|
ECH POR 190MM STR SZ 20
|
Facility
|
IP
|
$28,756.44
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,626.93 |
| Max. Negotiated Rate |
$27,606.18 |
| Rate for Payer: Aetna Commercial |
$22,142.46
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$22,430.02
|
| Rate for Payer: Cash Price |
$14,378.22
|
| Rate for Payer: Cigna Commercial |
$23,867.85
|
| Rate for Payer: First Health Commercial |
$27,318.62
|
| Rate for Payer: Humana Commercial |
$24,442.97
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$23,580.28
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$21,222.25
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$8,626.93
|
| Rate for Payer: Ohio Health Choice Commercial |
$25,305.67
|
| Rate for Payer: Ohio Health Group HMO |
$21,567.33
|
| Rate for Payer: Ohio Health Group PPO Differential |
$23,005.15
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$25,018.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$19,841.94
|
| Rate for Payer: PHCS Commercial |
$27,606.18
|
| Rate for Payer: United Healthcare All Payer |
$25,305.67
|
|
|
ECH POR 260BW 15 CAL SZ 12L
|
Facility
|
IP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 12L
|
Facility
|
OP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem Medicaid |
$10,873.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Humana KY Medicaid |
$10,873.71
|
| Rate for Payer: Kentucky WC Medicaid |
$10,984.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,091.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 12R
|
Facility
|
OP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem Medicaid |
$10,833.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Humana KY Medicaid |
$10,833.15
|
| Rate for Payer: Kentucky WC Medicaid |
$10,943.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,050.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 12R
|
Facility
|
IP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 13L
|
Facility
|
OP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem Medicaid |
$10,873.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Humana KY Medicaid |
$10,873.71
|
| Rate for Payer: Kentucky WC Medicaid |
$10,984.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,091.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 13L
|
Facility
|
IP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 13R
|
Facility
|
IP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 13R
|
Facility
|
OP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem Medicaid |
$10,833.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Humana KY Medicaid |
$10,833.15
|
| Rate for Payer: Kentucky WC Medicaid |
$10,943.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,050.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 14L
|
Facility
|
IP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 14L
|
Facility
|
OP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem Medicaid |
$10,873.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Humana KY Medicaid |
$10,873.71
|
| Rate for Payer: Kentucky WC Medicaid |
$10,984.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,091.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 14R
|
Facility
|
IP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 14R
|
Facility
|
OP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem Medicaid |
$10,833.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Humana KY Medicaid |
$10,833.15
|
| Rate for Payer: Kentucky WC Medicaid |
$10,943.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,050.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 15L
|
Facility
|
IP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 15L
|
Facility
|
OP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem Medicaid |
$10,873.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Humana KY Medicaid |
$10,873.71
|
| Rate for Payer: Kentucky WC Medicaid |
$10,984.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,091.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 15R
|
Facility
|
OP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem Medicaid |
$10,833.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Humana KY Medicaid |
$10,833.15
|
| Rate for Payer: Kentucky WC Medicaid |
$10,943.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,050.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 15R
|
Facility
|
IP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 16L
|
Facility
|
IP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 16L
|
Facility
|
OP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem Medicaid |
$10,873.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Humana KY Medicaid |
$10,873.71
|
| Rate for Payer: Kentucky WC Medicaid |
$10,984.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,091.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 16R
|
Facility
|
IP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 16R
|
Facility
|
OP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem Medicaid |
$10,833.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Humana KY Medicaid |
$10,833.15
|
| Rate for Payer: Kentucky WC Medicaid |
$10,943.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,050.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 17L
|
Facility
|
OP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem Medicaid |
$10,873.71
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Humana KY Medicaid |
$10,873.71
|
| Rate for Payer: Kentucky WC Medicaid |
$10,984.37
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,091.88
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 17L
|
Facility
|
IP
|
$31,618.81
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,485.64 |
| Max. Negotiated Rate |
$30,354.06 |
| Rate for Payer: Aetna Commercial |
$24,346.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,662.67
|
| Rate for Payer: Cash Price |
$15,809.41
|
| Rate for Payer: Cigna Commercial |
$26,243.61
|
| Rate for Payer: First Health Commercial |
$30,037.87
|
| Rate for Payer: Humana Commercial |
$26,875.99
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,927.42
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,334.68
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,485.64
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,824.55
|
| Rate for Payer: Ohio Health Group HMO |
$23,714.11
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,295.05
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,508.36
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,816.98
|
| Rate for Payer: PHCS Commercial |
$30,354.06
|
| Rate for Payer: United Healthcare All Payer |
$27,824.55
|
|
|
ECH POR 260BW 15 CAL SZ 17R
|
Facility
|
OP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem Medicaid |
$10,833.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Humana KY Medicaid |
$10,833.15
|
| Rate for Payer: Kentucky WC Medicaid |
$10,943.41
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Molina Healthcare Medicaid |
$11,050.51
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
|
ECH POR 260BW 15 CAL SZ 17R
|
Facility
|
IP
|
$31,500.88
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,450.26 |
| Max. Negotiated Rate |
$30,240.84 |
| Rate for Payer: Aetna Commercial |
$24,255.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$24,570.69
|
| Rate for Payer: Cash Price |
$15,750.44
|
| Rate for Payer: Cigna Commercial |
$26,145.73
|
| Rate for Payer: First Health Commercial |
$29,925.84
|
| Rate for Payer: Humana Commercial |
$26,775.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$25,830.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$23,247.65
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$9,450.26
|
| Rate for Payer: Ohio Health Choice Commercial |
$27,720.77
|
| Rate for Payer: Ohio Health Group HMO |
$23,625.66
|
| Rate for Payer: Ohio Health Group PPO Differential |
$25,200.70
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$27,405.77
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$21,735.61
|
| Rate for Payer: PHCS Commercial |
$30,240.84
|
| Rate for Payer: United Healthcare All Payer |
$27,720.77
|
|
