|
ECHO MYOCARDIAL STRAIN
|
Professional
|
Both
|
$66.06
|
|
|
Service Code
|
HCPCS 93356
|
| Hospital Charge Code |
48000111
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$66.06 |
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$9.59
|
| Rate for Payer: Anthem Medicaid |
$9.58
|
| Rate for Payer: Buckeye Medicare Advantage |
$66.06
|
| Rate for Payer: Cash Price |
$33.03
|
| Rate for Payer: Cash Price |
$33.03
|
| Rate for Payer: Humana Medicaid |
$9.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$17.10
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$9.77
|
| Rate for Payer: Molina Healthcare Passport |
$9.58
|
| Rate for Payer: Multiplan PHCS |
$39.64
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$46.24
|
| Rate for Payer: UHCCP Medicaid |
$10.07
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$9.68
|
|
|
ECHO MYOCARDIAL STRAIN
|
Facility
|
IP
|
$66.06
|
|
|
Service Code
|
HCPCS 93356
|
| Hospital Charge Code |
48000111
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$63.42 |
| Rate for Payer: Aetna Commercial |
$50.87
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$51.53
|
| Rate for Payer: Cash Price |
$33.03
|
| Rate for Payer: Cigna Commercial |
$54.83
|
| Rate for Payer: First Health Commercial |
$62.76
|
| Rate for Payer: Humana Commercial |
$56.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$54.17
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$48.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$19.82
|
| Rate for Payer: Ohio Health Choice Commercial |
$58.13
|
| Rate for Payer: Ohio Health Group HMO |
$49.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$13.21
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$8.59
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$20.48
|
| Rate for Payer: PHCS Commercial |
$63.42
|
| Rate for Payer: United Healthcare All Payer |
$58.13
|
|
|
ECHO MYOCARDIAL STRAIN (P
|
Professional
|
Both
|
$12.06
|
|
|
Service Code
|
HCPCS 93356
|
| Hospital Charge Code |
480P0111
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$17.10 |
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$9.59
|
| Rate for Payer: Anthem Medicaid |
$9.58
|
| Rate for Payer: Buckeye Medicare Advantage |
$12.06
|
| Rate for Payer: Cash Price |
$6.03
|
| Rate for Payer: Cash Price |
$6.03
|
| Rate for Payer: Humana Medicaid |
$9.58
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$17.10
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$9.77
|
| Rate for Payer: Molina Healthcare Passport |
$9.58
|
| Rate for Payer: Multiplan PHCS |
$7.24
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$8.44
|
| Rate for Payer: UHCCP Medicaid |
$10.07
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$9.68
|
|
|
ECHO MYOCARDIAL STRAIN (T
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
HCPCS 93356
|
| Hospital Charge Code |
480T0111
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$51.84 |
| Rate for Payer: Aetna Commercial |
$41.58
|
| Rate for Payer: Anthem Medicaid |
$18.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$42.12
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna Commercial |
$44.82
|
| Rate for Payer: First Health Commercial |
$51.30
|
| Rate for Payer: Humana Commercial |
$45.90
|
| Rate for Payer: Humana KY Medicaid |
$18.57
|
| Rate for Payer: Kentucky WC Medicaid |
$18.76
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$44.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$39.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$16.20
|
| Rate for Payer: Molina Healthcare Medicaid |
$18.94
|
| Rate for Payer: Ohio Health Choice Commercial |
$47.52
|
| Rate for Payer: Ohio Health Group HMO |
$40.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16.74
|
| Rate for Payer: PHCS Commercial |
$51.84
|
| Rate for Payer: United Healthcare All Payer |
$47.52
|
|
|
ECHO MYOCARDIAL STRAIN (T
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
HCPCS 93356
|
| Hospital Charge Code |
480T0111
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$51.84 |
| Rate for Payer: Aetna Commercial |
$41.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$42.12
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna Commercial |
$44.82
|
| Rate for Payer: First Health Commercial |
$51.30
|
| Rate for Payer: Humana Commercial |
$45.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$44.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$39.85
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$16.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$47.52
|
| Rate for Payer: Ohio Health Group HMO |
$40.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$10.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16.74
|
| Rate for Payer: PHCS Commercial |
$51.84
|
| Rate for Payer: United Healthcare All Payer |
$47.52
|
|
|
ECHO TRANSESOPHAGEAL
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
HCPCS 93313
|
| Hospital Charge Code |
48000093
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$10.79 |
| Max. Negotiated Rate |
$79.68 |
| Rate for Payer: Aetna Commercial |
$63.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$64.74
|
| Rate for Payer: Cash Price |
$41.50
|
| Rate for Payer: Cigna Commercial |
$68.89
|
| Rate for Payer: First Health Commercial |
$78.85
|
| Rate for Payer: Humana Commercial |
$70.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$24.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$73.04
|
| Rate for Payer: Ohio Health Group HMO |
$62.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25.73
|
| Rate for Payer: PHCS Commercial |
$79.68
|
| Rate for Payer: United Healthcare All Payer |
$73.04
|
|
|
ECHO TRANSESOPHAGEAL
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
HCPCS 93313
|
| Hospital Charge Code |
48000093
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$10.79 |
| Max. Negotiated Rate |
$667.88 |
| Rate for Payer: Aetna Commercial |
$63.91
|
| Rate for Payer: Anthem Medicaid |
