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Service Code HCPCS 43220
Hospital Charge Code 761T1732
Hospital Revenue Code 761
Min. Negotiated Rate $406.95
Max. Negotiated Rate $3,005.18
Rate for Payer: Aetna Commercial $2,410.41
Rate for Payer: Anthem POS/PPO/Traditional $2,441.71
Rate for Payer: Cash Price $1,565.20
Rate for Payer: Cigna Commercial $2,598.23
Rate for Payer: First Health Commercial $2,973.88
Rate for Payer: Humana Commercial $2,660.84
Rate for Payer: Medical Mutual Of Ohio HMO $2,566.93
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,310.24
Rate for Payer: Molina Healthcare Benefit Exchange $939.12
Rate for Payer: Ohio Health Choice Commercial $2,754.75
Rate for Payer: Ohio Health Group HMO $2,347.80
Rate for Payer: Ohio Health Group PPO Differential $626.08
Rate for Payer: Ohio Health Group PPO No Differential $406.95
Rate for Payer: Ohio Health Group PPO SOMC Employees $970.42
Rate for Payer: PHCS Commercial $3,005.18
Rate for Payer: United Healthcare All Payer $2,754.75
Service Code CPT 43229
Hospital Revenue Code 360
Min. Negotiated Rate $3,311.80
Max. Negotiated Rate $4,636.52
Rate for Payer: Anthem Medicare Advantage/PPO $3,311.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $4,636.52
Rate for Payer: CareSource Just4Me Medicare $4,470.93
Rate for Payer: Humana Medicare Advantage $3,311.80
Rate for Payer: Molina Healthcare Benefit Exchange $3,974.16
Service Code HCPCS 43229
Hospital Charge Code 76101733
Hospital Revenue Code 761
Min. Negotiated Rate $160.90
Max. Negotiated Rate $938.67
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $160.90
Rate for Payer: Anthem Medicaid $167.11
Rate for Payer: Buckeye Medicare Advantage $405.00
Rate for Payer: Cash Price $202.50
Rate for Payer: Cash Price $202.50
Rate for Payer: Cigna Commercial $344.54
Rate for Payer: Healthspan PPO $938.67
Rate for Payer: Humana Medicaid $167.11
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $270.44
Rate for Payer: Molina Healthcare CHIP/Medicaid $170.45
Rate for Payer: Molina Healthcare Passport $167.11
Rate for Payer: Multiplan PHCS $243.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $283.50
Rate for Payer: UHCCP Medicaid $168.94
Rate for Payer: Wellcare CHIP/Medicaid $168.78
Service Code HCPCS 43229
Hospital Charge Code 76101733
Hospital Revenue Code 761
Min. Negotiated Rate $52.65
Max. Negotiated Rate $4,636.52
Rate for Payer: Aetna Commercial $311.85
Rate for Payer: Anthem Medicaid $139.28
Rate for Payer: Anthem Medicare Advantage/PPO $3,311.80
Rate for Payer: Anthem POS/PPO/Traditional $315.90
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $4,636.52
Rate for Payer: CareSource Just4Me Medicare $4,470.93
Rate for Payer: Cash Price $202.50
Rate for Payer: Cash Price $202.50
Rate for Payer: Cigna Commercial $336.15
Rate for Payer: First Health Commercial $384.75
Rate for Payer: Humana Commercial $344.25
Rate for Payer: Humana KY Medicaid $139.28
Rate for Payer: Humana Medicare Advantage $3,311.80
Rate for Payer: Kentucky WC Medicaid $140.70
Rate for Payer: Medical Mutual Of Ohio HMO $332.10
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $298.89
Rate for Payer: Molina Healthcare Benefit Exchange $3,974.16
Rate for Payer: Molina Healthcare Medicaid $142.07
Rate for Payer: Ohio Health Choice Commercial $356.40
Rate for Payer: Ohio Health Group HMO $303.75
Rate for Payer: Ohio Health Group PPO Differential $81.00
Rate for Payer: Ohio Health Group PPO No Differential $52.65
Rate for Payer: Ohio Health Group PPO SOMC Employees $125.55
