|
EXC MALIG LES OVER 4.0 CM(P
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
761P0086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$161.41 |
| Max. Negotiated Rate |
$527.28 |
| Rate for Payer: Aetna Commercial |
$424.81
|
| Rate for Payer: Ambetter Exchange |
$274.15
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$161.41
|
| Rate for Payer: Anthem Medicaid |
$227.10
|
| Rate for Payer: Buckeye Individual/Medicaid |
$274.15
|
| Rate for Payer: Buckeye Medicare Advantage |
$274.15
|
| Rate for Payer: CareSource Just4Me Medicare |
$328.98
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cigna Commercial |
$527.28
|
| Rate for Payer: Healthspan PPO |
$446.23
|
| Rate for Payer: Humana Medicaid |
$227.10
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$370.01
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$274.15
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$274.15
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$231.64
|
| Rate for Payer: Molina Healthcare Passport |
$227.10
|
| Rate for Payer: Multiplan PHCS |
$420.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$356.39
|
| Rate for Payer: UHCCP Medicaid |
$169.48
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$229.37
|
| Rate for Payer: Wellcare Medicare Advantage |
$274.15
|
|
|
EXC MALIG LES OVER 4.0 CM(P
|
Professional
|
Both
|
$600.00
|
|
|
Service Code
|
HCPCS 11606
|
| Hospital Charge Code |
761P0080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$161.27 |
| Max. Negotiated Rate |
$471.17 |
| Rate for Payer: Aetna Commercial |
$439.41
|
| Rate for Payer: Ambetter Exchange |
$297.75
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$161.27
|
| Rate for Payer: Anthem Medicaid |
$194.50
|
| Rate for Payer: Buckeye Individual/Medicaid |
$297.75
|
| Rate for Payer: Buckeye Medicare Advantage |
$297.75
|
| Rate for Payer: CareSource Just4Me Medicare |
$357.30
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$390.19
|
| Rate for Payer: Healthspan PPO |
$471.17
|
| Rate for Payer: Humana Medicaid |
$194.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$394.82
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$297.75
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$297.75
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$198.39
|
| Rate for Payer: Molina Healthcare Passport |
$194.50
|
| Rate for Payer: Multiplan PHCS |
$360.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$387.07
|
| Rate for Payer: UHCCP Medicaid |
$169.33
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$196.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$297.75
|
|
|
EXC MALIG LES OVER 4.0 CM(T
|
Facility
|
OP
|
$5,130.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
761T0086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,764.21 |
| Max. Negotiated Rate |
$4,924.80 |
| Rate for Payer: Aetna Commercial |
$3,950.10
|
| Rate for Payer: Anthem Medicaid |
$1,764.21
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$2,644.48
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,001.40
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$3,702.27
|
| Rate for Payer: CareSource Just4Me Medicare |
$3,570.05
|
| Rate for Payer: Cash Price |
$2,565.00
|
| Rate for Payer: Cash Price |
$2,565.00
|
| Rate for Payer: Cigna Commercial |
$4,257.90
|
| Rate for Payer: First Health Commercial |
$4,873.50
|
| Rate for Payer: Humana Commercial |
$4,360.50
|
| Rate for Payer: Humana KY Medicaid |
$1,764.21
|
| Rate for Payer: Humana Medicare Advantage |
$2,644.48
|
| Rate for Payer: Kentucky WC Medicaid |
$1,782.16
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,206.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,785.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$3,173.38
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,799.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,514.40
|
| Rate for Payer: Ohio Health Group HMO |
$3,847.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,104.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,463.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,539.70
|
| Rate for Payer: PHCS Commercial |
$4,924.80
|
| Rate for Payer: United Healthcare All Payer |
$4,514.40
|
|
|
EXC MALIG LES OVER 4.0 CM(T
|
Facility
|
OP
|
$4,297.00
|
|
|
Service Code
|
HCPCS 11606
|
| Hospital Charge Code |
761T0080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,477.74 |
| Max. Negotiated Rate |
$4,125.12 |
| Rate for Payer: Aetna Commercial |
$3,308.69
|
| Rate for Payer: Anthem Medicaid |
$1,477.74
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,497.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,351.66
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,095.90