$28.54
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$477.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$64.74
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$667.88
|
| Rate for Payer: CareSource Just4Me Medicare |
$644.03
|
| Rate for Payer: Cash Price |
$41.50
|
| Rate for Payer: Cash Price |
$41.50
|
| Rate for Payer: Cigna Commercial |
$68.89
|
| Rate for Payer: First Health Commercial |
$78.85
|
| Rate for Payer: Humana Commercial |
$70.55
|
| Rate for Payer: Humana KY Medicaid |
$28.54
|
| Rate for Payer: Humana Medicare Advantage |
$477.06
|
| Rate for Payer: Kentucky WC Medicaid |
$28.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$68.06
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$61.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$572.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$29.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$73.04
|
| Rate for Payer: Ohio Health Group HMO |
$62.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$16.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$10.79
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$25.73
|
| Rate for Payer: PHCS Commercial |
$79.68
|
| Rate for Payer: United Healthcare All Payer |
$73.04
|
|
|
ECHO TRANSESOPHAGEAL INTRAO(P
|
Professional
|
Both
|
$420.00
|
|
|
Service Code
|
HCPCS 93318
|
| Hospital Charge Code |
483P0009
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$739.16 |
| Rate for Payer: Aetna Commercial |
$367.08
|
| Rate for Payer: Anthem Medicaid |
$203.83
|
| Rate for Payer: Buckeye Medicare Advantage |
$420.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$333.03
|
| Rate for Payer: Healthspan PPO |
$739.16
|
| Rate for Payer: Humana Medicaid |
$203.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$154.77
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$207.91
|
| Rate for Payer: Molina Healthcare Passport |
$203.83
|
| Rate for Payer: Multiplan PHCS |
$252.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$294.00
|
| Rate for Payer: UHCCP Medicaid |
$147.00
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$205.87
|
|
|
ECHO TRANSESOPHAGEAL INTRAOP
|
Facility
|
IP
|
$2,426.00
|
|
|
Service Code
|
HCPCS 93318
|
| Hospital Charge Code |
48300009
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$315.38 |
| Max. Negotiated Rate |
$2,328.96 |
| Rate for Payer: Aetna Commercial |
$1,868.02
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,892.28
|
| Rate for Payer: Cash Price |
$1,213.00
|
| Rate for Payer: Cigna Commercial |
$2,013.58
|
| Rate for Payer: First Health Commercial |
$2,304.70
|
| Rate for Payer: Humana Commercial |
$2,062.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,989.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,790.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$727.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,134.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,819.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$485.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$315.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$752.06
|
| Rate for Payer: PHCS Commercial |
$2,328.96
|
| Rate for Payer: United Healthcare All Payer |
$2,134.88
|
|
|
ECHO TRANSESOPHAGEAL INTRAOP
|
Professional
|
Both
|
$2,426.00
|
|
|
Service Code
|
HCPCS 93318
|
| Hospital Charge Code |
48300009
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$154.77 |
| Max. Negotiated Rate |
$2,426.00 |
| Rate for Payer: Aetna Commercial |
$367.08
|
| Rate for Payer: Anthem Medicaid |
$203.83
|
| Rate for Payer: Buckeye Medicare Advantage |
$2,426.00
|
| Rate for Payer: Cash Price |
$1,213.00
|
| Rate for Payer: Cash Price |
$1,213.00
|
| Rate for Payer: Cigna Commercial |
$333.03
|
| Rate for Payer: Healthspan PPO |
$739.16
|
| Rate for Payer: Humana Medicaid |
$203.83
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$154.77
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$207.91
|
| Rate for Payer: Molina Healthcare Passport |
$203.83
|
| Rate for Payer: Multiplan PHCS |
$1,455.60
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$1,698.20
|
| Rate for Payer: UHCCP Medicaid |
$849.10
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$205.87
|
|
|
ECHO TRANSESOPHAGEAL INTRAOP
|
Facility
|
OP
|
$2,426.00
|
|
|
Service Code
|
HCPCS 93318
|
| Hospital Charge Code |
48300009
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$315.38 |
| Max. Negotiated Rate |
$2,328.96 |
| Rate for Payer: Aetna Commercial |
$1,868.02
|
| Rate for Payer: Anthem Medicaid |
$834.30
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$477.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,892.28
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$667.88
|
| Rate for Payer: CareSource Just4Me Medicare |
$644.03
|
| Rate for Payer: Cash Price |
$1,213.00
|
| Rate for Payer: Cash Price |
$1,213.00
|
| Rate for Payer: Cigna Commercial |
$2,013.58
|
| Rate for Payer: First Health Commercial |
$2,304.70
|
| Rate for Payer: Humana Commercial |
$2,062.10
|
| Rate for Payer: Humana KY Medicaid |
$834.30
|
| Rate for Payer: Humana Medicare Advantage |
$477.06
|
| Rate for Payer: Kentucky WC Medicaid |
$842.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,989.32
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,790.39
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$572.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$851.04
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,134.88
|
| Rate for Payer: Ohio Health Group HMO |
$1,819.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$485.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$315.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$752.06
|
| Rate for Payer: PHCS Commercial |
$2,328.96
|
| Rate for Payer: United Healthcare All Payer |
$2,134.88
|
|
|
ECHO TRANSESOPHAGEAL INTRAO(T
|
Facility
|
OP
|
$2,006.00
|
|
|
Service Code
|
HCPCS 93318
|
| Hospital Charge Code |
