{"hospital_name":"TRINITY HOSPITAL HOLDING COMPANY","last_updated_on":"2026-02-28","version":"3.0.0","location_name": ["Trinity West","Trinity East","St. Clairsville Neighborhood Hospital"],"hospital_address": ["4000 Johnson Rd, Steubenville, OH 43952","380 Summit Ave, Steubenville, OH 43952","280 W Main St, St.Clairsville, OH 43950"],"license_information":{"license_number":"1208AHR","state":"OH"},"type_2_npi": ["1285715144","1093896961"],"attestation": {"attestation":"To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.","confirm_attestation": true,"attester_name":"Dwayne Richardson , (Interim) President"},"standard_charge_information":[{"description":"KELL (K/K) ANTIGEN GENOTYPIN","code_information":[{"code":"0001U","type":"CPT"},{"code":"0309","type":"RC"}],"standard_charges":[{"gross_charge":544,"discounted_cash":269.79,"setting":"inpatient","additional_generic_notes":"Not separately reimbursable and/or included in pricing for other item/service listed"}]},{"description":"KELL (K/K) ANTIGEN GENOTYPIN","code_information":[{"code":"0001U","type":"CPT"},{"code":"0309","type":"RC"}],"standard_charges":[{"minimum":228.9,"maximum":2426.24,"gross_charge":544,"discounted_cash":269.79,"setting":"outpatient","payers_information":[{"payer_name":"AultCare","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"BCBS - 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EARMOLD)","code_information":[{"code":"V5264","type":"HCPCS"},{"code":"0470","type":"RC"}],"standard_charges":[{"minimum":25.46,"maximum":90.86,"gross_charge":118,"discounted_cash":58.52,"setting":"outpatient","payers_information":[{"payer_name":"AultCare","plan_name":"Commercial|All Plans","standard_charge_dollar":70.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":90.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Non-Options","standard_charge_dollar":88.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":88.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Medicaid|Better Health","standard_charge_dollar":26.73,"methodology":"fee schedule"},{"payer_name":"BCBS - Anthem","plan_name":"Medicaid|All Plans","standard_charge_dollar":25.46,"methodology":"fee schedule"},{"payer_name":"Buckeye","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.73,"methodology":"fee schedule"},{"payer_name":"CareSource","plan_name":"Medicaid|MyCare","standard_charge_dollar":25.46,"methodology":"fee schedule"},{"payer_name":"Molina","plan_name":"Medicaid|All Plans","standard_charge_dollar":25.46,"methodology":"fee schedule"},{"payer_name":"Paramount","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.73,"methodology":"fee schedule"}]}]}],"modifier_information": [{"description": "Bilateral procedure", "code": "50", "modifier_payer_information": [{"payer_name": "BCBS - Anthem","plan_name": "Medicare|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Aetna","plan_name": "Medicare|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "The Health Plan","plan_name": "Medicare|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Centene","plan_name": "Medicare|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "CareSource","plan_name": "Medicare|Just 4 Me","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "BCBS - Anthem","plan_name": "Commercial|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Commercial|Steel","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Commercial|All Other Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Medicare|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "United","plan_name": "Medicare|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "CareSource","plan_name": "Medicare|MyCare","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Molina","plan_name": "Medicare|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Humana","plan_name": "Medicare|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Medical Mutual","plan_name": "Medicare|All Plans","description": "150% payment adjustment for the item or service to which the modifier is appended"}]},{"description": "Item designated by FDA as Class III Devices", "code": "KF", "modifier_payer_information": [{"payer_name": "Highmark","plan_name": "Medicare|All Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "The Health Plan","plan_name": "Medicare|All Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Centene","plan_name": "Medicare|All Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Aetna","plan_name": "Medicare|All Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "BCBS - Anthem","plan_name": "Medicare|All Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Humana","plan_name": "Medicare|All Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Molina","plan_name": "Medicare|All Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "CareSource","plan_name": "Medicare|MyCare","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "United","plan_name": "Medicare|All Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Medical Mutual","plan_name": "Medicare|All Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Commercial|Steel","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "CareSource","plan_name": "Medicare|Just 4 Me","description": "116% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Commercial|All Other Plans","description": "116% payment adjustment for the item or service to which the modifier is appended"}]},{"description": "Replacement of facial prosthesis including new impression/moulage", "code": "KM", "modifier_payer_information": [{"payer_name": "Highmark","plan_name": "Commercial|Steel","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Aetna","plan_name": "Medicare|All Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "BCBS - Anthem","plan_name": "Medicare|All Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Commercial|All