809.00
|
| Rate for Payer: Cigna Commercial |
$4,662.94
|
| Rate for Payer: First Health Commercial |
$5,337.10
|
| Rate for Payer: Humana Commercial |
$4,775.30
|
| Rate for Payer: Humana KY Medicaid |
$1,932.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,951.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,606.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,146.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,685.40
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,970.79
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,943.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,213.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,494.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,887.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,876.42
|
| Rate for Payer: PHCS Commercial |
$5,393.28
|
| Rate for Payer: United Healthcare All Payer |
$4,943.84
|
|
|
DIST FEM AUG BLOCK #9/10MM
|
Facility
|
IP
|
$5,618.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,685.40 |
| Max. Negotiated Rate |
$5,393.28 |
| Rate for Payer: Aetna Commercial |
$4,325.86
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,382.04
|
| Rate for Payer: Cash Price |
$2,809.00
|
| Rate for Payer: Cigna Commercial |
$4,662.94
|
| Rate for Payer: First Health Commercial |
$5,337.10
|
| Rate for Payer: Humana Commercial |
$4,775.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,606.76
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$4,146.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,685.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,943.84
|
| Rate for Payer: Ohio Health Group HMO |
$4,213.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,494.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,887.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,876.42
|
| Rate for Payer: PHCS Commercial |
$5,393.28
|
| Rate for Payer: United Healthcare All Payer |
$4,943.84
|
|