Rate for Payer: PHCS Commercial $388.80
Rate for Payer: United Healthcare All Payer $356.40
Service Code HCPCS 43229
Hospital Charge Code 76101733
Hospital Revenue Code 761
Min. Negotiated Rate $52.65
Max. Negotiated Rate $388.80
Rate for Payer: Aetna Commercial $311.85
Rate for Payer: Anthem POS/PPO/Traditional $315.90
Rate for Payer: Cash Price $202.50
Rate for Payer: Cigna Commercial $336.15
Rate for Payer: First Health Commercial $384.75
Rate for Payer: Humana Commercial $344.25
Rate for Payer: Medical Mutual Of Ohio HMO $332.10
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $298.89
Rate for Payer: Molina Healthcare Benefit Exchange $121.50
Rate for Payer: Ohio Health Choice Commercial $356.40
Rate for Payer: Ohio Health Group HMO $303.75
Rate for Payer: Ohio Health Group PPO Differential $81.00
Rate for Payer: Ohio Health Group PPO No Differential $52.65
Rate for Payer: Ohio Health Group PPO SOMC Employees $125.55
Rate for Payer: PHCS Commercial $388.80
Rate for Payer: United Healthcare All Payer $356.40
Service Code HCPCS 43229
Hospital Charge Code 761P1733
Hospital Revenue Code 761
Min. Negotiated Rate $160.90
Max. Negotiated Rate $938.67
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $160.90
Rate for Payer: Anthem Medicaid $167.11
Rate for Payer: Buckeye Medicare Advantage $405.00
Rate for Payer: Cash Price $202.50
Rate for Payer: Cash Price $202.50
Rate for Payer: Cigna Commercial $344.54
Rate for Payer: Healthspan PPO $938.67
Rate for Payer: Humana Medicaid $167.11
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $270.44
Rate for Payer: Molina Healthcare CHIP/Medicaid $170.45
Rate for Payer: Molina Healthcare Passport $167.11
Rate for Payer: Multiplan PHCS $243.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $283.50
Rate for Payer: UHCCP Medicaid $168.94
Rate for Payer: Wellcare CHIP/Medicaid $168.78
Service Code HCPCS 43200
Hospital Charge Code 761P1726
Hospital Revenue Code 761
Min. Negotiated Rate $87.50
Max. Negotiated Rate $550.00
Rate for Payer: Aetna Commercial $155.63
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $87.50
Rate for Payer: Anthem Medicaid $107.69
Rate for Payer: Buckeye Medicare Advantage $550.00
Rate for Payer: Cash Price $275.00
Rate for Payer: Cash Price $275.00
Rate for Payer: Cigna Commercial $149.16
Rate for Payer: Healthspan PPO $255.38
Rate for Payer: Humana Medicaid $107.69
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $135.80
Rate for Payer: Molina Healthcare CHIP/Medicaid $109.84
Rate for Payer: Molina Healthcare Passport $107.69
Rate for Payer: Multiplan PHCS $330.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $385.00
Rate for Payer: UHCCP Medicaid $91.88
Rate for Payer: Wellcare CHIP/Medicaid $108.77
Service Code HCPCS 43202
Hospital Charge Code 761P1728
Hospital Revenue Code 761
Min. Negotiated Rate $97.44
Max. Negotiated Rate $550.00
Rate for Payer: Aetna Commercial $173.30
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $97.44
Rate for Payer: Anthem Medicaid $127.63
Rate for Payer: Buckeye Medicare Advantage $550.00
Rate for Payer: Cash Price $275.00
Rate for Payer: Cash Price $275.00
Rate for Payer: Cigna Commercial $161.26
Rate for Payer: Healthspan PPO $334.37
Rate for Payer: Humana Medicaid $127.63
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $150.35
Rate for Payer: Molina Healthcare CHIP/Medicaid $130.18
Rate for Payer: Molina Healthcare Passport $127.63
Rate for Payer: Multiplan PHCS $330.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $385.00