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,021.04
|
| Rate for Payer: Cash Price |
$2,148.50
|
| Rate for Payer: Cash Price |
$2,148.50
|
| Rate for Payer: Cigna Commercial |
$3,566.51
|
| Rate for Payer: First Health Commercial |
$4,082.15
|
| Rate for Payer: Humana Commercial |
$3,652.45
|
| Rate for Payer: Humana KY Medicaid |
$1,477.74
|
| Rate for Payer: Humana Medicare Advantage |
$1,497.07
|
| Rate for Payer: Kentucky WC Medicaid |
$1,492.78
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,523.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,171.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,796.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,507.39
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,781.36
|
| Rate for Payer: Ohio Health Group HMO |
$3,222.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,437.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,738.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,964.93
|
| Rate for Payer: PHCS Commercial |
$4,125.12
|
| Rate for Payer: United Healthcare All Payer |
$3,781.36
|
|
|
EXC MALIG LES OVER 4.0 CM(T
|
Facility
|
IP
|
$4,297.00
|
|
|
Service Code
|
HCPCS 11606
|
| Hospital Charge Code |
761T0080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,289.10 |
| Max. Negotiated Rate |
$4,125.12 |
| Rate for Payer: Aetna Commercial |
$3,308.69
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$3,351.66
|
| Rate for Payer: Cash Price |
$2,148.50
|
| Rate for Payer: Cigna Commercial |
$3,566.51
|
| Rate for Payer: First Health Commercial |
$4,082.15
|
| Rate for Payer: Humana Commercial |
$3,652.45
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$3,523.54
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,171.19
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,289.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,781.36
|
| Rate for Payer: Ohio Health Group HMO |
$3,222.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$3,437.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,738.39
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,964.93
|
| Rate for Payer: PHCS Commercial |
$4,125.12
|
| Rate for Payer: United Healthcare All Payer |
$3,781.36
|
|
|
EXC MALIG LES OVER 4.0 CM(T
|
Facility
|
IP
|
$5,130.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
761T0086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,539.00 |
| Max. Negotiated Rate |
$4,924.80 |
| Rate for Payer: Aetna Commercial |
$3,950.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$4,001.40
|
| Rate for Payer: Cash Price |
$2,565.00
|
| Rate for Payer: Cigna Commercial |
$4,257.90
|
| Rate for Payer: First Health Commercial |
$4,873.50
|
| Rate for Payer: Humana Commercial |
$4,360.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$4,206.60
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$3,785.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,539.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$4,514.40
|
| Rate for Payer: Ohio Health Group HMO |
$3,847.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$4,104.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$4,463.10
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$3,539.70
|
| Rate for Payer: PHCS Commercial |
$4,924.80
|
| Rate for Payer: United Healthcare All Payer |
$4,514.40
|
|
|
EXC MALIG LES UP TO 0.5CM
|
Facility
|
IP
|
$2,914.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$874.20 |
| Max. Negotiated Rate |
$2,797.44 |
| Rate for Payer: Aetna Commercial |
$2,243.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,272.92
|
| Rate for Payer: Cash Price |
$1,457.00
|
| Rate for Payer: Cigna Commercial |
$2,418.62
|
| Rate for Payer: First Health Commercial |
$2,768.30
|
| Rate for Payer: Humana Commercial |
$2,476.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,389.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,150.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$874.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,564.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,185.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,331.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,535.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,010.66
|
| Rate for Payer: PHCS Commercial |
$2,797.44
|
| Rate for Payer: United Healthcare All Payer |
$2,564.32
|
|
|
EXC MALIG LES UP TO 0.5CM
|
Facility
|
OP
|
$2,914.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$650.10 |
| Max. Negotiated Rate |
$2,797.44 |
| Rate for Payer: Aetna Commercial |
$2,243.78
|
| Rate for Payer: Anthem Medicaid |
$1,002.12
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$650.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,272.92
