|
ICU ROOM RATE
|
Facility
|
IP
|
$3,658.00
|
|
| Hospital Charge Code |
20000001
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$1,097.40 |
| Max. Negotiated Rate |
$3,511.68 |
| Rate for Payer: Aetna Commercial |
$2,816.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,853.24
|
| Rate for Payer: Cash Price |
$1,829.00
|
| Rate for Payer: Cigna Commercial |
$3,036.14
|
| Rate for Payer: First Health Commercial |
$3,475.10
|
| Rate for Payer: Humana Commercial |
$3,109.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,999.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,699.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,097.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,219.04
|
| Rate for Payer: Ohio Health Group HMO |
$2,743.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,926.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,182.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,524.02
|
| Rate for Payer: PHCS Commercial |
$3,511.68
|
| Rate for Payer: United Healthcare All Payer |
$3,219.04
|
|
|
HCU ROOM RATE
|
Facility
|
IP
|
$3,658.00
|
|
| Hospital Charge Code |
21000001
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$1,097.40 |
| Max. Negotiated Rate |
$3,511.68 |
| Rate for Payer: Aetna Commercial |
$2,816.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,853.24
|
| Rate for Payer: Cash Price |
$1,829.00
|
| Rate for Payer: Cigna Commercial |
$3,036.14
|
| Rate for Payer: First Health Commercial |
$3,475.10
|
| Rate for Payer: Humana Commercial |
$3,109.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,999.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,699.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,097.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,219.04
|
| Rate for Payer: Ohio Health Group HMO |
$2,743.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,926.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,182.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,524.02
|
| Rate for Payer: PHCS Commercial |
$3,511.68
|
| Rate for Payer: United Healthcare All Payer |
$3,219.04
|
|
|
ACUTE HOSPICE ROOM RATE
|
Facility
|
IP
|
$1,022.19
|
|
| Hospital Charge Code |
11000011
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$306.66 |
| Max. Negotiated Rate |
$981.30 |
| Rate for Payer: Aetna Commercial |
$787.09
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$797.31
|
| Rate for Payer: Cash Price |
$511.10
|
| Rate for Payer: Cigna Commercial |
$848.42
|
| Rate for Payer: First Health Commercial |
$971.08
|
| Rate for Payer: Humana Commercial |
$868.86
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$838.20
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$754.38
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$306.66
|
| Rate for Payer: Ohio Health Choice Commercial |
$899.53
|
| Rate for Payer: Ohio Health Group HMO |
$766.64
|
| Rate for Payer: Ohio Health Group PPO Differential |
$817.75
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$889.31
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$705.31
|
| Rate for Payer: PHCS Commercial |
$981.30
|
| Rate for Payer: United Healthcare All Payer |
$899.53
|
|
|
ER INP ROOM RATE
|
Facility
|
IP
|
$1,790.00
|
|
| Hospital Charge Code |
11000006
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$537.00 |
| Max. Negotiated Rate |
$1,718.40 |
| Rate for Payer: Aetna Commercial |
$1,378.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,396.20
|
| Rate for Payer: Cash Price |
$895.00
|
| Rate for Payer: Cigna Commercial |
$1,485.70
|
| Rate for Payer: First Health Commercial |
$1,700.50
|
| Rate for Payer: Humana Commercial |
$1,521.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,467.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,321.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$537.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,575.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,342.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,432.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,557.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,235.10
|
| Rate for Payer: PHCS Commercial |
$1,718.40
|
| Rate for Payer: United Healthcare All Payer |
$1,575.20
|
|
|
RESPITE HOSPICE ROOM RATE
|
Facility
|
IP
|
$434.44
|
|
| Hospital Charge Code |
11000012
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$130.33 |
| Max. Negotiated Rate |
$417.06 |
| Rate for Payer: Aetna Commercial |
$334.52
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$338.86
|
| Rate for Payer: Cash Price |
$217.22
|
| Rate for Payer: Cigna Commercial |
$360.59
|
| Rate for Payer: First Health Commercial |
$412.72
|
| Rate for Payer: Humana Commercial |
$369.27
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$356.24
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$320.62
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$130.33
|
| Rate for Payer: Ohio Health Choice Commercial |
$382.31
|
| Rate for Payer: Ohio Health Group HMO |
$325.83
|
| Rate for Payer: Ohio Health Group PPO Differential |
$347.55
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$377.96
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$299.76