Rate for Payer: UHCCP Medicaid $102.31
Rate for Payer: Wellcare CHIP/Medicaid $128.91
Service Code HCPCS 43215
Hospital Charge Code 76101730
Hospital Revenue Code 761
Min. Negotiated Rate $132.01
Max. Negotiated Rate $4,152.00
Rate for Payer: Aetna Commercial $234.81
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $132.01
Rate for Payer: Anthem Medicaid $176.79
Rate for Payer: Buckeye Medicare Advantage $4,152.00
Rate for Payer: Cash Price $2,076.00
Rate for Payer: Cash Price $2,076.00
Rate for Payer: Cigna Commercial $217.90
Rate for Payer: Healthspan PPO $198.02
Rate for Payer: Humana Medicaid $176.79
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $202.12
Rate for Payer: Molina Healthcare CHIP/Medicaid $180.33
Rate for Payer: Molina Healthcare Passport $176.79
Rate for Payer: Multiplan PHCS $2,491.20
Rate for Payer: Ohio Health Choice Preferred Health Choice $2,906.40
Rate for Payer: UHCCP Medicaid $138.61
Rate for Payer: Wellcare CHIP/Medicaid $178.56
Service Code HCPCS 43215
Hospital Charge Code 761T1730
Hospital Revenue Code 761
Min. Negotiated Rate $429.26
Max. Negotiated Rate $3,169.92
Rate for Payer: Aetna Commercial $2,542.54
Rate for Payer: Anthem Medicaid $1,135.56
Rate for Payer: Anthem Medicare Advantage/PPO $1,645.47
Rate for Payer: Anthem POS/PPO/Traditional $2,575.56
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $2,303.66
Rate for Payer: CareSource Just4Me Medicare $2,221.38
Rate for Payer: Cash Price $1,651.00
Rate for Payer: Cash Price $1,651.00
Rate for Payer: Cigna Commercial $2,740.66
Rate for Payer: First Health Commercial $3,136.90
Rate for Payer: Humana Commercial $2,806.70
Rate for Payer: Humana KY Medicaid $1,135.56
Rate for Payer: Humana Medicare Advantage $1,645.47
Rate for Payer: Kentucky WC Medicaid $1,147.11
Rate for Payer: Medical Mutual Of Ohio HMO $2,707.64
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,436.88
Rate for Payer: Molina Healthcare Benefit Exchange $1,974.56
Rate for Payer: Molina Healthcare Medicaid $1,158.34
Rate for Payer: Ohio Health Choice Commercial $2,905.76
Rate for Payer: Ohio Health Group HMO $2,476.50
Rate for Payer: Ohio Health Group PPO Differential $660.40
Rate for Payer: Ohio Health Group PPO No Differential $429.26
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,023.62
Rate for Payer: PHCS Commercial $3,169.92
Rate for Payer: United Healthcare All Payer $2,905.76
Service Code HCPCS 43215
Hospital Charge Code 761T1730
Hospital Revenue Code 761
Min. Negotiated Rate $429.26
Max. Negotiated Rate $3,169.92
Rate for Payer: Aetna Commercial $2,542.54
Rate for Payer: Anthem POS/PPO/Traditional $2,575.56
Rate for Payer: Cash Price $1,651.00
Rate for Payer: Cigna Commercial $2,740.66
Rate for Payer: First Health Commercial $3,136.90
Rate for Payer: Humana Commercial $2,806.70
Rate for Payer: Medical Mutual Of Ohio HMO $2,707.64
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,436.88
Rate for Payer: Molina Healthcare Benefit Exchange $990.60
Rate for Payer: Ohio Health Choice Commercial $2,905.76
Rate for Payer: Ohio Health Group HMO $2,476.50
Rate for Payer: Ohio Health Group PPO Differential $660.40
Rate for Payer: Ohio Health Group PPO No Differential $429.26
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,023.62
Rate for Payer: PHCS Commercial $3,169.92
Rate for Payer: United Healthcare All Payer $2,905.76
Service Code HCPCS 43215
Hospital Charge Code 76101730
Hospital Revenue Code 761
Min. Negotiated Rate $539.76
Max. Negotiated Rate $3,985.92
Rate for Payer: Aetna Commercial $3,197.04
