Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MSCU ROOM RATE

Facility

$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

MS-DRG 42.00: ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$12,975.02

Service Code	MSDRG 770
Min. Negotiated Rate	$8,804.48
Max. Negotiated Rate	$12,975.02
Rate for Payer: Anthem Medicaid	$8,804.48
Rate for Payer: Anthem Medicare Advantage/PPO	$9,267.87
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,975.02
Rate for Payer: CareSource Just4Me Medicare	$12,511.62
Rate for Payer: Humana KY Medicaid	$8,804.48
Rate for Payer: Humana Medicare Advantage	$9,267.87
Rate for Payer: Kentucky WC Medicaid	$8,892.52
Rate for Payer: Molina Healthcare Benefit Exchange	$11,121.44
Rate for Payer: Molina Healthcare Medicaid	$8,980.57

MS-DRG 42.00: ABORTION WITHOUT D&C

Facility

$11,272.35

Service Code	MSDRG 779
Min. Negotiated Rate	$7,649.10
Max. Negotiated Rate	$11,272.35
Rate for Payer: Anthem Medicaid	$7,649.10
Rate for Payer: Anthem Medicare Advantage/PPO	$8,051.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,272.35
Rate for Payer: CareSource Just4Me Medicare	$10,869.77
Rate for Payer: Humana KY Medicaid	$7,649.10
Rate for Payer: Humana Medicare Advantage	$8,051.68
Rate for Payer: Kentucky WC Medicaid	$7,725.59
Rate for Payer: Molina Healthcare Benefit Exchange	$9,662.02
Rate for Payer: Molina Healthcare Medicaid	$7,802.08

MS-DRG 42.00: ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION

Facility

$11,559.35

Service Code	MSDRG 880
Min. Negotiated Rate	$7,843.85
Max. Negotiated Rate	$11,559.35
Rate for Payer: Anthem Medicaid	$7,843.85
Rate for Payer: Anthem Medicare Advantage/PPO	$8,256.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,559.35
Rate for Payer: CareSource Just4Me Medicare	$11,146.52
Rate for Payer: Humana KY Medicaid	$7,843.85
Rate for Payer: Humana Medicare Advantage	$8,256.68
Rate for Payer: Kentucky WC Medicaid	$7,922.28
Rate for Payer: Molina Healthcare Benefit Exchange	$9,908.02
Rate for Payer: Molina Healthcare Medicaid	$8,000.72

MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH CC

Facility

$19,012.74

Service Code	MSDRG 289
Min. Negotiated Rate	$12,901.50
Max. Negotiated Rate	$19,012.74
Rate for Payer: Anthem Medicaid	$12,901.50
Rate for Payer: Anthem Medicare Advantage/PPO	$13,580.53
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,012.74
Rate for Payer: CareSource Just4Me Medicare	$18,333.72
Rate for Payer: Humana KY Medicaid	$12,901.50
Rate for Payer: Humana Medicare Advantage	$13,580.53
Rate for Payer: Kentucky WC Medicaid	$13,030.52
Rate for Payer: Molina Healthcare Benefit Exchange	$16,296.64
Rate for Payer: Molina Healthcare Medicaid	$13,159.53

MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC

Facility

$32,937.98

Service Code	MSDRG 288
Min. Negotiated Rate	$22,350.77
Max. Negotiated Rate	$32,937.98
Rate for Payer: Anthem Medicaid	$22,350.77
Rate for Payer: Anthem Medicare Advantage/PPO	$23,527.13
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$32,937.98
Rate for Payer: CareSource Just4Me Medicare	$31,761.63
Rate for Payer: Humana KY Medicaid	$22,350.77
Rate for Payer: Humana Medicare Advantage	$23,527.13
Rate for Payer: Kentucky WC Medicaid	$22,574.28
Rate for Payer: Molina Healthcare Benefit Exchange	$28,232.56
Rate for Payer: Molina Healthcare Medicaid	$22,797.79

MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC

Facility

$11,805.35

Service Code	MSDRG 290
Min. Negotiated Rate	$8,010.77
Max. Negotiated Rate	$11,805.35
Rate for Payer: Anthem Medicaid	$8,010.77
Rate for Payer: Anthem Medicare Advantage/PPO	$8,432.39
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,805.35
Rate for Payer: CareSource Just4Me Medicare	$11,383.73
Rate for Payer: Humana KY Medicaid	$8,010.77
Rate for Payer: Humana Medicare Advantage	$8,432.39
Rate for Payer: Kentucky WC Medicaid	$8,090.88
Rate for Payer: Molina Healthcare Benefit Exchange	$10,118.87
Rate for Payer: Molina Healthcare Medicaid	$8,170.99