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$910.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$877.63
|
| Rate for Payer: Cash Price |
$1,457.00
|
| Rate for Payer: Cash Price |
$1,457.00
|
| Rate for Payer: Cigna Commercial |
$2,418.62
|
| Rate for Payer: First Health Commercial |
$2,768.30
|
| Rate for Payer: Humana Commercial |
$2,476.90
|
| Rate for Payer: Humana KY Medicaid |
$1,002.12
|
| Rate for Payer: Humana Medicare Advantage |
$650.10
|
| Rate for Payer: Kentucky WC Medicaid |
$1,012.32
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,389.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,150.53
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,022.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,564.32
|
| Rate for Payer: Ohio Health Group HMO |
$2,185.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,331.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,535.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,010.66
|
| Rate for Payer: PHCS Commercial |
$2,797.44
|
| Rate for Payer: United Healthcare All Payer |
$2,564.32
|
|
|
EXC MALIG LES UP TO 0.5CM
|
Professional
|
Both
|
$2,914.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.29 |
| Max. Negotiated Rate |
$1,748.40 |
| Rate for Payer: Aetna Commercial |
$168.79
|
| Rate for Payer: Ambetter Exchange |
$118.50
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$72.29
|
| Rate for Payer: Anthem Medicaid |
$91.33
|
| Rate for Payer: Buckeye Individual/Medicaid |
$118.50
|
| Rate for Payer: Buckeye Medicare Advantage |
$118.50
|
| Rate for Payer: CareSource Just4Me Medicare |
$142.20
|
| Rate for Payer: Cash Price |
$1,457.00
|
| Rate for Payer: Cash Price |
$1,457.00
|
| Rate for Payer: Cigna Commercial |
$244.06
|
| Rate for Payer: Healthspan PPO |
$206.86
|
| Rate for Payer: Humana Medicaid |
$91.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$153.22
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$118.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$118.50
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$93.16
|
| Rate for Payer: Molina Healthcare Passport |
$91.33
|
| Rate for Payer: Multiplan PHCS |
$1,748.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$154.05
|
| Rate for Payer: UHCCP Medicaid |
$75.90
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$92.24
|
| Rate for Payer: Wellcare Medicare Advantage |
$118.50
|
|
|
EXC MALIG LES UP TO 0.5CM(P
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
761P0087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.29 |
| Max. Negotiated Rate |
$244.06 |
| Rate for Payer: Aetna Commercial |
$168.79
|
| Rate for Payer: Ambetter Exchange |
$118.50
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$72.29
|
| Rate for Payer: Anthem Medicaid |
$91.33
|
| Rate for Payer: Buckeye Individual/Medicaid |
$118.50
|
| Rate for Payer: Buckeye Medicare Advantage |
$118.50
|
| Rate for Payer: CareSource Just4Me Medicare |
$142.20
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cigna Commercial |
$244.06
|
| Rate for Payer: Healthspan PPO |
$206.86
|
| Rate for Payer: Humana Medicaid |
$91.33
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$153.22
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$118.50
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$118.50
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$93.16
|
| Rate for Payer: Molina Healthcare Passport |
$91.33
|
| Rate for Payer: Multiplan PHCS |
$240.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$154.05
|
| Rate for Payer: UHCCP Medicaid |
$75.90
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$92.24
|
| Rate for Payer: Wellcare Medicare Advantage |
$118.50
|
|
|
EXC MALIG LES UP TO 0.5CM(T
|
Facility
|
IP
|
$2,514.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
761T0087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$754.20 |
| Max. Negotiated Rate |
$2,413.44 |
| Rate for Payer: Aetna Commercial |
$1,935.78
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,960.92
|
| Rate for Payer: Cash Price |
$1,257.00
|
| Rate for Payer: Cigna Commercial |
$2,086.62
|
| Rate for Payer: First Health Commercial |
$2,388.30
|
| Rate for Payer: Humana Commercial |
$2,136.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,061.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,855.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$754.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,212.32
|
| Rate for Payer: Ohio Health Group HMO |
$1,885.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,011.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,187.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,734.66
|
| Rate for Payer: PHCS Commercial |
$2,413.44
|
| Rate for Payer: United Healthcare All Payer |
$2,212.32
|
|
|
