▸ Hospital · OH · CCN 360159
ADENA REGIONAL MEDICAL CENTER
272 HOSPITAL ROAD, CHILLICOTHE, OH, 45601-9031
237 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
190
of 209 target codes
Payers
21
with negotiated rates
Rates published
43,605
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 12 | — | — | $11,727 | $14,994 | $32,248 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 11 | — | — | $153.1 | $153.1 | $421.03 |
| Psychiatric eval with medical services | CPT | 90792 | 11 | — | — | $153.1 | $153.1 | $421.03 |
| Psychotherapy 30 minutes | CPT | 90832 | 21 | $562.35 | $281.18 | $153.1 | $393.65 | $534.23 |
| Psychotherapy 45 minutes | CPT | 90834 | 21 | $562.35 | $281.18 | $153.1 | $393.65 | $534.23 |
| Psychotherapy 60 minutes | CPT | 90837 | 21 | $562.35 | $281.18 | $153.1 | $393.65 | $534.23 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 11 | — | — | $153.1 | $153.1 | $421.03 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 21 | $339.79 | $169.9 | $83.9 | $234.29 | $322.8 |
| ED visit level 2 | CPT | 99282 | 21 | $554.26 | $277.13 | $150.9 | $395 | $541 |
| ED visit level 3 | CPT | 99283 | 21 | $1,087.3 | $543.65 | $263.85 | $768.06 | $1,060 |
| ED visit level 4 | CPT | 99284 | 21 | $1,772.81 | $886.41 | $405.76 | $1,252.49 | $3,251 |
| ED visit level 5 | CPT | 99285 | 21 | $2,145.85 | $1,072.93 | $584.22 | $1,529.99 | $7,143 |
| Critical care, first hour | CPT | 99291 | 21 | $2,949.14 | $1,474.57 | $802.92 | $2,064.4 | $2,801.68 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 21 | $1,528.63 | $764.32 | $101.33 | $1,079.98 | $2,086 |
| CT head with contrast | CPT | 70460 | 21 | $2,016.23 | $1,008.12 | $169.64 | $1,411.36 | $2,086 |
| CT head with and without contrast | CPT | 70470 | 21 | $2,390.46 | $1,195.23 | $169.64 | $1,548.3 | $2,270.94 |
| CT neck with contrast | CPT | 70491 | 21 | $2,016.23 | $1,008.12 | $169.64 | $1,411.36 | $2,086 |
| MRI brain without contrast | CPT | 70551 | 21 | $2,319.65 | $1,159.83 | $230.34 | $1,623.76 | $2,203.67 |
| MRI brain with contrast | CPT | 70552 | 21 | $2,517.04 | $1,258.52 | $340.31 | $1,741.47 | $2,391.19 |
| MRI brain with and without contrast | CPT | 70553 | 21 | $2,990.35 | $1,495.18 | $340.31 | $1,906.93 | $2,840.83 |
| Chest X-ray single view | CPT | 71045 | 21 | $346.87 | $173.44 | $83.9 | $242.81 | $403.57 |
| Chest X-ray 2 views | CPT | 71046 | 21 | $346.87 | $173.44 | $83.9 | $242.81 | $403.57 |
| Chest X-ray 3 views | CPT | 71047 | 21 | $346.87 | $173.44 | $83.9 | $242.81 | $403.57 |
| CT chest without contrast | CPT | 71250 | 21 | $1,528.63 | $764.32 | $101.33 | $1,079.98 | $2,086 |
| CT chest with contrast | CPT | 71260 | 21 | $2,016.23 | $1,008.12 | $169.64 | $1,411.36 | $2,086 |
| CT chest with and without contrast | CPT | 71270 | 21 | $2,390.46 | $1,195.23 | $169.64 | $1,548.3 | $2,270.94 |
| MRI chest without contrast | CPT | 71550 | 21 | $1,697.4 | $848.7 | $230.34 | $1,199.22 | $2,020 |
| MRI chest with contrast | CPT | 71551 | 21 | $2,924.57 | $1,462.29 | $752.85 | $1,964.23 | $3,440.96 |
| MRI chest with and without contrast | CPT | 71552 | 21 | $3,207.35 | $1,603.68 | $340.31 | $2,010 | $3,046.98 |
| Lumbosacral spine X-ray | CPT | 72100 | 21 | $372.19 | $186.1 | $101.33 | $260.53 | $496.49 |