|
| Rate for Payer: PHCS Commercial |
$417.06
|
| Rate for Payer: United Healthcare All Payer |
$382.31
|
|
|
C-SECTION EMERGENCY ROOM
|
Facility
|
OP
|
$3,193.00
|
|
| Hospital Charge Code |
76102549
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$957.90 |
| Max. Negotiated Rate |
$3,065.28 |
| Rate for Payer: Aetna Commercial |
$2,458.61
|
| Rate for Payer: Anthem Medicaid |
$1,098.07
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,490.54
|
| Rate for Payer: Cash Price |
$1,596.50
|
| Rate for Payer: Cigna Commercial |
$2,650.19
|
| Rate for Payer: First Health Commercial |
$3,033.35
|
| Rate for Payer: Humana Commercial |
$2,714.05
|
| Rate for Payer: Humana KY Medicaid |
$1,098.07
|
| Rate for Payer: Kentucky WC Medicaid |
$1,109.25
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,618.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,356.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$957.90
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,120.10
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,809.84
|
| Rate for Payer: Ohio Health Group HMO |
$2,394.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,554.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,777.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,203.17
|
| Rate for Payer: PHCS Commercial |
$3,065.28
|
| Rate for Payer: United Healthcare All Payer |
$2,809.84
|
|
|
HCU CRITICAL CARE ROOM RATE
|
Facility
|
IP
|
$3,658.00
|
|
| Hospital Charge Code |
20000002
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$1,097.40 |
| Max. Negotiated Rate |
$3,511.68 |
| Rate for Payer: Aetna Commercial |
$2,816.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,853.24
|
| Rate for Payer: Cash Price |
$1,829.00
|
| Rate for Payer: Cigna Commercial |
$3,036.14
|
| Rate for Payer: First Health Commercial |
$3,475.10
|
| Rate for Payer: Humana Commercial |
$3,109.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,999.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,699.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,097.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,219.04
|
| Rate for Payer: Ohio Health Group HMO |
$2,743.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,926.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,182.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,524.02
|
| Rate for Payer: PHCS Commercial |
$3,511.68
|
| Rate for Payer: United Healthcare All Payer |
$3,219.04
|
|
|
C-SECTION EMERGENCY ROOM
|
Facility
|
OP
|
$3,329.00
|
|
| Hospital Charge Code |
45000319
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$998.70 |
| Max. Negotiated Rate |
$3,195.84 |
| Rate for Payer: Aetna Commercial |
$2,563.33
|
| Rate for Payer: Anthem Medicaid |
$1,144.84
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,596.62
|
| Rate for Payer: Cash Price |
$1,664.50
|
| Rate for Payer: Cigna Commercial |
$2,763.07
|
| Rate for Payer: First Health Commercial |
$3,162.55
|
| Rate for Payer: Humana Commercial |
$2,829.65
|
| Rate for Payer: Humana KY Medicaid |
$1,144.84
|
| Rate for Payer: Kentucky WC Medicaid |
$1,156.49
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,729.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,456.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$998.70
|
| Rate for Payer: Molina Healthcare Medicaid |
$1,167.81
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,929.52
|
| Rate for Payer: Ohio Health Group HMO |
$2,496.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,663.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,896.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,297.01
|
| Rate for Payer: PHCS Commercial |
$3,195.84
|
| Rate for Payer: United Healthcare All Payer |
$2,929.52
|
|
|
PACU CRITICAL CARE ROOM RATE
|
Facility
|
IP
|
$3,658.00
|
|
| Hospital Charge Code |
20000004
|
|
Hospital Revenue Code
|
150
|
| Min. Negotiated Rate |
$1,097.40 |
| Max. Negotiated Rate |
$3,511.68 |
| Rate for Payer: Aetna Commercial |
$2,816.66
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,853.24
|
| Rate for Payer: Cash Price |
$1,829.00
|
| Rate for Payer: Cigna Commercial |
$3,036.14
|
| Rate for Payer: First Health Commercial |
$3,475.10
|
| Rate for Payer: Humana Commercial |
$3,109.30
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,999.56
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,699.60
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,097.40
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,219.04
|
| Rate for Payer: Ohio Health Group HMO |
$2,743.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,926.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,182.46
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,524.02
|
| Rate for Payer: PHCS Commercial |
$3,511.68
|
| Rate for Payer: United Healthcare All Payer |
$3,219.04
|
|
|
SVCU ROOM RATE
|
Facility
|
IP
|
$1,790.00
|
|
| Hospital Charge Code |
11000010
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$537.00 |
| Max. Negotiated Rate |
$1,718.40 |
| Rate for Payer: Aetna Commercial |
$1,378.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,396.20
|
| Rate for Payer: Cash Price |
$895.00
|
| Rate for Payer: Cigna Commercial |
