|
ECH CEM FEM CMP BOW SZ12 R 300
|
Facility
|
OP
|
$29,616.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,850.13 |
| Max. Negotiated Rate |
$28,431.70 |
| Rate for Payer: Aetna Commercial |
$22,804.59
|
| Rate for Payer: Anthem Medicaid |
$10,185.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,100.75
|
| Rate for Payer: Cash Price |
$14,808.17
|
| Rate for Payer: Cigna Commercial |
$24,581.57
|
| Rate for Payer: First Health Commercial |
$28,135.53
|
| Rate for Payer: Humana Commercial |
$25,173.90
|
| Rate for Payer: Humana KY Medicaid |
$10,185.06
|
| Rate for Payer: Kentucky WC Medicaid |
$10,288.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,285.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,856.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,884.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,389.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,062.39
|
| Rate for Payer: Ohio Health Group HMO |
$22,212.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,923.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,850.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,181.07
|
| Rate for Payer: PHCS Commercial |
$28,431.70
|
| Rate for Payer: United Healthcare All Payer |
$26,062.39
|
|
|
ECH CEM FEM CMP BOW SZ14 L 300
|
Facility
|
IP
|
$29,616.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,850.13 |
| Max. Negotiated Rate |
$28,431.70 |
| Rate for Payer: Aetna Commercial |
$22,804.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,100.75
|
| Rate for Payer: Cash Price |
$14,808.17
|
| Rate for Payer: Cigna Commercial |
$24,581.57
|
| Rate for Payer: First Health Commercial |
$28,135.53
|
| Rate for Payer: Humana Commercial |
$25,173.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,285.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,856.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,884.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,062.39
|
| Rate for Payer: Ohio Health Group HMO |
$22,212.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,923.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,850.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,181.07
|
| Rate for Payer: PHCS Commercial |
$28,431.70
|
| Rate for Payer: United Healthcare All Payer |
$26,062.39
|
|
|
ECH CEM FEM CMP BOW SZ14 L 300
|
Facility
|
OP
|
$29,616.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,850.13 |
| Max. Negotiated Rate |
$28,431.70 |
| Rate for Payer: Aetna Commercial |
$22,804.59
|
| Rate for Payer: Anthem Medicaid |
$10,185.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,100.75
|
| Rate for Payer: Cash Price |
$14,808.17
|
| Rate for Payer: Cigna Commercial |
$24,581.57
|
| Rate for Payer: First Health Commercial |
$28,135.53
|
| Rate for Payer: Humana Commercial |
$25,173.90
|
| Rate for Payer: Humana KY Medicaid |
$10,185.06
|
| Rate for Payer: Kentucky WC Medicaid |
$10,288.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,285.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,856.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,884.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,389.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,062.39
|
| Rate for Payer: Ohio Health Group HMO |
$22,212.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,923.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,850.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,181.07
|
| Rate for Payer: PHCS Commercial |
$28,431.70
|
| Rate for Payer: United Healthcare All Payer |
$26,062.39
|
|
|
ECH CEM FEM CMP BOW SZ14 R 300
|
Facility
|
OP
|
$29,616.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,850.13 |
| Max. Negotiated Rate |
$28,431.70 |
| Rate for Payer: Aetna Commercial |
$22,804.59
|
| Rate for Payer: Anthem Medicaid |
$10,185.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,100.75
|
| Rate for Payer: Cash Price |
$14,808.17
|
| Rate for Payer: Cigna Commercial |
$24,581.57
|
| Rate for Payer: First Health Commercial |
$28,135.53
|
| Rate for Payer: Humana Commercial |
$25,173.90
|
| Rate for Payer: Humana KY Medicaid |
$10,185.06
|
| Rate for Payer: Kentucky WC Medicaid |
$10,288.72
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,285.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,856.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,884.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,389.42
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,062.39
|
| Rate for Payer: Ohio Health Group HMO |
$22,212.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,923.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,850.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,181.07
|
| Rate for Payer: PHCS Commercial |
$28,431.70
|
| Rate for Payer: United Healthcare All Payer |
$26,062.39
|
|
|
ECH CEM FEM CMP BOW SZ14 R 300
|
Facility
|
IP
|
$29,616.35
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,850.13 |
| Max. Negotiated Rate |
$28,431.70 |
| Rate for Payer: Aetna Commercial |
$22,804.59
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,100.75
|
| Rate for Payer: Cash Price |
$14,808.17
|
| Rate for Payer: Cigna Commercial |
$24,581.57