Other Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "CareSource","plan_name": "Medicare|MyCare","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Molina","plan_name": "Medicare|All Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "CareSource","plan_name": "Medicare|Just 4 Me","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "United","plan_name": "Medicare|All Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Medical Mutual","plan_name": "Medicare|All Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Humana","plan_name": "Medicare|All Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "The Health Plan","plan_name": "Medicare|All Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Centene","plan_name": "Medicare|All Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Medicare|All Plans","description": "95% payment adjustment for the item or service to which the modifier is appended"}]},{"description": "Replacement of facial prosthesis", "code": "KN", "modifier_payer_information": [{"payer_name": "CareSource","plan_name": "Medicare|MyCare","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Molina","plan_name": "Medicare|All Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Commercial|All Other Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "CareSource","plan_name": "Medicare|Just 4 Me","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Aetna","plan_name": "Medicare|All Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Commercial|Steel","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Humana","plan_name": "Medicare|All Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "United","plan_name": "Medicare|All Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Medical Mutual","plan_name": "Medicare|All Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Centene","plan_name": "Medicare|All Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "BCBS - Anthem","plan_name": "Medicare|All Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "Highmark","plan_name": "Medicare|All Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"},{"payer_name": "The Health Plan","plan_name": "Medicare|All Plans","description": "40% payment adjustment for the item or service to which the modifier is appended"}]}],"general_contract_provisions": [ 
{ "payer_name": "Aetna", "plan_name": "Commercial|All Other Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges/Inpatient - Reimbursement for the entire encounter may be 41.2 Percent of Billed Charges when Billed Charges exceeds a threshold of $150,184.00" },{ "payer_name": "Aetna", "plan_name": "Commercial|HMO", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges/Inpatient - Reimbursement for the entire encounter may be 41.2 Percent of Billed Charges when Billed Charges exceeds a threshold of $150,184.00" },{ "payer_name": "Aetna", "plan_name": "Commercial|PPO", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges/Inpatient - Reimbursement for the entire encounter may be 41.2 Percent of Billed Charges when Billed Charges exceeds a threshold of $150,184.00" },{ "payer_name": "BCBS - Anthem", "plan_name": "Commercial|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be 79.6 Percent of Billed Charges when Billed Charges exceeds a threshold of $120,415.00/Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Cigna", "plan_name": "Commercial|All Other Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Cigna", "plan_name": "Commercial|PPO", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Highmark", "plan_name": "Commercial|All Other Plans", "description": "Outpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Highmark", "plan_name": "Commercial|Steel", "description": "Inpatient - Reimbursement for the entire encounter may be 93 Percent of Billed Charges when Billed Charges exceeds a threshold of $96,910.00/Outpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Humana", "plan_name": "Commercial|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Medical Mutual", "plan_name": "Commercial|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be 55 Percent of Billed Charges when Billed Charges exceeds a threshold of $87,388.00/Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "The Health Plan", "plan_name": "Commercial|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "United", "plan_name": "Commercial|Non-Options", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges/Inpatient - Reimbursement for the entire encounter may be $3,581.00 Per Diem when Billed Charges exceeds a threshold of $154,440.00" },{ "payer_name": "United", "plan_name": "Commercial|Options", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges/Inpatient - Reimbursement for the entire encounter may be $3,581.00 Per Diem when Billed Charges exceeds a threshold of $154,440.00" },{ "payer_name": "Aetna", "plan_name": "Medicaid|Better Health", "description": "Outpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Buckeye", "plan_name": "Medicaid|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "CareSource", "plan_name": "Medicaid|All Other Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Molina", "plan_name": "Medicaid|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Paramount", "plan_name": "Medicaid|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "United", "plan_name": "Medicaid|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "BCBS - Anthem", "plan_name": "Medicare|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "CareSource", "plan_name": "Medicare|Just 4 Me", "description": "Outpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Highmark", "plan_name": "Medicare|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" },{ "payer_name": "Humana", "plan_name": "Medicare|All Plans", "description": "Inpatient - Reimbursement for the entire encounter may be limited to 100 Percent of Billed Charges" }]}