$1,485.70
|
| Rate for Payer: First Health Commercial |
$1,700.50
|
| Rate for Payer: Humana Commercial |
$1,521.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,467.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,321.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$537.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,575.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,342.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,432.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,557.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,235.10
|
| Rate for Payer: PHCS Commercial |
$1,718.40
|
| Rate for Payer: United Healthcare All Payer |
$1,575.20
|
|
|
C-SECTION EMERGENCY ROOM
|
Facility
|
IP
|
$3,329.00
|
|
| Hospital Charge Code |
45000319
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$998.70 |
| Max. Negotiated Rate |
$3,195.84 |
| Rate for Payer: Aetna Commercial |
$2,563.33
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,596.62
|
| Rate for Payer: Cash Price |
$1,664.50
|
| Rate for Payer: Cigna Commercial |
$2,763.07
|
| Rate for Payer: First Health Commercial |
$3,162.55
|
| Rate for Payer: Humana Commercial |
$2,829.65
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,729.78
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,456.80
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$998.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,929.52
|
| Rate for Payer: Ohio Health Group HMO |
$2,496.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,663.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,896.23
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,297.01
|
| Rate for Payer: PHCS Commercial |
$3,195.84
|
| Rate for Payer: United Healthcare All Payer |
$2,929.52
|
|
|
PCU ROOM RATE
|
Facility
|
IP
|
$3,234.00
|
|
| Hospital Charge Code |
20600001
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$970.20 |
| Max. Negotiated Rate |
$3,104.64 |
| Rate for Payer: Aetna Commercial |
$2,490.18
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,522.52
|
| Rate for Payer: Cash Price |
$1,617.00
|
| Rate for Payer: Cigna Commercial |
$2,684.22
|
| Rate for Payer: First Health Commercial |
$3,072.30
|
| Rate for Payer: Humana Commercial |
$2,748.90
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,651.88
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,386.69
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$970.20
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,845.92
|
| Rate for Payer: Ohio Health Group HMO |
$2,425.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,587.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,813.58
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,231.46
|
| Rate for Payer: PHCS Commercial |
$3,104.64
|
| Rate for Payer: United Healthcare All Payer |
$2,845.92
|
|
|
FIELD HOSPITAL ROOM RATE
|
Facility
|
IP
|
$500.00
|
|
| Hospital Charge Code |
11000014
|
|
Hospital Revenue Code
|
150
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$480.00 |
| Rate for Payer: Aetna Commercial |
$385.00
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$390.00
|
| Rate for Payer: Cash Price |
$250.00
|
| Rate for Payer: Cigna Commercial |
$415.00
|
| Rate for Payer: First Health Commercial |
$475.00
|
| Rate for Payer: Humana Commercial |
$425.00
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$410.00
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$369.00
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$150.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$440.00
|
| Rate for Payer: Ohio Health Group HMO |
$375.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$400.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$435.00
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$345.00
|
| Rate for Payer: PHCS Commercial |
$480.00
|
| Rate for Payer: United Healthcare All Payer |
$440.00
|
|
|
MATERNITY ROOM RATE
|
Facility
|
IP
|
$3,512.00
|
|
| Hospital Charge Code |
11000005
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$1,053.60 |
| Max. Negotiated Rate |
$3,371.52 |
| Rate for Payer: Aetna Commercial |
$2,704.24
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,739.36
|
| Rate for Payer: Cash Price |
$1,756.00
|
| Rate for Payer: Cigna Commercial |
$2,914.96
|
| Rate for Payer: First Health Commercial |
$3,336.40
|
| Rate for Payer: Humana Commercial |
$2,985.20
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,879.84
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,591.86
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$1,053.60
|
| Rate for Payer: Ohio Health Choice Commercial |
$3,090.56
|
| Rate for Payer: Ohio Health Group HMO |
$2,634.00
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,809.60
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$3,055.44
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,423.28
|
| Rate for Payer: PHCS Commercial |
$3,371.52
|
| Rate for Payer: United Healthcare All Payer |
$3,090.56
|
|
|
REHAB ROOM RATE
|
Facility
|
IP
|
$2,439.00
|
|
| Hospital Charge Code |
11800001
|
|
Hospital Revenue Code
|
118
|
| Min. Negotiated Rate |
$731.70 |
| Max. Negotiated Rate |
$2,341.44 |
| Rate for Payer: Aetna Commercial |