EXC MALIG LES UP TO 0.5CM(T
|
Facility
|
OP
|
$2,514.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
761T0087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$650.10 |
| Max. Negotiated Rate |
$2,413.44 |
| Rate for Payer: Aetna Commercial |
$1,935.78
|
| Rate for Payer: Anthem Medicaid |
$864.56
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$650.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,960.92
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$910.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$877.63
|
| Rate for Payer: Cash Price |
$1,257.00
|
| Rate for Payer: Cash Price |
$1,257.00
|
| Rate for Payer: Cigna Commercial |
$2,086.62
|
| Rate for Payer: First Health Commercial |
$2,388.30
|
| Rate for Payer: Humana Commercial |
$2,136.90
|
| Rate for Payer: Humana KY Medicaid |
$864.56
|
| Rate for Payer: Humana Medicare Advantage |
$650.10
|
| Rate for Payer: Kentucky WC Medicaid |
$873.36
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,061.48
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,855.33
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$881.91
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,212.32
|
| Rate for Payer: Ohio Health Group HMO |
$1,885.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,011.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,187.18
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,734.66
|
| Rate for Payer: PHCS Commercial |
$2,413.44
|
| Rate for Payer: United Healthcare All Payer |
$2,212.32
|
|
|
EXC MALIG LES UP TO .5 CM
|
Facility
|
IP
|
$3,519.00
|
|
|
Service Code
|
HCPCS 11620
|
| Hospital Charge Code |
76100081
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,055.70 |
| Max. Negotiated Rate |
$3,378.24 |
| Rate for Payer: Aetna Commercial |
$2,709.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,744.82
|
| Rate for Payer: Cash Price |
$1,759.50
|
| Rate for Payer: Cigna Commercial |
$2,920.77
|
| Rate for Payer: First Health Commercial |
$3,343.05
|
| Rate for Payer: Humana Commercial |
$2,991.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,885.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,597.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,055.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,096.72
|
| Rate for Payer: Ohio Health Group HMO |
$2,639.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,815.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,061.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,428.11
|
| Rate for Payer: PHCS Commercial |
$3,378.24
|
| Rate for Payer: United Healthcare All Payer |
$3,096.72
|
|
|
EXC MALIG LES UP TO .5 CM
|
Facility
|
OP
|
$2,635.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$650.10 |
| Max. Negotiated Rate |
$2,529.60 |
| Rate for Payer: Aetna Commercial |
$2,028.95
|
| Rate for Payer: Anthem Medicaid |
$906.18
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$650.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,055.30
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$910.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$877.63
|
| Rate for Payer: Cash Price |
$1,317.50
|
| Rate for Payer: Cash Price |
$1,317.50
|
| Rate for Payer: Cigna Commercial |
$2,187.05
|
| Rate for Payer: First Health Commercial |
$2,503.25
|
| Rate for Payer: Humana Commercial |
$2,239.75
|
| Rate for Payer: Humana KY Medicaid |
$906.18
|
| Rate for Payer: Humana Medicare Advantage |
$650.10
|
| Rate for Payer: Kentucky WC Medicaid |
$915.40
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,160.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,944.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$924.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,318.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,976.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,108.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,292.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,818.15
|
| Rate for Payer: PHCS Commercial |
$2,529.60
|
| Rate for Payer: United Healthcare All Payer |
$2,318.80
|
|
|
EXC MALIG LES UP TO .5 CM
|
Professional
|
Both
|
$2,635.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.70 |
| Max. Negotiated Rate |
$1,581.00 |
| Rate for Payer: Aetna Commercial |
$157.74
|
| Rate for Payer: Ambetter Exchange |
$114.26
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$67.70
|
| Rate for Payer: Anthem Medicaid |
$72.65
|
| Rate for Payer: Buckeye Individual/Medicaid |
$114.26
|
| Rate for Payer: Buckeye Medicare Advantage |
$114.26
|
| Rate for Payer: CareSource Just4Me Medicare |
$137.11
|
| Rate for Payer: Cash Price |
$1,317.50
|
| Rate for Payer: Cash Price |
$1,317.50
|
| Rate for Payer: Cigna Commercial |
$236.18
|
