|
FEM DIS W/P MAK OSS 7CM E R
|
Facility
|
IP
|
$76,180.72
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,854.22 |
| Max. Negotiated Rate |
$73,133.49 |
| Rate for Payer: Aetna Commercial |
$58,659.15
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$59,420.96
|
| Rate for Payer: Cash Price |
$38,090.36
|
| Rate for Payer: Cigna Commercial |
$63,230.00
|
| Rate for Payer: First Health Commercial |
$72,371.68
|
| Rate for Payer: Humana Commercial |
$64,753.61
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$62,468.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$56,221.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,854.22
|
| Rate for Payer: Ohio Health Choice Commercial |
$67,039.03
|
| Rate for Payer: Ohio Health Group HMO |
$57,135.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60,944.58
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$66,277.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$52,564.70
|
| Rate for Payer: PHCS Commercial |
$73,133.49
|
| Rate for Payer: United Healthcare All Payer |
$67,039.03
|
|
|
FEM DIS W/P MAK OSS 7CM E R
|
Facility
|
OP
|
$76,180.72
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,854.22 |
| Max. Negotiated Rate |
$73,133.49 |
| Rate for Payer: Aetna Commercial |
$58,659.15
|
| Rate for Payer: Anthem Medicaid |
$26,198.55
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$59,420.96
|
| Rate for Payer: Cash Price |
$38,090.36
|
| Rate for Payer: Cigna Commercial |
$63,230.00
|
| Rate for Payer: First Health Commercial |
$72,371.68
|
| Rate for Payer: Humana Commercial |
$64,753.61
|
| Rate for Payer: Humana KY Medicaid |
$26,198.55
|
| Rate for Payer: Kentucky WC Medicaid |
$26,465.18
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$62,468.19
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$56,221.37
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,854.22
|
| Rate for Payer: Molina Healthcare Medicaid |
$26,724.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$67,039.03
|
| Rate for Payer: Ohio Health Group HMO |
$57,135.54
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60,944.58
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$66,277.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$52,564.70
|
| Rate for Payer: PHCS Commercial |
$73,133.49
|
| Rate for Payer: United Healthcare All Payer |
$67,039.03
|
|
|
FEM DIS W/P MAK OSS 8.5CM E L
|
Facility
|
IP
|
$75,286.96
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,586.09 |
| Max. Negotiated Rate |
$72,275.48 |
| Rate for Payer: Aetna Commercial |
$57,970.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$58,723.83
|
| Rate for Payer: Cash Price |
$37,643.48
|
| Rate for Payer: Cigna Commercial |
$62,488.18
|
| Rate for Payer: First Health Commercial |
$71,522.61
|
| Rate for Payer: Humana Commercial |
$63,993.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$61,735.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$55,561.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,586.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$66,252.52
|
| Rate for Payer: Ohio Health Group HMO |
$56,465.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60,229.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$65,499.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51,948.00
|
| Rate for Payer: PHCS Commercial |
$72,275.48
|
| Rate for Payer: United Healthcare All Payer |
$66,252.52
|
|
|
FEM DIS W/P MAK OSS 8.5CM E L
|
Facility
|
OP
|
$75,286.96
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,586.09 |
| Max. Negotiated Rate |
$72,275.48 |
| Rate for Payer: Aetna Commercial |
$57,970.96
|
| Rate for Payer: Anthem Medicaid |
$25,891.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$58,723.83
|
| Rate for Payer: Cash Price |
$37,643.48
|
| Rate for Payer: Cigna Commercial |
$62,488.18
|
| Rate for Payer: First Health Commercial |
$71,522.61
|
| Rate for Payer: Humana Commercial |
$63,993.92
|
| Rate for Payer: Humana KY Medicaid |
$25,891.19
|
| Rate for Payer: Kentucky WC Medicaid |
$26,154.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$61,735.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$55,561.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,586.09
|
| Rate for Payer: Molina Healthcare Medicaid |
$26,410.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$66,252.52
|
| Rate for Payer: Ohio Health Group HMO |
$56,465.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60,229.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$65,499.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51,948.00
|
| Rate for Payer: PHCS Commercial |
$72,275.48
|
| Rate for Payer: United Healthcare All Payer |
$66,252.52
|
|
|
FEM DIS W/P MAK OSS 8.5CM E R
|
Facility
|
OP
|
$75,286.96
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,586.09 |
| Max. Negotiated Rate |
$72,275.48 |
