|
ECH CEM FEM CMP BOW SZ14 L 300
|
Facility
|
OP
|
$30,496.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,148.88 |
| Max. Negotiated Rate |
$29,276.40 |
| Rate for Payer: Aetna Commercial |
$23,482.11
|
| Rate for Payer: Anthem Medicaid |
$10,487.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,787.08
|
| Rate for Payer: Cash Price |
$15,248.12
|
| Rate for Payer: Cigna Commercial |
$25,311.89
|
| Rate for Payer: First Health Commercial |
$28,971.44
|
| Rate for Payer: Humana Commercial |
$25,921.81
|
| Rate for Payer: Humana KY Medicaid |
$10,487.66
|
| Rate for Payer: Kentucky WC Medicaid |
$10,594.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,006.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,506.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,148.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,698.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,836.70
|
| Rate for Payer: Ohio Health Group HMO |
$22,872.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$24,397.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$26,531.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,042.41
|
| Rate for Payer: PHCS Commercial |
$29,276.40
|
| Rate for Payer: United Healthcare All Payer |
$26,836.70
|
|
|
ECH CEM FEM CMP BOW SZ14 R 300
|
Facility
|
IP
|
$30,496.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,148.88 |
| Max. Negotiated Rate |
$29,276.40 |
| Rate for Payer: Aetna Commercial |
$23,482.11
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,787.08
|
| Rate for Payer: Cash Price |
$15,248.12
|
| Rate for Payer: Cigna Commercial |
$25,311.89
|
| Rate for Payer: First Health Commercial |
$28,971.44
|
| Rate for Payer: Humana Commercial |
$25,921.81
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,006.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,506.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,148.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,836.70
|
| Rate for Payer: Ohio Health Group HMO |
$22,872.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$24,397.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$26,531.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,042.41
|
| Rate for Payer: PHCS Commercial |
$29,276.40
|
| Rate for Payer: United Healthcare All Payer |
$26,836.70
|
|
|
ECH CEM FEM CMP BOW SZ14 R 300
|
Facility
|
OP
|
$30,496.25
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,148.88 |
| Max. Negotiated Rate |
$29,276.40 |
| Rate for Payer: Aetna Commercial |
$23,482.11
|
| Rate for Payer: Anthem Medicaid |
$10,487.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,787.08
|
| Rate for Payer: Cash Price |
$15,248.12
|
| Rate for Payer: Cigna Commercial |
$25,311.89
|
| Rate for Payer: First Health Commercial |
$28,971.44
|
| Rate for Payer: Humana Commercial |
$25,921.81
|
| Rate for Payer: Humana KY Medicaid |
$10,487.66
|
| Rate for Payer: Kentucky WC Medicaid |
$10,594.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,006.92
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,506.23
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,148.88
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,698.08
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,836.70
|
| Rate for Payer: Ohio Health Group HMO |
$22,872.19
|
| Rate for Payer: Ohio Health Group PPO Differential |
$24,397.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$26,531.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,042.41
|
| Rate for Payer: PHCS Commercial |
$29,276.40
|
| Rate for Payer: United Healthcare All Payer |
$26,836.70
|
|
|
ECH CEM FEM COMP SZ 12 175MM
|
Facility
|
IP
|
$15,605.64
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,681.69 |
| Max. Negotiated Rate |
$14,981.41 |
| Rate for Payer: Aetna Commercial |
$12,016.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,172.40
|
| Rate for Payer: Cash Price |
$7,802.82
|
| Rate for Payer: Cigna Commercial |
$12,952.68
|
| Rate for Payer: First Health Commercial |
$14,825.36
|
| Rate for Payer: Humana Commercial |
$13,264.79
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,796.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,516.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,681.69
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,732.96
|
| Rate for Payer: Ohio Health Group HMO |
$11,704.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,484.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,576.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,767.89
|
| Rate for Payer: PHCS Commercial |
$14,981.41
|
| Rate for Payer: United Healthcare All Payer |
$13,732.96
|
|
|
ECH CEM FEM COMP SZ 12 175MM
|
Facility
|
OP
|
$15,605.64
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,681.69 |
| Max. Negotiated Rate |
$14,981.41 |
| Rate for Payer: Aetna Commercial |
$12,016.34
|
| Rate for Payer: Anthem Medicaid |
$5,366.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$12,172.40
|
| Rate for Payer: Cash Price |
$7,802.82
|
| Rate for Payer: Cigna Commercial |
$12,952.68
|
| Rate for Payer: First Health Commercial |
$14,825.36
|
| Rate for Payer: Humana Commercial |
$13,264.79
|
| Rate for Payer: Humana KY Medicaid |
$5,366.78