| Rate for Payer: Healthspan PPO |
$193.75
|
| Rate for Payer: Humana Medicaid |
$72.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$144.60
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$114.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$114.26
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$74.10
|
| Rate for Payer: Molina Healthcare Passport |
$72.65
|
| Rate for Payer: Multiplan PHCS |
$1,581.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$148.54
|
| Rate for Payer: UHCCP Medicaid |
$71.08
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$73.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$114.26
|
|
|
EXC MALIG LES UP TO .5 CM
|
Facility
|
OP
|
$3,519.00
|
|
|
Service Code
|
HCPCS 11620
|
| Hospital Charge Code |
76100081
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,210.18 |
| Max. Negotiated Rate |
$3,378.24 |
| Rate for Payer: Aetna Commercial |
$2,709.63
|
| Rate for Payer: Anthem Medicaid |
$1,210.18
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,497.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,744.82
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,095.90
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,021.04
|
| Rate for Payer: Cash Price |
$1,759.50
|
| Rate for Payer: Cash Price |
$1,759.50
|
| Rate for Payer: Cigna Commercial |
$2,920.77
|
| Rate for Payer: First Health Commercial |
$3,343.05
|
| Rate for Payer: Humana Commercial |
$2,991.15
|
| Rate for Payer: Humana KY Medicaid |
$1,210.18
|
| Rate for Payer: Humana Medicare Advantage |
$1,497.07
|
| Rate for Payer: Kentucky WC Medicaid |
$1,222.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,885.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,597.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,796.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,234.47
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,096.72
|
| Rate for Payer: Ohio Health Group HMO |
$2,639.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,815.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,061.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,428.11
|
| Rate for Payer: PHCS Commercial |
$3,378.24
|
| Rate for Payer: United Healthcare All Payer |
$3,096.72
|
|
|
EXC MALIG LES UP TO .5 CM
|
Professional
|
Both
|
$3,519.00
|
|
|
Service Code
|
HCPCS 11620
|
| Hospital Charge Code |
76100081
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$2,111.40 |
| Rate for Payer: Aetna Commercial |
$159.75
|
| Rate for Payer: Ambetter Exchange |
$115.21
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$68.80
|
| Rate for Payer: Anthem Medicaid |
$76.71
|
| Rate for Payer: Buckeye Individual/Medicaid |
$115.21
|
| Rate for Payer: Buckeye Medicare Advantage |
$115.21
|
| Rate for Payer: CareSource Just4Me Medicare |
$138.25
|
| Rate for Payer: Cash Price |
$1,759.50
|
| Rate for Payer: Cash Price |
$1,759.50
|
| Rate for Payer: Cigna Commercial |
$236.20
|
| Rate for Payer: Healthspan PPO |
$197.49
|
| Rate for Payer: Humana Medicaid |
$76.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$147.06
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$115.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$115.21
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$78.24
|
| Rate for Payer: Molina Healthcare Passport |
$76.71
|
| Rate for Payer: Multiplan PHCS |
$2,111.40
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$149.77
|
| Rate for Payer: UHCCP Medicaid |
$72.24
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$77.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$115.21
|
|
|
EXC MALIG LES UP TO .5 CM
|
Facility
|
IP
|
$2,635.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$790.50 |
| Max. Negotiated Rate |
$2,529.60 |
| Rate for Payer: Aetna Commercial |
$2,028.95
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,055.30
|
| Rate for Payer: Cash Price |
$1,317.50
|
| Rate for Payer: Cigna Commercial |
$2,187.05
|
| Rate for Payer: First Health Commercial |
$2,503.25
|
| Rate for Payer: Humana Commercial |
$2,239.75
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,160.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,944.63
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$790.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,318.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,976.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,108.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,292.45
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,818.15
|
| Rate for Payer: PHCS Commercial |
$2,529.60
|
| Rate for Payer: United Healthcare All Payer |
$2,318.80
|
|
|
EXC MALIG LES UP TO .5 CM(P
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
761P0075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.70 |