483T0009
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$260.78 |
| Max. Negotiated Rate |
$1,925.76 |
| Rate for Payer: Aetna Commercial |
$1,544.62
|
| Rate for Payer: Anthem Medicaid |
$689.86
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$477.06
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,564.68
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$667.88
|
| Rate for Payer: CareSource Just4Me Medicare |
$644.03
|
| Rate for Payer: Cash Price |
$1,003.00
|
| Rate for Payer: Cash Price |
$1,003.00
|
| Rate for Payer: Cigna Commercial |
$1,664.98
|
| Rate for Payer: First Health Commercial |
$1,905.70
|
| Rate for Payer: Humana Commercial |
$1,705.10
|
| Rate for Payer: Humana KY Medicaid |
$689.86
|
| Rate for Payer: Humana Medicare Advantage |
$477.06
|
| Rate for Payer: Kentucky WC Medicaid |
$696.88
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,644.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,480.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$572.47
|
| Rate for Payer: Molina Healthcare Medicaid |
$703.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,765.28
|
| Rate for Payer: Ohio Health Group HMO |
$1,504.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$401.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$621.86
|
| Rate for Payer: PHCS Commercial |
$1,925.76
|
| Rate for Payer: United Healthcare All Payer |
$1,765.28
|
|
|
ECHO TRANSESOPHAGEAL INTRAO(T
|
Facility
|
IP
|
$2,006.00
|
|
|
Service Code
|
HCPCS 93318
|
| Hospital Charge Code |
483T0009
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$260.78 |
| Max. Negotiated Rate |
$1,925.76 |
| Rate for Payer: Aetna Commercial |
$1,544.62
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,564.68
|
| Rate for Payer: Cash Price |
$1,003.00
|
| Rate for Payer: Cigna Commercial |
$1,664.98
|
| Rate for Payer: First Health Commercial |
$1,905.70
|
| Rate for Payer: Humana Commercial |
$1,705.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,644.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,480.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$601.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,765.28
|
| Rate for Payer: Ohio Health Group HMO |
$1,504.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$401.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$260.78
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$621.86
|
| Rate for Payer: PHCS Commercial |
$1,925.76
|
| Rate for Payer: United Healthcare All Payer |
$1,765.28
|
|
|
ECH POR 190MM STR 15MM CALSZ11
|
Facility
|
IP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ11
|
Facility
|
OP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem Medicaid |
$10,453.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Humana KY Medicaid |
$10,453.05
|
| Rate for Payer: Kentucky WC Medicaid |
$10,559.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,662.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ12
|
Facility
|
OP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem Medicaid |
$10,453.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Humana KY Medicaid |
$10,453.05
|
| Rate for Payer: Kentucky WC Medicaid |
$10,559.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,662.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ12
|
Facility
|
IP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ13
|
Facility
|
OP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem Medicaid |
$10,453.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Humana KY Medicaid |
$10,453.05
|
| Rate for Payer: Kentucky WC Medicaid |
$10,559.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,662.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ13
|
Facility
|
IP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ14
|
Facility
|
OP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem Medicaid |
$10,453.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Humana KY Medicaid |
$10,453.05
|
| Rate for Payer: Kentucky WC Medicaid |
$10,559.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,662.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ14
|
Facility
|
IP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ15
|
Facility
|
OP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem Medicaid |
$10,453.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Humana KY Medicaid |
$10,453.05
|
| Rate for Payer: Kentucky WC Medicaid |
$10,559.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,662.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ15
|
Facility
|
IP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ16
|
Facility
|
IP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
|
ECH POR 190MM STR 15MM CALSZ16
|
Facility
|
OP
|
$30,395.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,951.43 |
| Max. Negotiated Rate |
$29,179.80 |
| Rate for Payer: Aetna Commercial |
$23,404.63
|
| Rate for Payer: Anthem Medicaid |
$10,453.05
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,708.58
|
| Rate for Payer: Cash Price |
$15,197.81
|
| Rate for Payer: Cigna Commercial |
$25,228.36
|
| Rate for Payer: First Health Commercial |
$28,875.84
|
| Rate for Payer: Humana Commercial |
$25,836.28
|
| Rate for Payer: Humana KY Medicaid |
$10,453.05
|
| Rate for Payer: Kentucky WC Medicaid |
$10,559.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,924.41
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,431.97
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,118.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,662.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,748.15
|
| Rate for Payer: Ohio Health Group HMO |
$22,796.72
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,079.12
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,951.43
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,422.64
|
| Rate for Payer: PHCS Commercial |
$29,179.80
|
| Rate for Payer: United Healthcare All Payer |
$26,748.15
|
|