|
| Rate for Payer: Kentucky WC Medicaid |
$5,421.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$12,796.62
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$11,516.96
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$4,681.69
|
| Rate for Payer: Molina Healthcare Medicaid |
$5,474.46
|
| Rate for Payer: Ohio Health Choice Commercial |
$13,732.96
|
| Rate for Payer: Ohio Health Group HMO |
$11,704.23
|
| Rate for Payer: Ohio Health Group PPO Differential |
$12,484.51
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$13,576.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$10,767.89
|
| Rate for Payer: PHCS Commercial |
$14,981.41
|
| Rate for Payer: United Healthcare All Payer |
$13,732.96
|
|
|
ECH CEM FEM COMP SZ 12 225MM
|
Facility
|
IP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECH CEM FEM COMP SZ 12 225MM
|
Facility
|
OP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem Medicaid |
$8,399.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Humana KY Medicaid |
$8,399.63
|
| Rate for Payer: Kentucky WC Medicaid |
$8,485.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,568.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECH CEM FEM COMP SZ 14 175MM
|
Facility
|
OP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem Medicaid |
$8,399.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Humana KY Medicaid |
$8,399.63
|
| Rate for Payer: Kentucky WC Medicaid |
$8,485.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,568.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECH CEM FEM COMP SZ 14 175MM
|
Facility
|
IP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECH CEM FEM COMP SZ 14 225MM
|
Facility
|
OP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem Medicaid |
$8,399.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Humana KY Medicaid |
$8,399.63
|
| Rate for Payer: Kentucky WC Medicaid |
$8,485.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,568.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECH CEM FEM COMP SZ 14 225MM
|
Facility
|
IP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECH CEM FEM COMP SZ 16 175MM
|
Facility
|
OP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem Medicaid |
$8,399.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Humana KY Medicaid |
$8,399.63
|
| Rate for Payer: Kentucky WC Medicaid |
$8,485.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,568.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECH CEM FEM COMP SZ 16 175MM
|
Facility
|
IP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECH CEM FEM COMP SZ 16 225MM
|
Facility
|
OP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem Medicaid |
$8,399.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Humana KY Medicaid |
$8,399.63
|
| Rate for Payer: Kentucky WC Medicaid |
$8,485.11
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Molina Healthcare Medicaid |
$8,568.16
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECH CEM FEM COMP SZ 16 225MM
|
Facility
|
IP
|
$24,424.62
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,327.39 |
| Max. Negotiated Rate |
$23,447.64 |
| Rate for Payer: Aetna Commercial |
$18,806.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$19,051.20
|
| Rate for Payer: Cash Price |
$12,212.31
|
| Rate for Payer: Cigna Commercial |
$20,272.43
|
| Rate for Payer: First Health Commercial |
$23,203.39
|
| Rate for Payer: Humana Commercial |
$20,760.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$20,028.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$18,025.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,327.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$21,493.67
|
| Rate for Payer: Ohio Health Group HMO |
$18,318.47
|
| Rate for Payer: Ohio Health Group PPO Differential |
$19,539.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$21,249.42
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$16,852.99
|
| Rate for Payer: PHCS Commercial |
$23,447.64
|
| Rate for Payer: United Healthcare All Payer |
$21,493.67
|
|
|
ECHELN FEM COMP BOW SZ12L 300M
|
Facility
|
OP
|
$26,435.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,930.78 |
| Max. Negotiated Rate |
$25,378.50 |
| Rate for Payer: Aetna Commercial |
$20,355.67
|
| Rate for Payer: Anthem Medicaid |
$9,091.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,620.03
|
| Rate for Payer: Cash Price |
$13,217.97
|
| Rate for Payer: Cigna Commercial |
$21,941.83
|
| Rate for Payer: First Health Commercial |
$25,114.14
|
| Rate for Payer: Humana Commercial |
$22,470.55
|
| Rate for Payer: Humana KY Medicaid |
$9,091.32
|
| Rate for Payer: Kentucky WC Medicaid |
$9,183.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,677.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,509.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,930.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,273.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,263.63
|
| Rate for Payer: Ohio Health Group HMO |
$19,826.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,148.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,999.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,240.80
|
| Rate for Payer: PHCS Commercial |