| Max. Negotiated Rate |
$236.18 |
| Rate for Payer: Aetna Commercial |
$157.74
|
| Rate for Payer: Ambetter Exchange |
$114.26
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$67.70
|
| Rate for Payer: Anthem Medicaid |
$72.65
|
| Rate for Payer: Buckeye Individual/Medicaid |
$114.26
|
| Rate for Payer: Buckeye Medicare Advantage |
$114.26
|
| Rate for Payer: CareSource Just4Me Medicare |
$137.11
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cigna Commercial |
$236.18
|
| Rate for Payer: Healthspan PPO |
$193.75
|
| Rate for Payer: Humana Medicaid |
$72.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$144.60
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$114.26
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$114.26
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$74.10
|
| Rate for Payer: Molina Healthcare Passport |
$72.65
|
| Rate for Payer: Multiplan PHCS |
$150.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$148.54
|
| Rate for Payer: UHCCP Medicaid |
$71.08
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$73.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$114.26
|
|
|
EXC MALIG LES UP TO .5 CM(P
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 11620
|
| Hospital Charge Code |
761P0081
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$236.20 |
| Rate for Payer: Aetna Commercial |
$159.75
|
| Rate for Payer: Ambetter Exchange |
$115.21
|
| Rate for Payer: Anthem HMO/Medicare Advantage/POS/PPO/Pathway Tiered Hospital/Pathway X Tiered Hospital/Traditional |
$68.80
|
| Rate for Payer: Anthem Medicaid |
$76.71
|
| Rate for Payer: Buckeye Individual/Medicaid |
$115.21
|
| Rate for Payer: Buckeye Medicare Advantage |
$115.21
|
| Rate for Payer: CareSource Just4Me Medicare |
$138.25
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$236.20
|
| Rate for Payer: Healthspan PPO |
$197.49
|
| Rate for Payer: Humana Medicaid |
$76.71
|
| Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation |
$147.06
|
| Rate for Payer: Medical Mutual Of Ohio Medicare Advantage |
$115.21
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$115.21
|
| Rate for Payer: Molina Healthcare CHIP/Medicaid |
$78.24
|
| Rate for Payer: Molina Healthcare Passport |
$76.71
|
| Rate for Payer: Multiplan PHCS |
$180.00
|
| Rate for Payer: Ohio Health Choice Preferred Health Choice |
$149.77
|
| Rate for Payer: UHCCP Medicaid |
$72.24
|
| Rate for Payer: Wellcare CHIP/Medicaid |
$77.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$115.21
|
|
|
EXC MALIG LES UP TO .5 CM(T
|
Facility
|
IP
|
$3,219.00
|
|
|
Service Code
|
HCPCS 11620
|
| Hospital Charge Code |
761T0081
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$965.70 |
| Max. Negotiated Rate |
$3,090.24 |
| Rate for Payer: Aetna Commercial |
$2,478.63
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,510.82
|
| Rate for Payer: Cash Price |
$1,609.50
|
| Rate for Payer: Cigna Commercial |
$2,671.77
|
| Rate for Payer: First Health Commercial |
$3,058.05
|
| Rate for Payer: Humana Commercial |
$2,736.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,639.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,375.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$965.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,832.72
|
| Rate for Payer: Ohio Health Group HMO |
$2,414.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,575.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,800.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,221.11
|
| Rate for Payer: PHCS Commercial |
$3,090.24
|
| Rate for Payer: United Healthcare All Payer |
$2,832.72
|
|
|
EXC MALIG LES UP TO .5 CM(T
|
Facility
|
IP
|
$2,385.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
761T0075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$715.50 |
| Max. Negotiated Rate |
$2,289.60 |
| Rate for Payer: Aetna Commercial |
$1,836.45
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,860.30
|
| Rate for Payer: Cash Price |
$1,192.50
|
| Rate for Payer: Cigna Commercial |
$1,979.55
|
| Rate for Payer: First Health Commercial |
$2,265.75
|
| Rate for Payer: Humana Commercial |
$2,027.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,955.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,760.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$715.50
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,098.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,788.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,908.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,074.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,645.65
|
| Rate for Payer: PHCS Commercial |
$2,289.60
|
| Rate for Payer: United Healthcare All Payer |
$2,098.80
|
|
|