|
| Rate for Payer: First Health Commercial |
$28,135.53
|
| Rate for Payer: Humana Commercial |
$25,173.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,285.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,856.87
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,884.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,062.39
|
| Rate for Payer: Ohio Health Group HMO |
$22,212.26
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,923.27
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,850.13
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,181.07
|
| Rate for Payer: PHCS Commercial |
$28,431.70
|
| Rate for Payer: United Healthcare All Payer |
$26,062.39
|
|
|
ECH CEM FEM COMP SZ 12 175MM
|
Facility
|
OP
|
$15,102.78
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,963.36 |
| Max. Negotiated Rate |
$14,498.67 |
| Rate for Payer: Aetna Commercial |
$11,629.14
|
| Rate for Payer: Anthem Medicaid |
$5,193.85
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,780.17
|
| Rate for Payer: Cash Price |
$7,551.39
|
| Rate for Payer: Cigna Commercial |
$12,535.31
|
| Rate for Payer: First Health Commercial |
$14,347.64
|
| Rate for Payer: Humana Commercial |
$12,837.36
|
| Rate for Payer: Humana KY Medicaid |
$5,193.85
|
| Rate for Payer: Kentucky WC Medicaid |
$5,246.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,384.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,145.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,530.83
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,298.06
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,290.45
|
| Rate for Payer: Ohio Health Group HMO |
$11,327.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,020.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,963.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,681.86
|
| Rate for Payer: PHCS Commercial |
$14,498.67
|
| Rate for Payer: United Healthcare All Payer |
$13,290.45
|
|
|
ECH CEM FEM COMP SZ 12 175MM
|
Facility
|
IP
|
$15,102.78
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,963.36 |
| Max. Negotiated Rate |
$14,498.67 |
| Rate for Payer: Aetna Commercial |
$11,629.14
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$11,780.17
|
| Rate for Payer: Cash Price |
$7,551.39
|
| Rate for Payer: Cigna Commercial |
$12,535.31
|
| Rate for Payer: First Health Commercial |
$14,347.64
|
| Rate for Payer: Humana Commercial |
$12,837.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,384.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,145.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,530.83
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,290.45
|
| Rate for Payer: Ohio Health Group HMO |
$11,327.08
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,020.56
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,963.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$4,681.86
|
| Rate for Payer: PHCS Commercial |
$14,498.67
|
| Rate for Payer: United Healthcare All Payer |
$13,290.45
|
|
|
ECH CEM FEM COMP SZ 12 225MM
|
Facility
|
IP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECH CEM FEM COMP SZ 12 225MM
|
Facility
|
OP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem Medicaid |
$8,152.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Humana KY Medicaid |
$8,152.71
|
| Rate for Payer: Kentucky WC Medicaid |
$8,235.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,316.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECH CEM FEM COMP SZ 14 175MM
|
Facility
|
IP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECH CEM FEM COMP SZ 14 175MM
|
Facility
|
OP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem Medicaid |
$8,152.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Humana KY Medicaid |
$8,152.71
|
| Rate for Payer: Kentucky WC Medicaid |
$8,235.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,316.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECH CEM FEM COMP SZ 14 225MM
|
Facility
|
OP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem Medicaid |
$8,152.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Humana KY Medicaid |
$8,152.71
|
| Rate for Payer: Kentucky WC Medicaid |
$8,235.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,316.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECH CEM FEM COMP SZ 14 225MM
|
Facility
|
IP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECH CEM FEM COMP SZ 16 175MM
|
Facility
|
OP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem Medicaid |
$8,152.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Humana KY Medicaid |
$8,152.71
|
| Rate for Payer: Kentucky WC Medicaid |
$8,235.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,316.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECH CEM FEM COMP SZ 16 175MM
|
Facility
|
IP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECH CEM FEM COMP SZ 16 225MM
|
Facility
|
OP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem Medicaid |
$8,152.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Humana KY Medicaid |
$8,152.71
|
| Rate for Payer: Kentucky WC Medicaid |