$1,878.03
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,902.42
|
| Rate for Payer: Cash Price |
$1,219.50
|
| Rate for Payer: Cigna Commercial |
$2,024.37
|
| Rate for Payer: First Health Commercial |
$2,317.05
|
| Rate for Payer: Humana Commercial |
$2,073.15
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,999.98
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,799.98
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$731.70
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,146.32
|
| Rate for Payer: Ohio Health Group HMO |
$1,829.25
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,951.20
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,121.93
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,682.91
|
| Rate for Payer: PHCS Commercial |
$2,341.44
|
| Rate for Payer: United Healthcare All Payer |
$2,146.32
|
|
|
SDS MEDICAL CARE ROOM RATE
|
Facility
|
IP
|
$1,790.00
|
|
| Hospital Charge Code |
11000015
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$537.00 |
| Max. Negotiated Rate |
$1,718.40 |
| Rate for Payer: Aetna Commercial |
$1,378.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,396.20
|
| Rate for Payer: Cash Price |
$895.00
|
| Rate for Payer: Cigna Commercial |
$1,485.70
|
| Rate for Payer: First Health Commercial |
$1,700.50
|
| Rate for Payer: Humana Commercial |
$1,521.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,467.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,321.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$537.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,575.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,342.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,432.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,557.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,235.10
|
| Rate for Payer: PHCS Commercial |
$1,718.40
|
| Rate for Payer: United Healthcare All Payer |
$1,575.20
|
|
|
OCU ROOM RATE
|
Facility
|
IP
|
$1,790.00
|
|
| Hospital Charge Code |
11000008
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$537.00 |
| Max. Negotiated Rate |
$1,718.40 |
| Rate for Payer: Aetna Commercial |
$1,378.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,396.20
|
| Rate for Payer: Cash Price |
$895.00
|
| Rate for Payer: Cigna Commercial |
$1,485.70
|
| Rate for Payer: First Health Commercial |
$1,700.50
|
| Rate for Payer: Humana Commercial |
$1,521.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,467.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,321.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$537.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,575.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,342.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,432.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,557.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,235.10
|
| Rate for Payer: PHCS Commercial |
$1,718.40
|
| Rate for Payer: United Healthcare All Payer |
$1,575.20
|
|
|
C-SECTION EMERGENCY ROOM
|
Facility
|
IP
|
$3,193.00
|
|
| Hospital Charge Code |
76102549
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$957.90 |
| Max. Negotiated Rate |
$3,065.28 |
| Rate for Payer: Aetna Commercial |
$2,458.61
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$2,490.54
|
| Rate for Payer: Cash Price |
$1,596.50
|
| Rate for Payer: Cigna Commercial |
$2,650.19
|
| Rate for Payer: First Health Commercial |
$3,033.35
|
| Rate for Payer: Humana Commercial |
$2,714.05
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$2,618.26
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$2,356.43
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$957.90
|
| Rate for Payer: Ohio Health Choice Commercial |
$2,809.84
|
| Rate for Payer: Ohio Health Group HMO |
$2,394.75
|
| Rate for Payer: Ohio Health Group PPO Differential |
$2,554.40
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$2,777.91
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$2,203.17
|
| Rate for Payer: PHCS Commercial |
$3,065.28
|
| Rate for Payer: United Healthcare All Payer |
$2,809.84
|
|
|
MSCU ROOM RATE
|
Facility
|
IP
|
$1,790.00
|
|
| Hospital Charge Code |
11000007
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$537.00 |
| Max. Negotiated Rate |
$1,718.40 |
| Rate for Payer: Aetna Commercial |
$1,378.30
|
| Rate for Payer: Anthem POS/PPO/Traditional |
$1,396.20
|
| Rate for Payer: Cash Price |
$895.00
|
| Rate for Payer: Cigna Commercial |
$1,485.70
|
| Rate for Payer: First Health Commercial |
$1,700.50
|
| Rate for Payer: Humana Commercial |
$1,521.50
|
| Rate for Payer: Medical Mutual Of Ohio HMO |
$1,467.80
|
| Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional |
$1,321.02
|
| Rate for Payer: Molina Healthcare Benefit Exchange |
$537.00
|
| Rate for Payer: Ohio Health Choice Commercial |
$1,575.20
|
| Rate for Payer: Ohio Health Group HMO |
$1,342.50
|
| Rate for Payer: Ohio Health Group PPO Differential |
$1,432.00
|
| Rate for Payer: Ohio Health Group PPO No Differential |
$1,557.30
|
| Rate for Payer: Ohio Health Group PPO SOMC Employees |
$1,235.10
|
| Rate for Payer: PHCS Commercial |
$1,718.40
|
| Rate for Payer: United Healthcare All Payer |
$1,575.20
|
|