| Rate for Payer: Aetna Commercial |
$57,970.96
|
| Rate for Payer: Anthem Medicaid |
$25,891.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$58,723.83
|
| Rate for Payer: Cash Price |
$37,643.48
|
| Rate for Payer: Cigna Commercial |
$62,488.18
|
| Rate for Payer: First Health Commercial |
$71,522.61
|
| Rate for Payer: Humana Commercial |
$63,993.92
|
| Rate for Payer: Humana KY Medicaid |
$25,891.19
|
| Rate for Payer: Kentucky WC Medicaid |
$26,154.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$61,735.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$55,561.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,586.09
|
| Rate for Payer: Molina Healthcare Medicaid |
$26,410.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$66,252.52
|
| Rate for Payer: Ohio Health Group HMO |
$56,465.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60,229.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$65,499.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51,948.00
|
| Rate for Payer: PHCS Commercial |
$72,275.48
|
| Rate for Payer: United Healthcare All Payer |
$66,252.52
|
|
|
FEM DIS W/P MAK OSS 8.5CM E R
|
Facility
|
IP
|
$75,286.96
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,586.09 |
| Max. Negotiated Rate |
$72,275.48 |
| Rate for Payer: Aetna Commercial |
$57,970.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$58,723.83
|
| Rate for Payer: Cash Price |
$37,643.48
|
| Rate for Payer: Cigna Commercial |
$62,488.18
|
| Rate for Payer: First Health Commercial |
$71,522.61
|
| Rate for Payer: Humana Commercial |
$63,993.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$61,735.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$55,561.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,586.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$66,252.52
|
| Rate for Payer: Ohio Health Group HMO |
$56,465.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60,229.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$65,499.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51,948.00
|
| Rate for Payer: PHCS Commercial |
$72,275.48
|
| Rate for Payer: United Healthcare All Payer |
$66,252.52
|
|
|
FEM DIS W/P MAK OSS 8.5CM R
|
Facility
|
IP
|
$75,286.96
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,586.09 |
| Max. Negotiated Rate |
$72,275.48 |
| Rate for Payer: Aetna Commercial |
$57,970.96
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$58,723.83
|
| Rate for Payer: Cash Price |
$37,643.48
|
| Rate for Payer: Cigna Commercial |
$62,488.18
|
| Rate for Payer: First Health Commercial |
$71,522.61
|
| Rate for Payer: Humana Commercial |
$63,993.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$61,735.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$55,561.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,586.09
|
| Rate for Payer: Ohio Health Choice Commercial |
$66,252.52
|
| Rate for Payer: Ohio Health Group HMO |
$56,465.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60,229.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$65,499.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51,948.00
|
| Rate for Payer: PHCS Commercial |
$72,275.48
|
| Rate for Payer: United Healthcare All Payer |
$66,252.52
|
|
|
FEM DIS W/P MAK OSS 8.5CM R
|
Facility
|
OP
|
$75,286.96
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,586.09 |
| Max. Negotiated Rate |
$72,275.48 |
| Rate for Payer: Aetna Commercial |
$57,970.96
|
| Rate for Payer: Anthem Medicaid |
$25,891.19
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$58,723.83
|
| Rate for Payer: Cash Price |
$37,643.48
|
| Rate for Payer: Cigna Commercial |
$62,488.18
|
| Rate for Payer: First Health Commercial |
$71,522.61
|
| Rate for Payer: Humana Commercial |
$63,993.92
|
| Rate for Payer: Humana KY Medicaid |
$25,891.19
|
| Rate for Payer: Kentucky WC Medicaid |
$26,154.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$61,735.31
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$55,561.78
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,586.09
|
| Rate for Payer: Molina Healthcare Medicaid |
$26,410.67
|
| Rate for Payer: Ohio Health Choice Commercial |
$66,252.52
|
| Rate for Payer: Ohio Health Group HMO |
$56,465.22
|
| Rate for Payer: Ohio Health Group PPO Differential |
$60,229.57
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$65,499.66
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$51,948.00
|
| Rate for Payer: PHCS Commercial |
$72,275.48
|
| Rate for Payer: United Healthcare All Payer |
$66,252.52
|
|
|
FEM DIS W/P MAK RS OSS 5CM L
|
Facility
|
OP
|
$70,571.92
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,171.58 |
| Max. Negotiated Rate |
$67,749.04 |
| Rate for Payer: Aetna Commercial |
$54,340.38
|
| Rate for Payer: Anthem Medicaid |
$24,269.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$55,046.10
|
| Rate for Payer: Cash Price |