MS-DRG 42.00: ACUTE LEUKEMIA WITH CC

Facility

$25,755.88

Service Code	MSDRG 835
Min. Negotiated Rate	$17,477.21
Max. Negotiated Rate	$25,755.88
Rate for Payer: Anthem Medicaid	$17,477.21
Rate for Payer: Anthem Medicare Advantage/PPO	$18,397.06
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,755.88
Rate for Payer: CareSource Just4Me Medicare	$24,836.03
Rate for Payer: Humana KY Medicaid	$17,477.21
Rate for Payer: Humana Medicare Advantage	$18,397.06
Rate for Payer: Kentucky WC Medicaid	$17,651.98
Rate for Payer: Molina Healthcare Benefit Exchange	$22,076.47
Rate for Payer: Molina Healthcare Medicaid	$17,826.75

MS-DRG 42.00: ACUTE LEUKEMIA WITH MCC

Facility

$66,651.33

Service Code	MSDRG 834
Min. Negotiated Rate	$45,227.69
Max. Negotiated Rate	$66,651.33
Rate for Payer: Anthem Medicaid	$45,227.69
Rate for Payer: Anthem Medicare Advantage/PPO	$47,608.09
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$66,651.33
Rate for Payer: CareSource Just4Me Medicare	$64,270.92
Rate for Payer: Humana KY Medicaid	$45,227.69
Rate for Payer: Humana Medicare Advantage	$47,608.09
Rate for Payer: Kentucky WC Medicaid	$45,679.96
Rate for Payer: Molina Healthcare Benefit Exchange	$57,129.71
Rate for Payer: Molina Healthcare Medicaid	$46,132.24

MS-DRG 42.00: ACUTE LEUKEMIA WITH OTHER PROCEDURES

Facility

$111,082.30

Service Code	MSDRG 850
Min. Negotiated Rate	$75,377.27
Max. Negotiated Rate	$111,082.30
Rate for Payer: Anthem Medicaid	$75,377.27
Rate for Payer: Anthem Medicare Advantage/PPO	$79,344.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$111,082.30
Rate for Payer: CareSource Just4Me Medicare	$107,115.07
Rate for Payer: Humana KY Medicaid	$75,377.27
Rate for Payer: Humana Medicare Advantage	$79,344.50
Rate for Payer: Kentucky WC Medicaid	$76,131.05
Rate for Payer: Molina Healthcare Benefit Exchange	$95,213.40
Rate for Payer: Molina Healthcare Medicaid	$76,884.82

MS-DRG 42.00: ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$15,322.82

Service Code	MSDRG 836
Min. Negotiated Rate	$10,397.63
Max. Negotiated Rate	$15,322.82
Rate for Payer: Anthem Medicaid	$10,397.63
Rate for Payer: Anthem Medicare Advantage/PPO	$10,944.87
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,322.82
Rate for Payer: CareSource Just4Me Medicare	$14,775.57
Rate for Payer: Humana KY Medicaid	$10,397.63
Rate for Payer: Humana Medicare Advantage	$10,944.87
Rate for Payer: Kentucky WC Medicaid	$10,501.60
Rate for Payer: Molina Healthcare Benefit Exchange	$13,133.84
Rate for Payer: Molina Healthcare Medicaid	$10,605.58

MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility

$14,026.54

Service Code	MSDRG 121
Min. Negotiated Rate	$9,518.01
Max. Negotiated Rate	$14,026.54
Rate for Payer: Anthem Medicaid	$9,518.01
Rate for Payer: Anthem Medicare Advantage/PPO	$10,018.96
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,026.54
Rate for Payer: CareSource Just4Me Medicare	$13,525.60
Rate for Payer: Humana KY Medicaid	$9,518.01
Rate for Payer: Humana Medicare Advantage	$10,018.96
Rate for Payer: Kentucky WC Medicaid	$9,613.19
Rate for Payer: Molina Healthcare Benefit Exchange	$12,022.75
Rate for Payer: Molina Healthcare Medicaid	$9,708.37

MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility

$8,179.35

Service Code	MSDRG 122
Min. Negotiated Rate	$5,550.27
Max. Negotiated Rate	$8,179.35
Rate for Payer: Anthem Medicaid	$5,550.27
Rate for Payer: Anthem Medicare Advantage/PPO	$5,842.39
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,179.35
Rate for Payer: CareSource Just4Me Medicare	$7,887.23
Rate for Payer: Humana KY Medicaid	$5,550.27
Rate for Payer: Humana Medicare Advantage	$5,842.39
Rate for Payer: Kentucky WC Medicaid	$5,605.77
Rate for Payer: Molina Healthcare Benefit Exchange	$7,010.87
Rate for Payer: Molina Healthcare Medicaid	$5,661.28