| CT cervical spine without contrast | CPT | 72125 | 21 | $1,528.63 | $764.32 | $101.33 | $1,079.98 | $2,086 |
| CT thoracic spine without contrast | CPT | 72128 | 21 | $1,528.63 | $764.32 | $101.33 | $1,079.98 | $2,086 |
| CT lumbar spine without contrast | CPT | 72131 | 21 | $1,528.63 | $764.32 | $101.33 | $1,079.98 | $2,086 |
| MRI cervical spine without contrast | CPT | 72141 | 21 | $2,301.92 | $1,150.96 | $230.34 | $1,611.34 | $2,186.82 |
| MRI thoracic spine without contrast | CPT | 72146 | 21 | $2,311.27 | $1,155.64 | $230.34 | $1,617.89 | $2,195.71 |
| MRI lumbar spine without contrast | CPT | 72148 | 21 | $2,288.5 | $1,144.25 | $230.34 | $1,601.95 | $2,174.08 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 21 | $2,587.5 | $1,293.75 | $340.31 | $1,758.5 | $2,458.13 |
| MRI cervical spine with and without contrast | CPT | 72156 | 21 | $2,975.49 | $1,487.75 | $340.31 | $1,902.21 | $2,826.72 |
| MRI lumbar spine with contrast | CPT | 72158 | 21 | $2,932.5 | $1,466.25 | $340.31 | $1,888.54 | $2,785.88 |
| CT pelvis without contrast | CPT | 72192 | 21 | $1,528.63 | $764.32 | $101.33 | $1,079.98 | $2,086 |
| CT pelvis with contrast | CPT | 72193 | 21 | $2,016.23 | $1,008.12 | $169.64 | $1,411.36 | $2,086 |
| Shoulder X-ray | CPT | 73030 | 21 | $707.02 | $353.51 | $83.9 | $480.56 | $671.67 |
| Humerus X-ray | CPT | 73060 | 21 | $353.51 | $176.76 | $83.9 | $247.46 | $403.57 |
| Hand X-ray 3 views | CPT | 73130 | 21 | $707.02 | $353.51 | $83.9 | $480.56 | $671.67 |
| MRI upper extremity joint without contrast | CPT | 73221 | 21 | $2,188.24 | $1,094.12 | $230.34 | $1,531.77 | $2,078.83 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 21 | $3,022.06 | $1,511.03 | $340.31 | $1,922.03 | $2,870.96 |
| Knee X-ray 1-2 views | CPT | 73560 | 21 | $707.02 | $353.51 | $83.9 | $480.56 | $671.67 |
| Ankle X-ray 3 views | CPT | 73610 | 21 | $707.02 | $353.51 | $83.9 | $480.56 | $671.67 |
| MRI lower extremity joint without contrast | CPT | 73721 | 21 | $4,232 | $2,116 | $230.34 | $2,319.81 | $4,020.4 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 21 | $5,750 | $2,875 | $340.31 | $3,084.3 | $5,462.5 |
| CT abdomen without contrast | CPT | 74150 | 21 | $1,528.63 | $764.32 | $101.33 | $1,079.98 | $2,086 |
| CT abdomen with contrast | CPT | 74160 | 21 | $2,016.23 | $1,008.12 | $169.64 | $1,411.36 | $2,086 |
| CT abdomen with and without contrast | CPT | 74170 | 21 | $2,390.46 | $1,195.23 | $169.64 | $1,548.3 | $2,270.94 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 21 | $3,053.6 | $1,526.8 | $230.34 | $1,942.09 | $2,900.92 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 21 | $4,032.45 | $2,016.23 | $340.31 | $2,291.05 | $3,830.83 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 21 | $4,780.93 | $2,390.47 | $340.31 | $2,564.5 | $4,541.88 |
| MRI abdomen without contrast | CPT | 74181 | 21 | $2,317.25 | $1,158.63 | $230.34 | $1,622.08 | $2,201.39 |
| MRI abdomen with and without contrast | CPT | 74183 | 21 | $3,151 | $1,575.5 | $340.31 | $2,002.02 | $2,993.45 |
| Abdominal ultrasound complete | CPT | 76700 | 21 | $818.4 | $409.2 | $101.33 | $556.27 | $777.48 |
| Abdominal ultrasound limited | CPT | 76705 | 21 | $818.4 | $409.2 | $101.33 | $556.27 | $777.48 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 21 | $743.83 | $371.92 | $101.33 | $508.59 | $706.64 |