$35,285.96
|
| Rate for Payer: Cigna Commercial |
$58,574.69
|
| Rate for Payer: First Health Commercial |
$67,043.32
|
| Rate for Payer: Humana Commercial |
$59,986.13
|
| Rate for Payer: Humana KY Medicaid |
$24,269.68
|
| Rate for Payer: Kentucky WC Medicaid |
$24,516.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$57,868.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$52,082.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,171.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,756.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$62,103.29
|
| Rate for Payer: Ohio Health Group HMO |
$52,928.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$56,457.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61,397.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$48,694.62
|
| Rate for Payer: PHCS Commercial |
$67,749.04
|
| Rate for Payer: United Healthcare All Payer |
$62,103.29
|
|
|
FEM DIS W/P MAK RS OSS 5CM L
|
Facility
|
IP
|
$70,571.92
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,171.58 |
| Max. Negotiated Rate |
$67,749.04 |
| Rate for Payer: Aetna Commercial |
$54,340.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$55,046.10
|
| Rate for Payer: Cash Price |
$35,285.96
|
| Rate for Payer: Cigna Commercial |
$58,574.69
|
| Rate for Payer: First Health Commercial |
$67,043.32
|
| Rate for Payer: Humana Commercial |
$59,986.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$57,868.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$52,082.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,171.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$62,103.29
|
| Rate for Payer: Ohio Health Group HMO |
$52,928.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$56,457.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61,397.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$48,694.62
|
| Rate for Payer: PHCS Commercial |
$67,749.04
|
| Rate for Payer: United Healthcare All Payer |
$62,103.29
|
|
|
FEM DIS W/P MAK RS OSS 5CM R
|
Facility
|
IP
|
$70,571.92
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,171.58 |
| Max. Negotiated Rate |
$67,749.04 |
| Rate for Payer: Aetna Commercial |
$54,340.38
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$55,046.10
|
| Rate for Payer: Cash Price |
$35,285.96
|
| Rate for Payer: Cigna Commercial |
$58,574.69
|
| Rate for Payer: First Health Commercial |
$67,043.32
|
| Rate for Payer: Humana Commercial |
$59,986.13
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$57,868.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$52,082.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,171.58
|
| Rate for Payer: Ohio Health Choice Commercial |
$62,103.29
|
| Rate for Payer: Ohio Health Group HMO |
$52,928.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$56,457.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61,397.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$48,694.62
|
| Rate for Payer: PHCS Commercial |
$67,749.04
|
| Rate for Payer: United Healthcare All Payer |
$62,103.29
|
|
|
FEM DIS W/P MAK RS OSS 5CM R
|
Facility
|
OP
|
$70,571.92
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,171.58 |
| Max. Negotiated Rate |
$67,749.04 |
| Rate for Payer: Aetna Commercial |
$54,340.38
|
| Rate for Payer: Anthem Medicaid |
$24,269.68
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$55,046.10
|
| Rate for Payer: Cash Price |
$35,285.96
|
| Rate for Payer: Cigna Commercial |
$58,574.69
|
| Rate for Payer: First Health Commercial |
$67,043.32
|
| Rate for Payer: Humana Commercial |
$59,986.13
|
| Rate for Payer: Humana KY Medicaid |
$24,269.68
|
| Rate for Payer: Kentucky WC Medicaid |
$24,516.69
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$57,868.97
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$52,082.08
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,171.58
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,756.63
|
| Rate for Payer: Ohio Health Choice Commercial |
$62,103.29
|
| Rate for Payer: Ohio Health Group HMO |
$52,928.94
|
| Rate for Payer: Ohio Health Group PPO Differential |
$56,457.54
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61,397.57
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$48,694.62
|
| Rate for Payer: PHCS Commercial |
$67,749.04
|
| Rate for Payer: United Healthcare All Payer |
$62,103.29
|
|
|
FEM DIS W/P MAK RS OSS 7CM L
|
Facility
|
OP
|
$72,455.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,736.56 |
| Max. Negotiated Rate |
$69,556.99 |
| Rate for Payer: Aetna Commercial |
$55,790.50
|
| Rate for Payer: Anthem Medicaid |
$24,917.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$56,515.06
|
| Rate for Payer: Cash Price |
$36,227.60
|
| Rate for Payer: Cigna Commercial |
$60,137.82
|
| Rate for Payer: First Health Commercial |
$68,832.44
|
| Rate for Payer: Humana Commercial |
$61,586.92
|