Rate for Payer: Anthem POS/PPO/Traditional $3,238.56
Rate for Payer: Cash Price $2,076.00
Rate for Payer: Cigna Commercial $3,446.16
Rate for Payer: First Health Commercial $3,944.40
Rate for Payer: Humana Commercial $3,529.20
Rate for Payer: Medical Mutual Of Ohio HMO $3,404.64
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,064.18
Rate for Payer: Molina Healthcare Benefit Exchange $1,245.60
Rate for Payer: Ohio Health Choice Commercial $3,653.76
Rate for Payer: Ohio Health Group HMO $3,114.00
Rate for Payer: Ohio Health Group PPO Differential $830.40
Rate for Payer: Ohio Health Group PPO No Differential $539.76
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,287.12
Rate for Payer: PHCS Commercial $3,985.92
Rate for Payer: United Healthcare All Payer $3,653.76
Service Code HCPCS 43215
Hospital Charge Code 76101730
Hospital Revenue Code 761
Min. Negotiated Rate $539.76
Max. Negotiated Rate $3,985.92
Rate for Payer: Aetna Commercial $3,197.04
Rate for Payer: Anthem Medicaid $1,427.87
Rate for Payer: Anthem Medicare Advantage/PPO $1,645.47
Rate for Payer: Anthem POS/PPO/Traditional $3,238.56
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $2,303.66
Rate for Payer: CareSource Just4Me Medicare $2,221.38
Rate for Payer: Cash Price $2,076.00
Rate for Payer: Cash Price $2,076.00
Rate for Payer: Cigna Commercial $3,446.16
Rate for Payer: First Health Commercial $3,944.40
Rate for Payer: Humana Commercial $3,529.20
Rate for Payer: Humana KY Medicaid $1,427.87
Rate for Payer: Humana Medicare Advantage $1,645.47
Rate for Payer: Kentucky WC Medicaid $1,442.40
Rate for Payer: Medical Mutual Of Ohio HMO $3,404.64
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3,064.18
Rate for Payer: Molina Healthcare Benefit Exchange $1,974.56
Rate for Payer: Molina Healthcare Medicaid $1,456.52
Rate for Payer: Ohio Health Choice Commercial $3,653.76
Rate for Payer: Ohio Health Group HMO $3,114.00
Rate for Payer: Ohio Health Group PPO Differential $830.40
Rate for Payer: Ohio Health Group PPO No Differential $539.76
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,287.12
Rate for Payer: PHCS Commercial $3,985.92
Rate for Payer: United Healthcare All Payer $3,653.76
Service Code HCPCS 43215
Hospital Charge Code 761P1730
Hospital Revenue Code 761
Min. Negotiated Rate $132.01
Max. Negotiated Rate $850.00
Rate for Payer: Aetna Commercial $234.81
Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional $132.01
Rate for Payer: Anthem Medicaid $176.79
Rate for Payer: Buckeye Medicare Advantage $850.00
Rate for Payer: Cash Price $425.00
Rate for Payer: Cash Price $425.00
Rate for Payer: Cigna Commercial $217.90
Rate for Payer: Healthspan PPO $198.02
Rate for Payer: Humana Medicaid $176.79
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $202.12
Rate for Payer: Molina Healthcare CHIP/Medicaid $180.33
Rate for Payer: Molina Healthcare Passport $176.79
Rate for Payer: Multiplan PHCS $510.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $595.00
Rate for Payer: UHCCP Medicaid $138.61
Rate for Payer: Wellcare CHIP/Medicaid $178.56
Service Code HCPCS 43195
Hospital Charge Code 76101725
Hospital Revenue Code 761
Min. Negotiated Rate $50.05
Max. Negotiated Rate $4,636.52
Rate for Payer: Aetna Commercial $296.45
Rate for Payer: Anthem Medicaid $132.40
Rate for Payer: Anthem Medicare Advantage/PPO $3,311.80
Rate for Payer: Anthem POS/PPO/Traditional $300.30
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $4,636.52
Rate for Payer: CareSource Just4Me Medicare $4,470.93