| Obstetric ultrasound first trimester | CPT | 76801 | 21 | $818.4 | $409.2 | $101.33 | $556.27 | $777.48 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 21 | $818.4 | $409.2 | $101.33 | $556.27 | $777.48 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | — | — | $230.34 | $230.34 | $1,084.76 |
| Transvaginal ultrasound | CPT | 76830 | 21 | $818.4 | $409.2 | $101.33 | $556.27 | $777.48 |
| Pelvic ultrasound complete | CPT | 76856 | 21 | $818.4 | $409.2 | $101.33 | $556.27 | $777.48 |
| Scrotal ultrasound | CPT | 76870 | 21 | $818.4 | $409.2 | $101.33 | $556.27 | $777.48 |
| Diagnostic mammography unilateral | CPT | 77065 | 21 | $652.05 | $326.03 | $77.58 | $443.2 | $619.45 |
| Diagnostic mammography bilateral | CPT | 77066 | 21 | $749.8 | $374.9 | $98.8 | $524.86 | $712.31 |
| Screening mammography bilateral | CPT | 77067 | 21 | $287.5 | $143.75 | $81.66 | $203.12 | $449.72 |
| EKG tracing only | CPT | 93005 | 21 | $307.67 | $153.84 | $56.6 | $209.13 | $292.29 |
| Transthoracic echocardiogram complete | CPT | 93306 | 21 | $4,778.55 | $2,389.28 | $522.48 | $2,610.67 | $4,539.62 |
| Transthoracic echocardiogram | CPT | 93307 | 21 | $782.36 | $391.18 | $230.34 | $547.65 | $743.24 |
| Stress echocardiogram | CPT | 93350 | 21 | $2,058.37 | $1,029.19 | $522.48 | $1,438.84 | $1,955.45 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 12 | — | — | $16,138 | $20,950 | $44,381 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 12 | — | — | $8,737.52 | $10,958 | $24,028 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 12 | — | — | $6,236.28 | $7,581.5 | $17,150 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 12 | — | — | $13,302 | $17,120 | $36,579 |
| COPD w MCC | MS-DRG | 190 | 12 | — | — | $9,545.13 | $12,048 | $26,249 |
| COPD w CC | MS-DRG | 191 | 12 | — | — | $7,536.38 | $9,336.64 | $20,725 |
| COPD w/o CC/MCC | MS-DRG | 192 | 12 | — | — | $5,923.44 | $7,159.15 | $16,289 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 12 | — | — | $7,238.75 | $8,934.85 | $19,907 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 12 | — | — | $5,736.95 | $6,907.39 | $15,777 |
| AMI discharged alive w MCC | MS-DRG | 280 | 12 | — | — | $13,491 | $17,376 | $37,100 |
| AMI discharged alive w CC | MS-DRG | 281 | 12 | — | — | $8,013.63 | $9,980.94 | $22,037 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 12 | — | — | $6,516.41 | $8,699.41 | $21,861 |
| Heart failure & shock w MCC | MS-DRG | 291 | 12 | — | — | $10,929 | $13,917 | $30,055 |
| Heart failure & shock w CC | MS-DRG | 292 | 12 | — | — | $7,552.36 | $9,358.22 | $20,769 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 12 | — | — | $5,173.67 | $6,146.96 | $14,228 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 12 | — | — | $10,176 | $12,900 | $27,984 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 12 | — | — | $6,624.48 | $8,105.57 | $18,217 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 12 | — | — | $5,255.89 | $7,016.62 | $14,454 |
| GI hemorrhage w CC | MS-DRG | 378 | 12 | — | — | $8,501.55 | $10,640 | $23,379 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 12 | — | — | $5,843.52 | $7,051.26 | $16,070 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 12 | — | — | $6,936.56 | $8,526.89 | $19,076 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 12 | — | — | $12,604 | $16,178 | $34,662 |
