|
FEM PROX OSS FINN MOD 7CM R
|
Facility
|
OP
|
$70,996.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,298.80 |
| Max. Negotiated Rate |
$68,156.16 |
| Rate for Payer: Aetna Commercial |
$54,666.92
|
| Rate for Payer: Anthem Medicaid |
$24,415.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$55,376.88
|
| Rate for Payer: Cash Price |
$35,498.00
|
| Rate for Payer: Cigna Commercial |
$58,926.68
|
| Rate for Payer: First Health Commercial |
$67,446.20
|
| Rate for Payer: Humana Commercial |
$60,346.60
|
| Rate for Payer: Humana KY Medicaid |
$24,415.52
|
| Rate for Payer: Kentucky WC Medicaid |
$24,664.01
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$58,216.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$52,395.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,298.80
|
| Rate for Payer: Molina Healthcare Medicaid |
$24,905.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$62,476.48
|
| Rate for Payer: Ohio Health Group HMO |
$53,247.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$56,796.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61,766.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$48,987.24
|
| Rate for Payer: PHCS Commercial |
$68,156.16
|
| Rate for Payer: United Healthcare All Payer |
$62,476.48
|
|
|
FEM PROX OSS FINN MOD 7CM R
|
Facility
|
IP
|
$70,996.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,298.80 |
| Max. Negotiated Rate |
$68,156.16 |
| Rate for Payer: Aetna Commercial |
$54,666.92
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$55,376.88
|
| Rate for Payer: Cash Price |
$35,498.00
|
| Rate for Payer: Cigna Commercial |
$58,926.68
|
| Rate for Payer: First Health Commercial |
$67,446.20
|
| Rate for Payer: Humana Commercial |
$60,346.60
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$58,216.72
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$52,395.05
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$21,298.80
|
| Rate for Payer: Ohio Health Choice Commercial |
$62,476.48
|
| Rate for Payer: Ohio Health Group HMO |
$53,247.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$56,796.80
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$61,766.52
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$48,987.24
|
| Rate for Payer: PHCS Commercial |
$68,156.16
|
| Rate for Payer: United Healthcare All Payer |
$62,476.48
|
|
|
FEMR PSN MCVE ASF R 10M 4-5/EF
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 10M 4-5/EF
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 10M 6-7/CD
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 10M 6-7/CD
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 10M 6-7/EF
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 10M 6-7/EF
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSNMCVE ASF R 10M 8-11 EF
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSNMCVE ASF R 10M 8-11 EF
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSNMCVE ASF R 10M 8-11 GH
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSNMCVE ASF R 10M 8-11 GH
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 10M 8-9/CD
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 10M 8-9/CD
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 11M 4-5/EF
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 11M 4-5/EF
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 11M 6-7/CD
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 11M 6-7/CD
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 11M 6-7/EF
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 11M 6-7/EF
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSNMCVE ASF R 11M 8-11 EF
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSNMCVE ASF R 11M 8-11 EF
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSNMCVE ASF R 11M 8-11 GH
|
Facility
|
IP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSNMCVE ASF R 11M 8-11 GH
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
|
FEMR PSN MCVE ASF R 11M 8-9/CD
|
Facility
|
OP
|
$8,365.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
27000011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,509.65 |
| Max. Negotiated Rate |
$8,030.88 |
| Rate for Payer: Aetna Commercial |
$6,441.44
|
| Rate for Payer: Anthem Medicaid |
$2,876.90
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$6,525.09
|
| Rate for Payer: Cash Price |
$4,182.75
|
| Rate for Payer: Cigna Commercial |
$6,943.36
|
| Rate for Payer: First Health Commercial |
$7,947.23
|
| Rate for Payer: Humana Commercial |
$7,110.68
|
| Rate for Payer: Humana KY Medicaid |
$2,876.90
|
| Rate for Payer: Kentucky WC Medicaid |
$2,906.17
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$6,859.71
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$6,173.74
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$2,509.65
|
| Rate for Payer: Molina Healthcare Medicaid |
$2,934.62
|
| Rate for Payer: Ohio Health Choice Commercial |
$7,361.64
|
| Rate for Payer: Ohio Health Group HMO |
$6,274.12
|
| Rate for Payer: Ohio Health Group PPO Differential |
$6,692.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$7,277.98
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$5,772.19
|
| Rate for Payer: PHCS Commercial |
$8,030.88
|
| Rate for Payer: United Healthcare All Payer |
$7,361.64
|
|