$25,378.50
|
| Rate for Payer: United Healthcare All Payer |
$23,263.63
|
|
|
ECHELN FEM COMP BOW SZ12L 300M
|
Facility
|
IP
|
$26,435.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,930.78 |
| Max. Negotiated Rate |
$25,378.50 |
| Rate for Payer: Aetna Commercial |
$20,355.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,620.03
|
| Rate for Payer: Cash Price |
$13,217.97
|
| Rate for Payer: Cigna Commercial |
$21,941.83
|
| Rate for Payer: First Health Commercial |
$25,114.14
|
| Rate for Payer: Humana Commercial |
$22,470.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,677.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,509.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,930.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,263.63
|
| Rate for Payer: Ohio Health Group HMO |
$19,826.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,148.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,999.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,240.80
|
| Rate for Payer: PHCS Commercial |
$25,378.50
|
| Rate for Payer: United Healthcare All Payer |
$23,263.63
|
|
|
ECHELN FEM COMP BOW SZ12R 300M
|
Facility
|
OP
|
$26,435.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,930.78 |
| Max. Negotiated Rate |
$25,378.50 |
| Rate for Payer: Aetna Commercial |
$20,355.67
|
| Rate for Payer: Anthem Medicaid |
$9,091.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,620.03
|
| Rate for Payer: Cash Price |
$13,217.97
|
| Rate for Payer: Cigna Commercial |
$21,941.83
|
| Rate for Payer: First Health Commercial |
$25,114.14
|
| Rate for Payer: Humana Commercial |
$22,470.55
|
| Rate for Payer: Humana KY Medicaid |
$9,091.32
|
| Rate for Payer: Kentucky WC Medicaid |
$9,183.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,677.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,509.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,930.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,273.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,263.63
|
| Rate for Payer: Ohio Health Group HMO |
$19,826.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,148.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,999.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,240.80
|
| Rate for Payer: PHCS Commercial |
$25,378.50
|
| Rate for Payer: United Healthcare All Payer |
$23,263.63
|
|
|
ECHELN FEM COMP BOW SZ12R 300M
|
Facility
|
IP
|
$26,435.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,930.78 |
| Max. Negotiated Rate |
$25,378.50 |
| Rate for Payer: Aetna Commercial |
$20,355.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,620.03
|
| Rate for Payer: Cash Price |
$13,217.97
|
| Rate for Payer: Cigna Commercial |
$21,941.83
|
| Rate for Payer: First Health Commercial |
$25,114.14
|
| Rate for Payer: Humana Commercial |
$22,470.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,677.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,509.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,930.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,263.63
|
| Rate for Payer: Ohio Health Group HMO |
$19,826.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,148.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,999.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,240.80
|
| Rate for Payer: PHCS Commercial |
$25,378.50
|
| Rate for Payer: United Healthcare All Payer |
$23,263.63
|
|
|
ECHELN FEM COMP BOW SZ14L 300M
|
Facility
|
IP
|
$26,435.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,930.78 |
| Max. Negotiated Rate |
$25,378.50 |
| Rate for Payer: Aetna Commercial |
$20,355.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,620.03
|
| Rate for Payer: Cash Price |
$13,217.97
|
| Rate for Payer: Cigna Commercial |
$21,941.83
|
| Rate for Payer: First Health Commercial |
$25,114.14
|
| Rate for Payer: Humana Commercial |
$22,470.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,677.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,509.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,930.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,263.63
|
| Rate for Payer: Ohio Health Group HMO |
$19,826.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,148.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,999.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,240.80
|
| Rate for Payer: PHCS Commercial |
$25,378.50
|
| Rate for Payer: United Healthcare All Payer |
$23,263.63
|
|
|
ECHELN FEM COMP BOW SZ14L 300M
|
Facility
|
OP
|
$26,435.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,930.78 |
| Max. Negotiated Rate |
$25,378.50 |
| Rate for Payer: Aetna Commercial |
$20,355.67
|
| Rate for Payer: Anthem Medicaid |
$9,091.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,620.03
|
| Rate for Payer: Cash Price |
$13,217.97
|
| Rate for Payer: Cigna Commercial |
$21,941.83
|
| Rate for Payer: First Health Commercial |
$25,114.14
|
| Rate for Payer: Humana Commercial |
$22,470.55
|
| Rate for Payer: Humana KY Medicaid |
$9,091.32
|
| Rate for Payer: Kentucky WC Medicaid |