Rate for Payer: Cash Price $192.50
Rate for Payer: Cash Price $192.50
Rate for Payer: Cigna Commercial $319.55
Rate for Payer: First Health Commercial $365.75
Rate for Payer: Humana Commercial $327.25
Rate for Payer: Humana KY Medicaid $132.40
Rate for Payer: Humana Medicare Advantage $3,311.80
Rate for Payer: Kentucky WC Medicaid $133.75
Rate for Payer: Medical Mutual Of Ohio HMO $315.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $284.13
Rate for Payer: Molina Healthcare Benefit Exchange $3,974.16
Rate for Payer: Molina Healthcare Medicaid $135.06
Rate for Payer: Ohio Health Choice Commercial $338.80
Rate for Payer: Ohio Health Group HMO $288.75
Rate for Payer: Ohio Health Group PPO Differential $77.00
Rate for Payer: Ohio Health Group PPO No Differential $50.05
Rate for Payer: Ohio Health Group PPO SOMC Employees $119.35
Rate for Payer: PHCS Commercial $369.60
Rate for Payer: United Healthcare All Payer $338.80
Service Code HCPCS 43195
Hospital Charge Code 76101725
Hospital Revenue Code 761
Min. Negotiated Rate $50.05
Max. Negotiated Rate $369.60
Rate for Payer: First Health Commercial $365.75
Rate for Payer: Aetna Commercial $296.45
Rate for Payer: Anthem POS/PPO/Traditional $300.30
Rate for Payer: Cash Price $192.50
Rate for Payer: Cigna Commercial $319.55
Rate for Payer: Humana Commercial $327.25
Rate for Payer: Medical Mutual Of Ohio HMO $315.70
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $284.13
Rate for Payer: Molina Healthcare Benefit Exchange $115.50
Rate for Payer: Ohio Health Choice Commercial $338.80
Rate for Payer: Ohio Health Group HMO $288.75
Rate for Payer: Ohio Health Group PPO Differential $77.00
Rate for Payer: Ohio Health Group PPO No Differential $50.05
Rate for Payer: Ohio Health Group PPO SOMC Employees $119.35
Rate for Payer: PHCS Commercial $369.60
Rate for Payer: United Healthcare All Payer $338.80
Service Code HCPCS 43195
Hospital Charge Code 76101725
Hospital Revenue Code 761
Min. Negotiated Rate $134.75
Max. Negotiated Rate $385.00
Rate for Payer: Anthem Medicaid $144.48
Rate for Payer: Buckeye Medicare Advantage $385.00
Rate for Payer: Cash Price $192.50
Rate for Payer: Cash Price $192.50
Rate for Payer: Cigna Commercial $297.01
Rate for Payer: Healthspan PPO $245.39
Rate for Payer: Humana Medicaid $144.48
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $231.98
Rate for Payer: Molina Healthcare CHIP/Medicaid $147.37
Rate for Payer: Molina Healthcare Passport $144.48
Rate for Payer: Multiplan PHCS $231.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $269.50
Rate for Payer: UHCCP Medicaid $134.75
Rate for Payer: Wellcare CHIP/Medicaid $145.92
Service Code HCPCS 43195
Hospital Charge Code 761P1725
Hospital Revenue Code 761
Min. Negotiated Rate $134.75
Max. Negotiated Rate $385.00
Rate for Payer: Anthem Medicaid $144.48
Rate for Payer: Buckeye Medicare Advantage $385.00
Rate for Payer: Cash Price $192.50
Rate for Payer: Cash Price $192.50
Rate for Payer: Cigna Commercial $297.01
Rate for Payer: Healthspan PPO $245.39
Rate for Payer: Humana Medicaid $144.48
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $231.98
Rate for Payer: Molina Healthcare CHIP/Medicaid $147.37
Rate for Payer: Molina Healthcare Passport $144.48
Rate for Payer: Multiplan PHCS $231.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $269.50
Rate for Payer: UHCCP Medicaid $134.75
Rate for Payer: Wellcare CHIP/Medicaid $145.92
Service Code HCPCS 43191
Hospital Charge Code 761P1723
Hospital Revenue Code 761
Min. Negotiated Rate $101.16
Max. Negotiated Rate $355.00
