|
ECH PRI FEM STDOFS 12/14 SZ 12
|
Facility
|
OP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem Medicaid |
$8,609.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Humana KY Medicaid |
$8,609.37
|
| Rate for Payer: Kentucky WC Medicaid |
$8,696.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,782.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 12
|
Facility
|
IP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 13
|
Facility
|
OP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem Medicaid |
$8,609.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Humana KY Medicaid |
$8,609.37
|
| Rate for Payer: Kentucky WC Medicaid |
$8,696.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,782.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 13
|
Facility
|
IP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 14
|
Facility
|
IP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 14
|
Facility
|
OP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem Medicaid |
$8,609.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Humana KY Medicaid |
$8,609.37
|
| Rate for Payer: Kentucky WC Medicaid |
$8,696.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,782.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 15
|
Facility
|
OP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem Medicaid |
$8,609.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Humana KY Medicaid |
$8,609.37
|
| Rate for Payer: Kentucky WC Medicaid |
$8,696.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,782.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 15
|
Facility
|
IP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 16
|
Facility
|
IP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 16
|
Facility
|
OP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem Medicaid |
$8,609.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Humana KY Medicaid |
$8,609.37
|
| Rate for Payer: Kentucky WC Medicaid |
$8,696.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,782.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 17
|
Facility
|
OP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem Medicaid |
$8,609.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Humana KY Medicaid |
$8,609.37
|
| Rate for Payer: Kentucky WC Medicaid |
$8,696.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,782.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 17
|
Facility
|
IP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 18
|
Facility
|
IP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 18
|
Facility
|
OP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem Medicaid |
$8,609.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Humana KY Medicaid |
$8,609.37
|
| Rate for Payer: Kentucky WC Medicaid |
$8,696.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,782.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 19
|
Facility
|
OP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem Medicaid |
$8,609.37
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Humana KY Medicaid |
$8,609.37
|
| Rate for Payer: Kentucky WC Medicaid |
$8,696.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,782.11
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH PRI FEM STDOFS 12/14 SZ 19
|
Facility
|
IP
|
$25,034.51
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,254.49 |
| Max. Negotiated Rate |
$24,033.13 |
| Rate for Payer: Aetna Commercial |
$19,276.57
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,526.92
|
| Rate for Payer: Cash Price |
$12,517.25
|
| Rate for Payer: Cigna Commercial |
$20,778.64
|
| Rate for Payer: First Health Commercial |
$23,782.78
|
| Rate for Payer: Humana Commercial |
$21,279.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,528.30
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,475.47
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,510.35
|
| Rate for Payer: Ohio Health Choice Commercial |
$22,030.37
|
| Rate for Payer: Ohio Health Group HMO |
$18,775.88
|
| Rate for Payer: Ohio Health Group PPO Differential |
$5,006.90
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,254.49
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$7,760.70
|
| Rate for Payer: PHCS Commercial |
$24,033.13
|
| Rate for Payer: United Healthcare All Payer |
$22,030.37
|
|
|
ECH STR FEM REAMER SZ 10.0MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 10.0MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 10.5MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 10.5MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 11.0MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 11.0MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 11.5MM
|
Facility
|
OP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem Medicaid |
$1,352.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Humana KY Medicaid |
$1,352.03
|
| Rate for Payer: Kentucky WC Medicaid |
$1,365.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,379.15
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 11.5MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
|
ECH STR FEM REAMER SZ 12.5MM
|
Facility
|
IP
|
$3,931.45
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.09 |
| Max. Negotiated Rate |
$3,774.19 |
| Rate for Payer: Aetna Commercial |
$3,027.22
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,066.53
|
| Rate for Payer: Cash Price |
$1,965.72
|
| Rate for Payer: Cigna Commercial |
$3,263.10
|
| Rate for Payer: First Health Commercial |
$3,734.88
|
| Rate for Payer: Humana Commercial |
$3,341.73
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,223.79
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,901.41
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,179.44
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,459.68
|
| Rate for Payer: Ohio Health Group HMO |
$2,948.59
|
| Rate for Payer: Ohio Health Group PPO Differential |
$786.29
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$511.09
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,218.75
|
| Rate for Payer: PHCS Commercial |
$3,774.19
|
| Rate for Payer: United Healthcare All Payer |
$3,459.68
|
|