| Kidney/UTI w MCC | MS-DRG | 689 | 12 | — | — | $9,905.16 | $12,535 | $27,239 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 12 | — | — | $7,106.31 | $8,756.05 | $19,542 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 12 | — | — | $15,932 | $20,671 | $43,814 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 12 | — | — | $8,844.84 | $11,103 | $24,323 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 21 | $40.22 | $20.11 | $8.46 | $26.05 | $61.55 |
| General health panel | CPT | 80050 | 14 | $634.7 | $317.35 | $112.27 | $444.29 | $602.97 |
| Electrolyte panel | CPT | 80051 | 21 | $25.2 | $12.6 | $7.01 | $17.5 | $51 |
| Comprehensive metabolic panel | CPT | 80053 | 21 | $57.93 | $28.97 | $10.56 | $36.84 | $76.85 |
| Lipid panel | CPT | 80061 | 21 | $69.76 | $34.88 | $13.39 | $45.03 | $97.44 |
| Renal function panel | CPT | 80069 | 21 | $47.62 | $23.81 | $8.68 | $30.29 | $63.16 |
| Hepatic function panel | CPT | 80076 | 21 | $34.66 | $17.33 | $8.17 | $22.66 | $59.45 |
| Urinalysis non-automated | CPT | 81002 | 21 | $12.65 | $6.33 | $3.48 | $8.74 | $25.33 |
| Urinalysis automated | CPT | 81003 | 21 | $12.32 | $6.16 | $2.25 | $7.84 | $16.38 |
| Glucose quantitative | CPT | 82947 | 21 | $18.73 | $9.37 | $3.93 | $12.13 | $28.61 |
| Hemoglobin A1c | CPT | 83036 | 21 | $46.28 | $23.14 | $9.71 | $29.98 | $70.66 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 21 | $80.12 | $40.06 | $16.8 | $51.9 | $122.24 |
| Complete blood count with automated differential | CPT | 85025 | 21 | $42.63 | $21.32 | $7.77 | $27.11 | $56.54 |
| Complete blood count without differential | CPT | 85027 | 21 | $35.47 | $17.74 | $6.47 | $22.56 | $47.07 |
| Urine culture bacterial | CPT | 87086 | 21 | $44.01 | $22.01 | $8.07 | $24.01 | $58.71 |
| Urine culture identification | CPT | 87088 | 21 | $44.14 | $22.07 | $8.09 | $28.07 | $58.86 |
| Tissue exam by pathologist level IV | CPT | 88305 | 21 | $195.5 | $97.75 | $50.91 | $126.63 | $280.86 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 21 | $704.1 | $352.05 | $191.69 | $492.87 | $4,433 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 1 | — | — | $11,032 | $12,564 | $15,092 |
| Vaginal delivery only | CPT | 59409 | 12 | — | — | $3,029.77 | $3,090.37 | $8,331.88 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | — | — | $11,032 | $12,564 | $15,092 |
| Routine obstetric care with C-section | CPT | 59510 | 1 | — | — | $11,032 | $12,564 | $15,092 |
| C-section delivery only | CPT | 59514 | 1 | — | — | $5,859 | $6,673 | $8,015 |
| C-section with postpartum | CPT | 59515 | 1 | — | — | $11,032 | $12,564 | $15,092 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 21 | $132.3 | $66.15 | $47.36 | $112.46 | $337.7 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 21 | $180.6 | $90.3 | $64.65 | $128.77 | $337.7 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 21 | $219.45 | $109.73 | $78.56 | $153.62 | $337.7 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 21 | $245.7 | $122.85 | $87.96 | $171.99 | $337.7 |