$8,235.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,316.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECH CEM FEM COMP SZ 16 225MM
|
Facility
|
IP
|
$23,706.63
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,081.86 |
| Max. Negotiated Rate |
$22,758.36 |
| Rate for Payer: Aetna Commercial |
$18,254.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$18,491.17
|
| Rate for Payer: Cash Price |
$11,853.32
|
| Rate for Payer: Cigna Commercial |
$19,676.50
|
| Rate for Payer: First Health Commercial |
$22,521.30
|
| Rate for Payer: Humana Commercial |
$20,150.64
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$19,439.44
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$17,495.49
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,111.99
|
| Rate for Payer: Ohio Health Choice Commercial |
$20,861.83
|
| Rate for Payer: Ohio Health Group HMO |
$17,779.97
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,741.33
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,081.86
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,349.06
|
| Rate for Payer: PHCS Commercial |
$22,758.36
|
| Rate for Payer: United Healthcare All Payer |
$20,861.83
|
|
|
ECHELN FEM COMP BOW SZ12L 300M
|
Facility
|
OP
|
$25,664.31
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,336.36 |
| Max. Negotiated Rate |
$24,637.74 |
| Rate for Payer: Aetna Commercial |
$19,761.52
|
| Rate for Payer: Anthem Medicaid |
$8,825.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,018.16
|
| Rate for Payer: Cash Price |
$12,832.16
|
| Rate for Payer: Cigna Commercial |
$21,301.38
|
| Rate for Payer: First Health Commercial |
$24,381.09
|
| Rate for Payer: Humana Commercial |
$21,814.66
|
| Rate for Payer: Humana KY Medicaid |
$8,825.96
|
| Rate for Payer: Kentucky WC Medicaid |
$8,915.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,044.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,940.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,699.29
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,003.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,584.59
|
| Rate for Payer: Ohio Health Group HMO |
$19,248.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,132.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,336.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,955.94
|
| Rate for Payer: PHCS Commercial |
$24,637.74
|
| Rate for Payer: United Healthcare All Payer |
$22,584.59
|
|
|
ECHELN FEM COMP BOW SZ12L 300M
|
Facility
|
IP
|
$25,664.31
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,336.36 |
| Max. Negotiated Rate |
$24,637.74 |
| Rate for Payer: Aetna Commercial |
$19,761.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,018.16
|
| Rate for Payer: Cash Price |
$12,832.16
|
| Rate for Payer: Cigna Commercial |
$21,301.38
|
| Rate for Payer: First Health Commercial |
$24,381.09
|
| Rate for Payer: Humana Commercial |
$21,814.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,044.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,940.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,699.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,584.59
|
| Rate for Payer: Ohio Health Group HMO |
$19,248.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,132.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,336.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,955.94
|
| Rate for Payer: PHCS Commercial |
$24,637.74
|
| Rate for Payer: United Healthcare All Payer |
$22,584.59
|
|
|
ECHELN FEM COMP BOW SZ12R 300M
|
Facility
|
OP
|
$25,664.31
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,336.36 |
| Max. Negotiated Rate |
$24,637.74 |
| Rate for Payer: Aetna Commercial |
$19,761.52
|
| Rate for Payer: Anthem Medicaid |
$8,825.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,018.16
|
| Rate for Payer: Cash Price |
$12,832.16
|
| Rate for Payer: Cigna Commercial |
$21,301.38
|
| Rate for Payer: First Health Commercial |
$24,381.09
|
| Rate for Payer: Humana Commercial |
$21,814.66
|
| Rate for Payer: Humana KY Medicaid |
$8,825.96
|
| Rate for Payer: Kentucky WC Medicaid |
$8,915.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,044.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,940.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,699.29
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,003.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,584.59
|
| Rate for Payer: Ohio Health Group HMO |
$19,248.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,132.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,336.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,955.94
|
| Rate for Payer: PHCS Commercial |
$24,637.74
|
| Rate for Payer: United Healthcare All Payer |
$22,584.59
|
|
|
ECHELN FEM COMP BOW SZ12R 300M
|
Facility
|
IP
|
$25,664.31
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,336.36 |
| Max. Negotiated Rate |
$24,637.74 |
| Rate for Payer: Aetna Commercial |
$19,761.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,018.16
|
| Rate for Payer: Cash Price |
$12,832.16
|
| Rate for Payer: Cigna Commercial |
$21,301.38
|
| Rate for Payer: First Health Commercial |
$24,381.09
|
| Rate for Payer: Humana Commercial |
