|
ECH POR STD 260MM BOW SZ 14L
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 14R
|
Facility
|
OP
|
$35,666.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,636.61 |
| Max. Negotiated Rate |
$34,239.57 |
| Rate for Payer: Aetna Commercial |
$27,462.99
|
| Rate for Payer: Anthem Medicaid |
$12,265.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,819.65
|
| Rate for Payer: Cash Price |
$17,833.11
|
| Rate for Payer: Cigna Commercial |
$29,602.96
|
| Rate for Payer: First Health Commercial |
$33,882.91
|
| Rate for Payer: Humana Commercial |
$30,316.29
|
| Rate for Payer: Humana KY Medicaid |
$12,265.61
|
| Rate for Payer: Kentucky WC Medicaid |
$12,390.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,246.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,321.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,699.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,511.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,386.27
|
| Rate for Payer: Ohio Health Group HMO |
$26,749.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,133.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,636.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,056.53
|
| Rate for Payer: PHCS Commercial |
$34,239.57
|
| Rate for Payer: United Healthcare All Payer |
$31,386.27
|
|
|
ECH POR STD 260MM BOW SZ 14R
|
Facility
|
IP
|
$35,666.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,636.61 |
| Max. Negotiated Rate |
$34,239.57 |
| Rate for Payer: Aetna Commercial |
$27,462.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,819.65
|
| Rate for Payer: Cash Price |
$17,833.11
|
| Rate for Payer: Cigna Commercial |
$29,602.96
|
| Rate for Payer: First Health Commercial |
$33,882.91
|
| Rate for Payer: Humana Commercial |
$30,316.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,246.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,321.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,699.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,386.27
|
| Rate for Payer: Ohio Health Group HMO |
$26,749.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,133.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,636.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,056.53
|
| Rate for Payer: PHCS Commercial |
$34,239.57
|
| Rate for Payer: United Healthcare All Payer |
$31,386.27
|
|
|
ECH POR STD 260MM BOW SZ 15L
|
Facility
|
OP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem Medicaid |
$10,560.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Humana KY Medicaid |
$10,560.82
|
| Rate for Payer: Kentucky WC Medicaid |
$10,668.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,772.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 15L
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 15R
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 15R
|
Facility
|
OP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem Medicaid |
$10,560.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Humana KY Medicaid |
$10,560.82
|
| Rate for Payer: Kentucky WC Medicaid |
$10,668.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,772.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 16L
|
Facility
|
OP
|
$35,666.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,636.61 |
| Max. Negotiated Rate |
$34,239.57 |
| Rate for Payer: Aetna Commercial |
$27,462.99
|
| Rate for Payer: Anthem Medicaid |
$12,265.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,819.65
|
| Rate for Payer: Cash Price |
$17,833.11
|
| Rate for Payer: Cigna Commercial |
$29,602.96
|
| Rate for Payer: First Health Commercial |
$33,882.91
|
| Rate for Payer: Humana Commercial |
$30,316.29
|
| Rate for Payer: Humana KY Medicaid |
$12,265.61
|
| Rate for Payer: Kentucky WC Medicaid |
$12,390.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,246.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,321.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,699.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,511.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,386.27
|
| Rate for Payer: Ohio Health Group HMO |
$26,749.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,133.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,636.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,056.53
|
| Rate for Payer: PHCS Commercial |
$34,239.57
|
| Rate for Payer: United Healthcare All Payer |
$31,386.27
|
|
|
ECH POR STD 260MM BOW SZ 16L
|
Facility
|
IP
|
$35,666.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,636.61 |
| Max. Negotiated Rate |
$34,239.57 |
| Rate for Payer: Aetna Commercial |
$27,462.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,819.65
|
| Rate for Payer: Cash Price |
$17,833.11
|
| Rate for Payer: Cigna Commercial |
$29,602.96
|
| Rate for Payer: First Health Commercial |
$33,882.91
|
| Rate for Payer: Humana Commercial |
$30,316.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,246.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,321.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,699.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,386.27
|
| Rate for Payer: Ohio Health Group HMO |
$26,749.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,133.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,636.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,056.53
|
| Rate for Payer: PHCS Commercial |
$34,239.57
|
| Rate for Payer: United Healthcare All Payer |
$31,386.27
|
|
|
ECH POR STD 260MM BOW SZ 16R
|
Facility
|
OP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem Medicaid |
$10,560.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Humana KY Medicaid |
$10,560.82
|
| Rate for Payer: Kentucky WC Medicaid |
$10,668.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,772.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 16R