EXC MALIG LES UP TO .5 CM(T
|
Facility
|
OP
|
$3,219.00
|
|
|
Service Code
|
HCPCS 11620
|
| Hospital Charge Code |
761T0081
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,107.01 |
| Max. Negotiated Rate |
$3,090.24 |
| Rate for Payer: Aetna Commercial |
$2,478.63
|
| Rate for Payer: Anthem Medicaid |
$1,107.01
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$1,497.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,510.82
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$2,095.90
|
| Rate for Payer: CareSource Just4Me Medicare |
$2,021.04
|
| Rate for Payer: Cash Price |
$1,609.50
|
| Rate for Payer: Cash Price |
$1,609.50
|
| Rate for Payer: Cigna Commercial |
$2,671.77
|
| Rate for Payer: First Health Commercial |
$3,058.05
|
| Rate for Payer: Humana Commercial |
$2,736.15
|
| Rate for Payer: Humana KY Medicaid |
$1,107.01
|
| Rate for Payer: Humana Medicare Advantage |
$1,497.07
|
| Rate for Payer: Kentucky WC Medicaid |
$1,118.28
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,639.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,375.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,796.48
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,129.23
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,832.72
|
| Rate for Payer: Ohio Health Group HMO |
$2,414.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,575.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,800.53
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,221.11
|
| Rate for Payer: PHCS Commercial |
$3,090.24
|
| Rate for Payer: United Healthcare All Payer |
$2,832.72
|
|
|
EXC MALIG LES UP TO .5 CM(T
|
Facility
|
OP
|
$2,385.00
|
|
|
Service Code
|
HCPCS 11600
|
| Hospital Charge Code |
761T0075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$650.10 |
| Max. Negotiated Rate |
$2,289.60 |
| Rate for Payer: Aetna Commercial |
$1,836.45
|
| Rate for Payer: Anthem Medicaid |
$820.20
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$650.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,860.30
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$910.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$877.63
|
| Rate for Payer: Cash Price |
$1,192.50
|
| Rate for Payer: Cash Price |
$1,192.50
|
| Rate for Payer: Cigna Commercial |
$1,979.55
|
| Rate for Payer: First Health Commercial |
$2,265.75
|
| Rate for Payer: Humana Commercial |
$2,027.25
|
| Rate for Payer: Humana KY Medicaid |
$820.20
|
| Rate for Payer: Humana Medicare Advantage |
$650.10
|
| Rate for Payer: Kentucky WC Medicaid |
$828.55
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,955.70
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,760.13
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$836.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,098.80
|
| Rate for Payer: Ohio Health Group HMO |
$1,788.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,908.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,074.95
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,645.65
|
| Rate for Payer: PHCS Commercial |
$2,289.60
|
| Rate for Payer: United Healthcare All Payer |
$2,098.80
|
|
|
EXC MALIGN INCL MARGINS
|
Facility
|
OP
|
$3,074.00
|
|
|
Service Code
|
HCPCS 11622
|
| Hospital Charge Code |
76100083
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$650.10 |
| Max. Negotiated Rate |
$2,951.04 |
| Rate for Payer: Aetna Commercial |
$2,366.98
|
| Rate for Payer: Anthem Medicaid |
$1,057.15
|
| Rate for Payer: Anthem Medicare Advantage/PPO |
$650.10
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,397.72
|
| Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage |
$910.14
|
| Rate for Payer: CareSource Just4Me Medicare |
$877.63
|
| Rate for Payer: Cash Price |
$1,537.00
|
| Rate for Payer: Cash Price |
$1,537.00
|
| Rate for Payer: Cigna Commercial |
$2,551.42
|
| Rate for Payer: First Health Commercial |
$2,920.30
|
| Rate for Payer: Humana Commercial |
$2,612.90
|
| Rate for Payer: Humana KY Medicaid |
$1,057.15
|
| Rate for Payer: Humana Medicare Advantage |
$650.10
|
| Rate for Payer: Kentucky WC Medicaid |
$1,067.91
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,520.68
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,268.61
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$780.12
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,078.36
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,705.12
|
| Rate for Payer: Ohio Health Group HMO |
$2,305.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,459.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,674.38
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,121.06
|
| Rate for Payer: PHCS Commercial |
$2,951.04
|
| Rate for Payer: United Healthcare All Payer |
$2,705.12
|
|