| Rate for Payer: Humana KY Medicaid |
$24,917.34
|
| Rate for Payer: Kentucky WC Medicaid |
$25,170.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$59,413.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$53,471.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,736.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$25,417.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$63,760.58
|
| Rate for Payer: Ohio Health Group HMO |
$54,341.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$57,964.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,036.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$49,994.09
|
| Rate for Payer: PHCS Commercial |
$69,556.99
|
| Rate for Payer: United Healthcare All Payer |
$63,760.58
|
|
|
FEM DIS W/P MAK RS OSS 7CM L
|
Facility
|
IP
|
$72,455.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,736.56 |
| Max. Negotiated Rate |
$69,556.99 |
| Rate for Payer: Aetna Commercial |
$55,790.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$56,515.06
|
| Rate for Payer: Cash Price |
$36,227.60
|
| Rate for Payer: Cigna Commercial |
$60,137.82
|
| Rate for Payer: First Health Commercial |
$68,832.44
|
| Rate for Payer: Humana Commercial |
$61,586.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$59,413.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$53,471.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,736.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$63,760.58
|
| Rate for Payer: Ohio Health Group HMO |
$54,341.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$57,964.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,036.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$49,994.09
|
| Rate for Payer: PHCS Commercial |
$69,556.99
|
| Rate for Payer: United Healthcare All Payer |
$63,760.58
|
|
|
FEM DIS W/P MAK RS OSS 7E L
|
Facility
|
OP
|
$72,455.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,736.56 |
| Max. Negotiated Rate |
$69,556.99 |
| Rate for Payer: Aetna Commercial |
$55,790.50
|
| Rate for Payer: Anthem Medicaid |
$24,917.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$56,515.06
|
| Rate for Payer: Cash Price |
$36,227.60
|
| Rate for Payer: Cigna Commercial |
$60,137.82
|
| Rate for Payer: First Health Commercial |
$68,832.44
|
| Rate for Payer: Humana Commercial |
$61,586.92
|
| Rate for Payer: Humana KY Medicaid |
$24,917.34
|
| Rate for Payer: Kentucky WC Medicaid |
$25,170.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$59,413.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$53,471.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,736.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$25,417.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$63,760.58
|
| Rate for Payer: Ohio Health Group HMO |
$54,341.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$57,964.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,036.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$49,994.09
|
| Rate for Payer: PHCS Commercial |
$69,556.99
|
| Rate for Payer: United Healthcare All Payer |
$63,760.58
|
|
|
FEM DIS W/P MAK RS OSS 7E L
|
Facility
|
IP
|
$72,455.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,736.56 |
| Max. Negotiated Rate |
$69,556.99 |
| Rate for Payer: Aetna Commercial |
$55,790.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$56,515.06
|
| Rate for Payer: Cash Price |
$36,227.60
|
| Rate for Payer: Cigna Commercial |
$60,137.82
|
| Rate for Payer: First Health Commercial |
$68,832.44
|
| Rate for Payer: Humana Commercial |
$61,586.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$59,413.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$53,471.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,736.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$63,760.58
|
| Rate for Payer: Ohio Health Group HMO |
$54,341.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$57,964.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,036.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$49,994.09
|
| Rate for Payer: PHCS Commercial |
$69,556.99
|
| Rate for Payer: United Healthcare All Payer |
$63,760.58
|
|
|
FEM DIS W/P MAK RS OSS 7E R
|
Facility
|
OP
|
$72,455.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,736.56 |
| Max. Negotiated Rate |
$69,556.99 |
| Rate for Payer: Aetna Commercial |
$55,790.50
|
| Rate for Payer: Anthem Medicaid |
$24,917.34
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$56,515.06
|
| Rate for Payer: Cash Price |
$36,227.60
|
| Rate for Payer: Cigna Commercial |
$60,137.82
|
| Rate for Payer: First Health Commercial |
$68,832.44
|
| Rate for Payer: Humana Commercial |
$61,586.92
|
| Rate for Payer: Humana KY Medicaid |
$24,917.34
|
| Rate for Payer: Kentucky WC Medicaid |
$25,170.94
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$59,413.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$53,471.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,736.56