Rate for Payer: Anthem Medicaid $101.16
Rate for Payer: Buckeye Medicare Advantage $355.00
Rate for Payer: Cash Price $177.50
Rate for Payer: Cash Price $177.50
Rate for Payer: Cigna Commercial $208.27
Rate for Payer: Healthspan PPO $171.90
Rate for Payer: Humana Medicaid $101.16
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $162.51
Rate for Payer: Molina Healthcare CHIP/Medicaid $103.18
Rate for Payer: Molina Healthcare Passport $101.16
Rate for Payer: Multiplan PHCS $213.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $248.50
Rate for Payer: UHCCP Medicaid $124.25
Rate for Payer: Wellcare CHIP/Medicaid $102.17
Service Code HCPCS 43191
Hospital Charge Code 76101723
Hospital Revenue Code 761
Min. Negotiated Rate $101.16
Max. Negotiated Rate $355.00
Rate for Payer: Anthem Medicaid $101.16
Rate for Payer: Buckeye Medicare Advantage $355.00
Rate for Payer: Cash Price $177.50
Rate for Payer: Cash Price $177.50
Rate for Payer: Cigna Commercial $208.27
Rate for Payer: Healthspan PPO $171.90
Rate for Payer: Humana Medicaid $101.16
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $162.51
Rate for Payer: Molina Healthcare CHIP/Medicaid $103.18
Rate for Payer: Molina Healthcare Passport $101.16
Rate for Payer: Multiplan PHCS $213.00
Rate for Payer: Ohio Health Choice Preferred Health Choice $248.50
Rate for Payer: UHCCP Medicaid $124.25
Rate for Payer: Wellcare CHIP/Medicaid $102.17
Service Code HCPCS 43191
Hospital Charge Code 76101723
Hospital Revenue Code 761
Min. Negotiated Rate $46.15
Max. Negotiated Rate $340.80
Rate for Payer: Aetna Commercial $273.35
Rate for Payer: Anthem POS/PPO/Traditional $276.90
Rate for Payer: Cash Price $177.50
Rate for Payer: Cigna Commercial $294.65
Rate for Payer: First Health Commercial $337.25
Rate for Payer: Humana Commercial $301.75
Rate for Payer: Medical Mutual Of Ohio HMO $291.10
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $261.99
Rate for Payer: Molina Healthcare Benefit Exchange $106.50
Rate for Payer: Ohio Health Choice Commercial $312.40
Rate for Payer: Ohio Health Group HMO $266.25
Rate for Payer: Ohio Health Group PPO Differential $71.00
Rate for Payer: Ohio Health Group PPO No Differential $46.15
Rate for Payer: Ohio Health Group PPO SOMC Employees $110.05
Rate for Payer: PHCS Commercial $340.80
Rate for Payer: United Healthcare All Payer $312.40
Service Code HCPCS 43191
Hospital Charge Code 76101723
Hospital Revenue Code 761
Min. Negotiated Rate $46.15
Max. Negotiated Rate $2,303.66
Rate for Payer: Aetna Commercial $273.35
Rate for Payer: Anthem Medicaid $122.08
Rate for Payer: Anthem Medicare Advantage/PPO $1,645.47
Rate for Payer: Anthem POS/PPO/Traditional $276.90
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $2,303.66
Rate for Payer: CareSource Just4Me Medicare $2,221.38
Rate for Payer: Cash Price $177.50
Rate for Payer: Cash Price $177.50
Rate for Payer: Cigna Commercial $294.65
Rate for Payer: First Health Commercial $337.25
Rate for Payer: Humana Commercial $301.75
Rate for Payer: Humana KY Medicaid $122.08
Rate for Payer: Humana Medicare Advantage $1,645.47
Rate for Payer: Kentucky WC Medicaid $123.33
Rate for Payer: Medical Mutual Of Ohio HMO $291.10
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $261.99
Rate for Payer: Molina Healthcare Benefit Exchange $1,974.56
Rate for Payer: Molina Healthcare Medicaid $124.53
Rate for Payer: Ohio Health Choice Commercial $312.40
Rate for Payer: Ohio Health Group HMO $266.25
Rate for Payer: Ohio Health Group PPO Differential $71.00