$21,814.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,044.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,940.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,699.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,584.59
|
| Rate for Payer: Ohio Health Group HMO |
$19,248.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,132.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,336.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,955.94
|
| Rate for Payer: PHCS Commercial |
$24,637.74
|
| Rate for Payer: United Healthcare All Payer |
$22,584.59
|
|
|
ECHELN FEM COMP BOW SZ14L 300M
|
Facility
|
OP
|
$25,664.31
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,336.36 |
| Max. Negotiated Rate |
$24,637.74 |
| Rate for Payer: Aetna Commercial |
$19,761.52
|
| Rate for Payer: Anthem Medicaid |
$8,825.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,018.16
|
| Rate for Payer: Cash Price |
$12,832.16
|
| Rate for Payer: Cigna Commercial |
$21,301.38
|
| Rate for Payer: First Health Commercial |
$24,381.09
|
| Rate for Payer: Humana Commercial |
$21,814.66
|
| Rate for Payer: Humana KY Medicaid |
$8,825.96
|
| Rate for Payer: Kentucky WC Medicaid |
$8,915.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,044.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,940.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,699.29
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,003.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,584.59
|
| Rate for Payer: Ohio Health Group HMO |
$19,248.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,132.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,336.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,955.94
|
| Rate for Payer: PHCS Commercial |
$24,637.74
|
| Rate for Payer: United Healthcare All Payer |
$22,584.59
|
|
|
ECHELN FEM COMP BOW SZ14L 300M
|
Facility
|
IP
|
$25,664.31
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,336.36 |
| Max. Negotiated Rate |
$24,637.74 |
| Rate for Payer: Aetna Commercial |
$19,761.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,018.16
|
| Rate for Payer: Cash Price |
$12,832.16
|
| Rate for Payer: Cigna Commercial |
$21,301.38
|
| Rate for Payer: First Health Commercial |
$24,381.09
|
| Rate for Payer: Humana Commercial |
$21,814.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,044.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,940.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,699.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,584.59
|
| Rate for Payer: Ohio Health Group HMO |
$19,248.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,132.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,336.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,955.94
|
| Rate for Payer: PHCS Commercial |
$24,637.74
|
| Rate for Payer: United Healthcare All Payer |
$22,584.59
|
|
|
ECHELN FEM COMP BOW SZ14R 300M
|
Facility
|
IP
|
$25,664.31
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,336.36 |
| Max. Negotiated Rate |
$24,637.74 |
| Rate for Payer: Aetna Commercial |
$19,761.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,018.16
|
| Rate for Payer: Cash Price |
$12,832.16
|
| Rate for Payer: Cigna Commercial |
$21,301.38
|
| Rate for Payer: First Health Commercial |
$24,381.09
|
| Rate for Payer: Humana Commercial |
$21,814.66
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,044.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,940.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,699.29
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,584.59
|
| Rate for Payer: Ohio Health Group HMO |
$19,248.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,132.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,336.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,955.94
|
| Rate for Payer: PHCS Commercial |
$24,637.74
|
| Rate for Payer: United Healthcare All Payer |
$22,584.59
|
|
|
ECHELN FEM COMP BOW SZ14R 300M
|
Facility
|
OP
|
$25,664.31
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,336.36 |
| Max. Negotiated Rate |
$24,637.74 |
| Rate for Payer: Aetna Commercial |
$19,761.52
|
| Rate for Payer: Anthem Medicaid |
$8,825.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,018.16
|
| Rate for Payer: Cash Price |
$12,832.16
|
| Rate for Payer: Cigna Commercial |
$21,301.38
|
| Rate for Payer: First Health Commercial |
$24,381.09
|
| Rate for Payer: Humana Commercial |
$21,814.66
|
| Rate for Payer: Humana KY Medicaid |
$8,825.96
|
| Rate for Payer: Kentucky WC Medicaid |
$8,915.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,044.73
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,940.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,699.29
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,003.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,584.59
|
| Rate for Payer: Ohio Health Group HMO |
$19,248.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,132.86
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,336.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,955.94
|
| Rate for Payer: PHCS Commercial |
$24,637.74
|
| Rate for Payer: United Healthcare All Payer |
$22,584.59
|
|