| Office visit, established patient, 5 min | CPT | 99211 | 14 | $87.15 | $43.58 | $31.2 | $62.49 | $82.79 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 21 | $103.95 | $51.98 | $37.21 | $88.36 | $337.7 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 21 | $131.25 | $65.63 | $46.99 | $111.56 | $337.7 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 21 | $164.85 | $82.43 | $59.02 | $123.22 | $337.7 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 21 | $203.7 | $101.85 | $72.92 | $142.59 | $337.7 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 21 | $4,942.57 | $2,471.29 | $893.4 | $3,459.8 | $4,695.44 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 21 | $5,492 | $2,746 | $893.4 | $3,844.4 | $5,217.4 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 21 | $4,136.74 | $2,068.37 | $868.77 | $2,922.61 | $4,433 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 21 | $4,910.52 | $2,455.26 | $868.77 | $3,437.36 | $4,664.99 |
| Colonoscopy diagnostic | CPT | 45378 | 21 | $5,695.76 | $2,847.88 | $868.77 | $3,987.03 | $5,410.97 |
| Colonoscopy with biopsy | CPT | 45380 | 21 | $6,355.05 | $3,177.53 | $1,123.55 | $4,489.85 | $8,015 |
| Colonoscopy with polyp removal | CPT | 45385 | 21 | $6,133.02 | $3,066.51 | $1,123.55 | $4,332.98 | $8,015 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 12 | — | — | $16,556 | $17,524 | $48,191 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $41,088 | $44,714 | $53,710 |
| Hip hemiarthroplasty | CPT | 27125 | 1 | — | — | $11,032 | $12,564 | $15,092 |
| Total hip replacement | CPT | 27130 | 12 | — | — | $12,261 | $12,506 | $33,717 |
| Total knee replacement | CPT | 27447 | 12 | — | — | $12,261 | $12,506 | $33,717 |
| Knee revision arthroplasty single component | CPT | 27486 | 1 | — | — | $16,556 | $18,855 | $22,648 |
| Knee revision arthroplasty all components | CPT | 27487 | 1 | — | — | $16,556 | $18,855 | $22,648 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 12 | — | — | $6,807.26 | $6,943.41 | $22,648 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 12 | — | — | $3,091.79 | $3,153.62 | $15,092 |
| ACL reconstruction | CPT | 29888 | 12 | — | — | $6,807.26 | $6,943.41 | $22,648 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 12 | — | — | $35,950 | $47,695 | $98,862 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 12 | — | — | $18,989 | $24,798 | $52,220 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 12 | — | — | $13,564 | $17,474 | $37,301 |
| CABG single arterial graft | CPT | 33533 | 1 | — | — | $21,971 | $25,022 | $30,057 |
| CABG 2 arterial grafts | CPT | 33534 | 1 | — | — | $21,971 | $25,022 | $30,057 |
| CABG 3 arterial grafts | CPT | 33535 | 1 | — | — | $21,971 | $25,022 | $30,057 |
| CABG 4+ arterial grafts | CPT | 33536 | 1 | — | — | $21,971 | $25,022 | $30,057 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 12 | — | — | $13,620 | $17,550 | $37,456 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 12 | — | — | $11,026 | $14,029 | $30,323 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 12 | — | — | $27,863 | $36,778 | $76,623 |
| Open appendectomy | CPT | 44950 | 12 | — | — | $5,945.86 | $6,064.77 | $16,351 |
| Laparoscopic appendectomy | CPT | 44970 | 12 | — | — | $5,559.56 | $5,670.75 | $21,917 |
| Major joint replacement w MCC | MS-DRG | 469 | 12 | — | — | $25,878 | $34,098 | $71,164 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 12 | — | — | $15,349 | $20,491 | $42,210 |