Rate for Payer: Ohio Health Group PPO No Differential $46.15
Rate for Payer: Ohio Health Group PPO SOMC Employees $110.05
Rate for Payer: PHCS Commercial $340.80
Rate for Payer: United Healthcare All Payer $312.40
Service Code HCPCS 43202
Hospital Charge Code 761T1728
Hospital Revenue Code 761
Min. Negotiated Rate $360.59
Max. Negotiated Rate $2,662.80
Rate for Payer: Aetna Commercial $2,135.79
Rate for Payer: Anthem POS/PPO/Traditional $2,163.52
Rate for Payer: Cash Price $1,386.88
Rate for Payer: Cigna Commercial $2,302.21
Rate for Payer: First Health Commercial $2,635.06
Rate for Payer: Humana Commercial $2,357.69
Rate for Payer: Medical Mutual Of Ohio HMO $2,274.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $2,047.03
Rate for Payer: Molina Healthcare Benefit Exchange $832.12
Rate for Payer: Ohio Health Choice Commercial $2,440.90
Rate for Payer: Ohio Health Group HMO $2,080.31
Rate for Payer: Ohio Health Group PPO Differential $554.75
Rate for Payer: Ohio Health Group PPO No Differential $360.59
Rate for Payer: Ohio Health Group PPO SOMC Employees $859.86
Rate for Payer: PHCS Commercial $2,662.80
Rate for Payer: United Healthcare All Payer $2,440.90
Service Code HCPCS 43200
Hospital Charge Code 761T1726
Hospital Revenue Code 761
Min. Negotiated Rate $348.94
Max. Negotiated Rate $2,576.76
Rate for Payer: Aetna Commercial $2,066.78
Rate for Payer: Anthem Medicaid $923.07
Rate for Payer: Anthem Medicare Advantage/PPO $783.89
Rate for Payer: Anthem POS/PPO/Traditional $2,093.62
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $1,097.45
Rate for Payer: CareSource Just4Me Medicare $1,058.25
Rate for Payer: Cash Price $1,342.07
Rate for Payer: Cash Price $1,342.07
Rate for Payer: Cigna Commercial $2,227.83
Rate for Payer: First Health Commercial $2,549.92
Rate for Payer: Humana Commercial $2,281.51
Rate for Payer: Humana KY Medicaid $923.07
Rate for Payer: Humana Medicare Advantage $783.89
Rate for Payer: Kentucky WC Medicaid $932.47
Rate for Payer: Medical Mutual Of Ohio HMO $2,200.99
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,980.89
Rate for Payer: Molina Healthcare Benefit Exchange $940.67
Rate for Payer: Molina Healthcare Medicaid $941.59
Rate for Payer: Ohio Health Choice Commercial $2,362.03
Rate for Payer: Ohio Health Group HMO $2,013.10
Rate for Payer: Ohio Health Group PPO Differential $536.83
Rate for Payer: Ohio Health Group PPO No Differential $348.94
Rate for Payer: Ohio Health Group PPO SOMC Employees $832.08
Rate for Payer: PHCS Commercial $2,576.76
Rate for Payer: United Healthcare All Payer $2,362.03
Service Code HCPCS 43200
Hospital Charge Code 761T1726
Hospital Revenue Code 761
Min. Negotiated Rate $348.94
Max. Negotiated Rate $2,576.76
Rate for Payer: Aetna Commercial $2,066.78
Rate for Payer: Anthem POS/PPO/Traditional $2,093.62
Rate for Payer: Cash Price $1,342.07
Rate for Payer: Cigna Commercial $2,227.83
Rate for Payer: First Health Commercial $2,549.92
Rate for Payer: Humana Commercial $2,281.51
Rate for Payer: Medical Mutual Of Ohio HMO $2,200.99
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $1,980.89
Rate for Payer: Molina Healthcare Benefit Exchange $805.24
Rate for Payer: Ohio Health Choice Commercial $2,362.03
Rate for Payer: Ohio Health Group HMO $2,013.10
Rate for Payer: Ohio Health Group PPO Differential $536.83
Rate for Payer: Ohio Health Group PPO No Differential $348.94
Rate for Payer: Ohio Health Group PPO SOMC Employees $832.08
Rate for Payer: PHCS Commercial $2,576.76
Rate for Payer: United Healthcare All Payer $2,362.03