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC

Facility

$11,115.58

Service Code	MSDRG 281
Min. Negotiated Rate	$7,542.72
Max. Negotiated Rate	$11,115.58
Rate for Payer: Anthem Medicaid	$7,542.72
Rate for Payer: Anthem Medicare Advantage/PPO	$7,939.70
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,115.58
Rate for Payer: CareSource Just4Me Medicare	$10,718.59
Rate for Payer: Humana KY Medicaid	$7,542.72
Rate for Payer: Humana Medicare Advantage	$7,939.70
Rate for Payer: Kentucky WC Medicaid	$7,618.14
Rate for Payer: Molina Healthcare Benefit Exchange	$9,527.64
Rate for Payer: Molina Healthcare Medicaid	$7,693.57

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC

Facility

$19,792.92

Service Code	MSDRG 280
Min. Negotiated Rate	$13,430.91
Max. Negotiated Rate	$19,792.92
Rate for Payer: Anthem Medicaid	$13,430.91
Rate for Payer: Anthem Medicare Advantage/PPO	$14,137.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,792.92
Rate for Payer: CareSource Just4Me Medicare	$19,086.03
Rate for Payer: Humana KY Medicaid	$13,430.91
Rate for Payer: Humana Medicare Advantage	$14,137.80
Rate for Payer: Kentucky WC Medicaid	$13,565.22
Rate for Payer: Molina Healthcare Benefit Exchange	$16,965.36
Rate for Payer: Molina Healthcare Medicaid	$13,699.53

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC

Facility

$8,743.69

Service Code	MSDRG 282
Min. Negotiated Rate	$5,933.22
Max. Negotiated Rate	$8,743.69
Rate for Payer: Anthem Medicaid	$5,933.22
Rate for Payer: Anthem Medicare Advantage/PPO	$6,245.49
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,743.69
Rate for Payer: CareSource Just4Me Medicare	$8,431.41
Rate for Payer: Humana KY Medicaid	$5,933.22
Rate for Payer: Humana Medicare Advantage	$6,245.49
Rate for Payer: Kentucky WC Medicaid	$5,992.55
Rate for Payer: Molina Healthcare Benefit Exchange	$7,494.59
Rate for Payer: Molina Healthcare Medicaid	$6,051.88

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC

Facility

$8,935.39

Service Code	MSDRG 284
Min. Negotiated Rate	$6,063.30
Max. Negotiated Rate	$8,935.39
Rate for Payer: Anthem Medicaid	$6,063.30
Rate for Payer: Anthem Medicare Advantage/PPO	$6,382.42
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,935.39
Rate for Payer: CareSource Just4Me Medicare	$8,616.27
Rate for Payer: Humana KY Medicaid	$6,063.30
Rate for Payer: Humana Medicare Advantage	$6,382.42
Rate for Payer: Kentucky WC Medicaid	$6,123.93
Rate for Payer: Molina Healthcare Benefit Exchange	$7,658.90
Rate for Payer: Molina Healthcare Medicaid	$6,184.56

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC

Facility

$23,579.30

Service Code	MSDRG 283
Min. Negotiated Rate	$16,000.24
Max. Negotiated Rate	$23,579.30
Rate for Payer: Anthem Medicaid	$16,000.24
Rate for Payer: Anthem Medicare Advantage/PPO	$16,842.36
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,579.30
Rate for Payer: CareSource Just4Me Medicare	$22,737.19
Rate for Payer: Humana KY Medicaid	$16,000.24
Rate for Payer: Humana Medicare Advantage	$16,842.36
Rate for Payer: Kentucky WC Medicaid	$16,160.24
Rate for Payer: Molina Healthcare Benefit Exchange	$20,210.83
Rate for Payer: Molina Healthcare Medicaid	$16,320.25

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC

Facility

$6,769.69

Service Code	MSDRG 285
Min. Negotiated Rate	$4,593.72
Max. Negotiated Rate	$6,769.69
Rate for Payer: Anthem Medicaid	$4,593.72
Rate for Payer: Anthem Medicare Advantage/PPO	$4,835.49
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$6,769.69
Rate for Payer: CareSource Just4Me Medicare	$6,527.91
Rate for Payer: Humana KY Medicaid	$4,593.72
Rate for Payer: Humana Medicare Advantage	$4,835.49
Rate for Payer: Kentucky WC Medicaid	$4,639.65
Rate for Payer: Molina Healthcare Benefit Exchange	$5,802.59
Rate for Payer: Molina Healthcare Medicaid	$4,685.59

MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC

Facility

$27,481.48

Service Code	MSDRG 614
Min. Negotiated Rate	$18,648.15
Max. Negotiated Rate	$27,481.48
Rate for Payer: Anthem Medicaid	$18,648.15
Rate for Payer: Anthem Medicare Advantage/PPO	$19,629.63
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$27,481.48
Rate for Payer: CareSource Just4Me Medicare	$26,500.00
Rate for Payer: Humana KY Medicaid	$18,648.15
Rate for Payer: Humana Medicare Advantage	$19,629.63
Rate for Payer: Kentucky WC Medicaid	$18,834.63
Rate for Payer: Molina Healthcare Benefit Exchange	$23,555.56
Rate for Payer: Molina Healthcare Medicaid	$19,021.11

MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC

Facility

$17,279.92

Service Code	MSDRG 615
Min. Negotiated Rate	$11,725.66
Max. Negotiated Rate	$17,279.92
Rate for Payer: Anthem Medicaid	$11,725.66
Rate for Payer: Anthem Medicare Advantage/PPO	$12,342.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,279.92
Rate for Payer: CareSource Just4Me Medicare	$16,662.78
Rate for Payer: Humana KY Medicaid	$11,725.66
Rate for Payer: Humana Medicare Advantage	$12,342.80
Rate for Payer: Kentucky WC Medicaid	$11,842.92
Rate for Payer: Molina Healthcare Benefit Exchange	$14,811.36
Rate for Payer: Molina Healthcare Medicaid	$11,960.17

MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$13,731.09

Service Code	MSDRG 560
Min. Negotiated Rate	$9,317.52
Max. Negotiated Rate	$13,731.09
Rate for Payer: Anthem Medicaid	$9,317.52
Rate for Payer: Anthem Medicare Advantage/PPO	$9,807.92
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,731.09
Rate for Payer: CareSource Just4Me Medicare	$13,240.69
Rate for Payer: Humana KY Medicaid	$9,317.52
Rate for Payer: Humana Medicare Advantage	$9,807.92
Rate for Payer: Kentucky WC Medicaid	$9,410.70
Rate for Payer: Molina Healthcare Benefit Exchange	$11,769.50
Rate for Payer: Molina Healthcare Medicaid	$9,503.87

MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$22,384.32

Service Code	MSDRG 559
Min. Negotiated Rate	$15,189.36
Max. Negotiated Rate	$22,384.32
Rate for Payer: Anthem Medicaid	$15,189.36
Rate for Payer: Anthem Medicare Advantage/PPO	$15,988.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,384.32
Rate for Payer: CareSource Just4Me Medicare	$21,584.88
Rate for Payer: Humana KY Medicaid	$15,189.36
Rate for Payer: Humana Medicare Advantage	$15,988.80
Rate for Payer: Kentucky WC Medicaid	$15,341.25
Rate for Payer: Molina Healthcare Benefit Exchange	$19,186.56
Rate for Payer: Molina Healthcare Medicaid	$15,493.15

MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

Facility

$9,859.07

Service Code	MSDRG 561
Min. Negotiated Rate	$6,690.08
Max. Negotiated Rate	$9,859.07
Rate for Payer: Anthem Medicaid	$6,690.08
Rate for Payer: Anthem Medicare Advantage/PPO	$7,042.19
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,859.07
Rate for Payer: CareSource Just4Me Medicare	$9,506.96
Rate for Payer: Humana KY Medicaid	$6,690.08
Rate for Payer: Humana Medicare Advantage	$7,042.19
Rate for Payer: Kentucky WC Medicaid	$6,756.98
Rate for Payer: Molina Healthcare Benefit Exchange	$8,450.63
Rate for Payer: Molina Healthcare Medicaid	$6,823.88

MS-DRG 42.00: AFTERCARE WITH CC/MCC

Facility

$13,011.19

Service Code	MSDRG 949
Min. Negotiated Rate	$8,829.02
Max. Negotiated Rate	$13,011.19
Rate for Payer: Anthem Medicaid	$8,829.02
Rate for Payer: Anthem Medicare Advantage/PPO	$9,293.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,011.19
Rate for Payer: CareSource Just4Me Medicare	$12,546.51
Rate for Payer: Humana KY Medicaid	$8,829.02
Rate for Payer: Humana Medicare Advantage	$9,293.71
Rate for Payer: Kentucky WC Medicaid	$8,917.31
Rate for Payer: Molina Healthcare Benefit Exchange	$11,152.45
Rate for Payer: Molina Healthcare Medicaid	$9,005.60

Know your out-of-pocket cost for care.

All Charges