|
| Rate for Payer: Molina Healthcare Medicaid |
$25,417.28
|
| Rate for Payer: Ohio Health Choice Commercial |
$63,760.58
|
| Rate for Payer: Ohio Health Group HMO |
$54,341.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$57,964.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,036.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$49,994.09
|
| Rate for Payer: PHCS Commercial |
$69,556.99
|
| Rate for Payer: United Healthcare All Payer |
$63,760.58
|
|
|
FEM DIS W/P MAK RS OSS 7E R
|
Facility
|
IP
|
$72,455.20
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,736.56 |
| Max. Negotiated Rate |
$69,556.99 |
| Rate for Payer: Aetna Commercial |
$55,790.50
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$56,515.06
|
| Rate for Payer: Cash Price |
$36,227.60
|
| Rate for Payer: Cigna Commercial |
$60,137.82
|
| Rate for Payer: First Health Commercial |
$68,832.44
|
| Rate for Payer: Humana Commercial |
$61,586.92
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$59,413.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$53,471.94
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,736.56
|
| Rate for Payer: Ohio Health Choice Commercial |
$63,760.58
|
| Rate for Payer: Ohio Health Group HMO |
$54,341.40
|
| Rate for Payer: Ohio Health Group PPO Differential |
$57,964.16
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,036.02
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$49,994.09
|
| Rate for Payer: PHCS Commercial |
$69,556.99
|
| Rate for Payer: United Healthcare All Payer |
$63,760.58
|
|
|
FEM DIS W/P MAK RS OSS 8.5E L
|
Facility
|
OP
|
$73,376.32
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,012.90 |
| Max. Negotiated Rate |
$70,441.27 |
| Rate for Payer: Aetna Commercial |
$56,499.77
|
| Rate for Payer: Anthem Medicaid |
$25,234.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$57,233.53
|
| Rate for Payer: Cash Price |
$36,688.16
|
| Rate for Payer: Cigna Commercial |
$60,902.35
|
| Rate for Payer: First Health Commercial |
$69,707.50
|
| Rate for Payer: Humana Commercial |
$62,369.87
|
| Rate for Payer: Humana KY Medicaid |
$25,234.12
|
| Rate for Payer: Kentucky WC Medicaid |
$25,490.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$60,168.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$54,151.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,012.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$25,740.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$64,571.16
|
| Rate for Payer: Ohio Health Group HMO |
$55,032.24
|
| Rate for Payer: Ohio Health Group PPO Differential |
$58,701.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,837.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50,629.66
|
| Rate for Payer: PHCS Commercial |
$70,441.27
|
| Rate for Payer: United Healthcare All Payer |
$64,571.16
|
|
|
FEM DIS W/P MAK RS OSS 8.5E L
|
Facility
|
IP
|
$73,376.32
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,012.90 |
| Max. Negotiated Rate |
$70,441.27 |
| Rate for Payer: Aetna Commercial |
$56,499.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$57,233.53
|
| Rate for Payer: Cash Price |
$36,688.16
|
| Rate for Payer: Cigna Commercial |
$60,902.35
|
| Rate for Payer: First Health Commercial |
$69,707.50
|
| Rate for Payer: Humana Commercial |
$62,369.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$60,168.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$54,151.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,012.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$64,571.16
|
| Rate for Payer: Ohio Health Group HMO |
$55,032.24
|
| Rate for Payer: Ohio Health Group PPO Differential |
$58,701.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,837.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50,629.66
|
| Rate for Payer: PHCS Commercial |
$70,441.27
|
| Rate for Payer: United Healthcare All Payer |
$64,571.16
|
|
|
FEM DIS W/P MAK RS OSS 8.5E R
|
Facility
|
OP
|
$73,376.32
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,012.90 |
| Max. Negotiated Rate |
$70,441.27 |
| Rate for Payer: Aetna Commercial |
$56,499.77
|
| Rate for Payer: Anthem Medicaid |
$25,234.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$57,233.53
|
| Rate for Payer: Cash Price |
$36,688.16
|
| Rate for Payer: Cigna Commercial |
$60,902.35
|
| Rate for Payer: First Health Commercial |
$69,707.50
|
| Rate for Payer: Humana Commercial |
$62,369.87
|
| Rate for Payer: Humana KY Medicaid |
$25,234.12
|
| Rate for Payer: Kentucky WC Medicaid |
$25,490.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$60,168.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$54,151.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,012.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$25,740.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$64,571.16