$9,183.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,677.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,509.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,930.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,273.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,263.63
|
| Rate for Payer: Ohio Health Group HMO |
$19,826.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,148.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,999.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,240.80
|
| Rate for Payer: PHCS Commercial |
$25,378.50
|
| Rate for Payer: United Healthcare All Payer |
$23,263.63
|
|
|
ECHELN FEM COMP BOW SZ14R 300M
|
Facility
|
OP
|
$26,435.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,930.78 |
| Max. Negotiated Rate |
$25,378.50 |
| Rate for Payer: Aetna Commercial |
$20,355.67
|
| Rate for Payer: Anthem Medicaid |
$9,091.32
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,620.03
|
| Rate for Payer: Cash Price |
$13,217.97
|
| Rate for Payer: Cigna Commercial |
$21,941.83
|
| Rate for Payer: First Health Commercial |
$25,114.14
|
| Rate for Payer: Humana Commercial |
$22,470.55
|
| Rate for Payer: Humana KY Medicaid |
$9,091.32
|
| Rate for Payer: Kentucky WC Medicaid |
$9,183.85
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,677.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,509.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,930.78
|
| Rate for Payer: Molina Healthcare Medicaid |
$9,273.73
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,263.63
|
| Rate for Payer: Ohio Health Group HMO |
$19,826.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,148.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,999.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,240.80
|
| Rate for Payer: PHCS Commercial |
$25,378.50
|
| Rate for Payer: United Healthcare All Payer |
$23,263.63
|
|
|
ECHELN FEM COMP BOW SZ14R 300M
|
Facility
|
IP
|
$26,435.94
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,930.78 |
| Max. Negotiated Rate |
$25,378.50 |
| Rate for Payer: Aetna Commercial |
$20,355.67
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$20,620.03
|
| Rate for Payer: Cash Price |
$13,217.97
|
| Rate for Payer: Cigna Commercial |
$21,941.83
|
| Rate for Payer: First Health Commercial |
$25,114.14
|
| Rate for Payer: Humana Commercial |
$22,470.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$21,677.47
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$19,509.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$7,930.78
|
| Rate for Payer: Ohio Health Choice Commercial |
$23,263.63
|
| Rate for Payer: Ohio Health Group HMO |
$19,826.96
|
| Rate for Payer: Ohio Health Group PPO Differential |
$21,148.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$22,999.27
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$18,240.80
|
| Rate for Payer: PHCS Commercial |
$25,378.50
|
| Rate for Payer: United Healthcare All Payer |
$23,263.63
|
|
|
ECHELON PP HA SZ 11 190MM
|
Facility
|
IP
|
$30,222.69
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,066.81 |
| Max. Negotiated Rate |
$29,013.78 |
| Rate for Payer: Aetna Commercial |
$23,271.47
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,573.70
|
| Rate for Payer: Cash Price |
$15,111.34
|
| Rate for Payer: Cigna Commercial |
$25,084.83
|
| Rate for Payer: First Health Commercial |
$28,711.56
|
| Rate for Payer: Humana Commercial |
$25,689.29
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,782.61
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,304.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,066.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,595.97
|
| Rate for Payer: Ohio Health Group HMO |
$22,667.02
|
| Rate for Payer: Ohio Health Group PPO Differential |
$24,178.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$26,293.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$20,853.66
|
| Rate for Payer: PHCS Commercial |
$29,013.78
|
| Rate for Payer: United Healthcare All Payer |
$26,595.97
|
|
|
ECHELON PP HA SZ 11 190MM
|
Facility
|
OP
|
$30,222.69
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,066.81 |
| Max. Negotiated Rate |
$29,013.78 |
| Rate for Payer: Aetna Commercial |
$23,271.47
|
| Rate for Payer: Anthem Medicaid |
$10,393.58
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$23,573.70
|
| Rate for Payer: Cash Price |
$15,111.34
|
| Rate for Payer: Cigna Commercial |
$25,084.83
|
| Rate for Payer: First Health Commercial |
$28,711.56
|
| Rate for Payer: Humana Commercial |
$25,689.29
|
| Rate for Payer: Humana KY Medicaid |
$10,393.58
|
| Rate for Payer: Kentucky WC Medicaid |
$10,499.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$24,782.61
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$22,304.35
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,066.81
|
| Rate for Payer: Molina Healthcare Medicaid |
$10,602.12
|
| Rate for Payer: Ohio Health Choice Commercial |
$26,595.97
|
| Rate for Payer: Ohio Health Group HMO |
$22,667.02
|
| Rate for Payer: Ohio Health Group PPO Differential |
$24,178.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$26,293.74
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$20,853.66
|
| Rate for Payer: PHCS Commercial |
$29,013.78
|
| Rate for Payer: United Healthcare All Payer |
$26,595.97
|
|