| Laparoscopic cholecystectomy | CPT | 47562 | 12 | — | — | $5,559.56 | $5,670.75 | $21,917 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 12 | — | — | $5,559.56 | $5,670.75 | $21,917 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 12 | — | — | $23,383 | $30,730 | $64,304 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 12 | — | — | $16,791 | $21,830 | $46,175 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 12 | — | — | $13,072 | $16,810 | $35,949 |
| Lap inguinal hernia repair | CPT | 49650 | 12 | — | — | $5,559.56 | $5,670.75 | $21,917 |
| Total abdominal hysterectomy | CPT | 58150 | 1 | — | — | $16,021 | $18,246 | $21,917 |
| Vaginal hysterectomy | CPT | 58260 | 12 | — | — | $4,703.94 | $4,798.02 | $16,907 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 12 | — | — | $5,559.56 | $5,670.75 | $21,917 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 12 | — | — | $9,920.85 | $10,119 | $30,057 |
| Lap salpingo-oophorectomy | CPT | 58661 | 12 | — | — | $5,559.56 | $5,670.75 | $21,917 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 12 | — | — | $21,751 | $28,526 | $59,814 |
| OR procedure for obesity w CC | MS-DRG | 620 | 12 | — | — | $13,153 | $16,919 | $36,171 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 12 | — | — | $12,124 | $15,530 | $33,341 |
| Complex cataract surgery | CPT | 66982 | 12 | — | — | $2,173.31 | $2,216.77 | $8,015 |
| Cataract surgery with lens implant | CPT | 66984 | 12 | — | — | $2,173.31 | $2,216.77 | $8,015 |
| Intravitreal injection | CPT | 67028 | 12 | — | — | $316.07 | $322.39 | $4,433 |
| Vitrectomy mechanical | CPT | 67042 | 12 | — | — | $3,833.38 | $3,910.05 | $16,907 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 12 | — | — | $10,121 | $12,826 | $27,834 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 12 | — | — | $15,871 | $20,588 | $43,644 |
| PCI single major coronary artery | CPT | 92920 | 21 | $22,012 | $11,006 | $5,432.98 | $15,175 | $20,912 |
| PCI with drug-eluting stent | CPT | 92928 | 21 | $59,875 | $29,937 | $10,806 | $40,697 | $56,881 |
| PCI bypass graft | CPT | 92937 | 21 | $81,889 | $40,945 | $10,806 | $55,660 | $77,795 |
| Left heart catheterization | CPT | 93452 | 12 | — | — | $3,064.92 | $3,126.22 | $15,092 |
| Coronary angiography with cath | CPT | 93455 | 21 | $18,505 | $9,252.48 | $3,064.92 | $12,953 | $17,580 |
| Coronary angiography with bypass cath | CPT | 93458 | 21 | $23,854 | $11,927 | $3,064.92 | $16,214 | $22,662 |
Payer mix (top 21)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 186 | $1,725.26 |
| Aetna | 176 | $583.52 |
| Humana | 176 | $777.48 |
| medical mutual of ohio | 176 | $693.69 |
| UnitedHealthcare | 176 | $1,484.08 |
| care source just4me | 174 | $612.56 |
| gateway health | 174 | $347.12 |
| medigold | 174 | $340.31 |
| Molina | 174 | $478.43 |
| sidecar health | 174 | $935.85 |
| buckeye community health plan | 174 | $340.31 |
| care source | 174 | $347.12 |
| Cigna | 109 | $506.59 |
| Multiplan | 108 | $905.21 |
| First Health | 108 | $852.44 |
| ohio health choice | 108 | $758.47 |
| healthsmart | 108 | $809.93 |
| the health plan | 108 | $667 |
| integrated health plan | 108 | $905.21 |
| ohio ppo connect | 108 | $667 |
| three rivers network | 108 | $905.21 |