|
| Rate for Payer: Ohio Health Group HMO |
$55,032.24
|
| Rate for Payer: Ohio Health Group PPO Differential |
$58,701.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,837.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50,629.66
|
| Rate for Payer: PHCS Commercial |
$70,441.27
|
| Rate for Payer: United Healthcare All Payer |
$64,571.16
|
|
|
FEM DIS W/P MAK RS OSS 8.5E R
|
Facility
|
IP
|
$73,376.32
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,012.90 |
| Max. Negotiated Rate |
$70,441.27 |
| Rate for Payer: Aetna Commercial |
$56,499.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$57,233.53
|
| Rate for Payer: Cash Price |
$36,688.16
|
| Rate for Payer: Cigna Commercial |
$60,902.35
|
| Rate for Payer: First Health Commercial |
$69,707.50
|
| Rate for Payer: Humana Commercial |
$62,369.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$60,168.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$54,151.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,012.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$64,571.16
|
| Rate for Payer: Ohio Health Group HMO |
$55,032.24
|
| Rate for Payer: Ohio Health Group PPO Differential |
$58,701.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,837.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50,629.66
|
| Rate for Payer: PHCS Commercial |
$70,441.27
|
| Rate for Payer: United Healthcare All Payer |
$64,571.16
|
|
|
FEM DIS W/P MAK RS OSS 8.5 L
|
Facility
|
OP
|
$73,376.32
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,012.90 |
| Max. Negotiated Rate |
$70,441.27 |
| Rate for Payer: Aetna Commercial |
$56,499.77
|
| Rate for Payer: Anthem Medicaid |
$25,234.12
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$57,233.53
|
| Rate for Payer: Cash Price |
$36,688.16
|
| Rate for Payer: Cigna Commercial |
$60,902.35
|
| Rate for Payer: First Health Commercial |
$69,707.50
|
| Rate for Payer: Humana Commercial |
$62,369.87
|
| Rate for Payer: Humana KY Medicaid |
$25,234.12
|
| Rate for Payer: Kentucky WC Medicaid |
$25,490.93
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$60,168.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$54,151.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,012.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$25,740.41
|
| Rate for Payer: Ohio Health Choice Commercial |
$64,571.16
|
| Rate for Payer: Ohio Health Group HMO |
$55,032.24
|
| Rate for Payer: Ohio Health Group PPO Differential |
$58,701.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,837.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50,629.66
|
| Rate for Payer: PHCS Commercial |
$70,441.27
|
| Rate for Payer: United Healthcare All Payer |
$64,571.16
|
|
|
FEM DIS W/P MAK RS OSS 8.5 L
|
Facility
|
IP
|
$73,376.32
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,012.90 |
| Max. Negotiated Rate |
$70,441.27 |
| Rate for Payer: Aetna Commercial |
$56,499.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$57,233.53
|
| Rate for Payer: Cash Price |
$36,688.16
|
| Rate for Payer: Cigna Commercial |
$60,902.35
|
| Rate for Payer: First Health Commercial |
$69,707.50
|
| Rate for Payer: Humana Commercial |
$62,369.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$60,168.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$54,151.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,012.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$64,571.16
|
| Rate for Payer: Ohio Health Group HMO |
$55,032.24
|
| Rate for Payer: Ohio Health Group PPO Differential |
$58,701.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,837.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50,629.66
|
| Rate for Payer: PHCS Commercial |
$70,441.27
|
| Rate for Payer: United Healthcare All Payer |
$64,571.16
|
|
|
FEM DIS W/P MAK RS OSS 8.5 R
|
Facility
|
IP
|
$73,376.32
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,012.90 |
| Max. Negotiated Rate |
$70,441.27 |
| Rate for Payer: Aetna Commercial |
$56,499.77
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$57,233.53
|
| Rate for Payer: Cash Price |
$36,688.16
|
| Rate for Payer: Cigna Commercial |
$60,902.35
|
| Rate for Payer: First Health Commercial |
$69,707.50
|
| Rate for Payer: Humana Commercial |
$62,369.87
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$60,168.58
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$54,151.72
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$22,012.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$64,571.16
|
| Rate for Payer: Ohio Health Group HMO |
$55,032.24
|
| Rate for Payer: Ohio Health Group PPO Differential |
$58,701.06
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$63,837.40
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$50,629.66
|
| Rate for Payer: PHCS Commercial |
$70,441.27
|
| Rate for Payer: United Healthcare All Payer |
$64,571.16
|
|