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 17L
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 17L
|
Facility
|
OP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem Medicaid |
$10,560.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Humana KY Medicaid |
$10,560.82
|
| Rate for Payer: Kentucky WC Medicaid |
$10,668.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,772.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 17R
|
Facility
|
IP
|
$35,666.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,636.61 |
| Max. Negotiated Rate |
$34,239.57 |
| Rate for Payer: Aetna Commercial |
$27,462.99
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,819.65
|
| Rate for Payer: Cash Price |
$17,833.11
|
| Rate for Payer: Cigna Commercial |
$29,602.96
|
| Rate for Payer: First Health Commercial |
$33,882.91
|
| Rate for Payer: Humana Commercial |
$30,316.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,246.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,321.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,699.87
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,386.27
|
| Rate for Payer: Ohio Health Group HMO |
$26,749.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,133.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,636.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,056.53
|
| Rate for Payer: PHCS Commercial |
$34,239.57
|
| Rate for Payer: United Healthcare All Payer |
$31,386.27
|
|
|
ECH POR STD 260MM BOW SZ 17R
|
Facility
|
OP
|
$35,666.22
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,636.61 |
| Max. Negotiated Rate |
$34,239.57 |
| Rate for Payer: Aetna Commercial |
$27,462.99
|
| Rate for Payer: Anthem Medicaid |
$12,265.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$27,819.65
|
| Rate for Payer: Cash Price |
$17,833.11
|
| Rate for Payer: Cigna Commercial |
$29,602.96
|
| Rate for Payer: First Health Commercial |
$33,882.91
|
| Rate for Payer: Humana Commercial |
$30,316.29
|
| Rate for Payer: Humana KY Medicaid |
$12,265.61
|
| Rate for Payer: Kentucky WC Medicaid |
$12,390.44
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$29,246.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$26,321.67
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$10,699.87
|
| Rate for Payer: Molina Healthcare Medicaid |
$12,511.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$31,386.27
|
| Rate for Payer: Ohio Health Group HMO |
$26,749.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$7,133.24
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,636.61
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$11,056.53
|
| Rate for Payer: PHCS Commercial |
$34,239.57
|
| Rate for Payer: United Healthcare All Payer |
$31,386.27
|
|
|
ECH POR STD 260MM BOW SZ 18L
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 18L
|
Facility
|
OP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem Medicaid |
$10,560.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Humana KY Medicaid |
$10,560.82
|
| Rate for Payer: Kentucky WC Medicaid |
$10,668.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,772.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 18R
|
Facility
|
OP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem Medicaid |
$10,560.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Humana KY Medicaid |
$10,560.82
|
| Rate for Payer: Kentucky WC Medicaid |
$10,668.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,772.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 18R
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 19L
|
Facility
|
OP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem Medicaid |
$10,560.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Humana KY Medicaid |
$10,560.82
|
| Rate for Payer: Kentucky WC Medicaid |
$10,668.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,772.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 19L
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 19R
|
Facility
|
OP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem Medicaid |
$10,560.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Humana KY Medicaid |
$10,560.82
|
| Rate for Payer: Kentucky WC Medicaid |
$10,668.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,772.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 19R
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 20L
|
Facility
|
OP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem Medicaid |
$10,560.82
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Humana KY Medicaid |
$10,560.82
|
| Rate for Payer: Kentucky WC Medicaid |
$10,668.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,772.71
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
|
ECH POR STD 260MM BOW SZ 20L
|
Facility
|
IP
|
$30,708.98
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,992.17 |
| Max. Negotiated Rate |
$29,480.62 |
| Rate for Payer: Aetna Commercial |
$23,645.91
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,953.00
|
| Rate for Payer: Cash Price |
$15,354.49
|
| Rate for Payer: Cigna Commercial |
$25,488.45
|
| Rate for Payer: First Health Commercial |
$29,173.53
|
| Rate for Payer: Humana Commercial |
$26,102.63
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,181.36
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,663.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,212.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,023.90
|
| Rate for Payer: Ohio Health Group HMO |
$23,031.74
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,141.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,992.17
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$9,519.78
|
| Rate for Payer: PHCS Commercial |
$29,480.62
|
| Rate for Payer: United Healthcare All Payer |
$27,023.90
|
|
