Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: APPENDIX PROCEDURES WITH CC

Facility

$18,247.03

Service Code	MSDRG 398
Min. Negotiated Rate	$12,381.91
Max. Negotiated Rate	$18,247.03
Rate for Payer: Anthem Medicaid	$12,381.91
Rate for Payer: Anthem Medicare Advantage/PPO	$13,033.59
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,247.03
Rate for Payer: CareSource Just4Me Medicare	$17,595.35
Rate for Payer: Humana KY Medicaid	$12,381.91
Rate for Payer: Humana Medicare Advantage	$13,033.59
Rate for Payer: Kentucky WC Medicaid	$12,505.73
Rate for Payer: Molina Healthcare Benefit Exchange	$15,640.31
Rate for Payer: Molina Healthcare Medicaid	$12,629.55

MS-DRG 42.00: APPENDIX PROCEDURES WITH MCC

Facility

$29,878.70

Service Code	MSDRG 397
Min. Negotiated Rate	$20,274.83
Max. Negotiated Rate	$29,878.70
Rate for Payer: Anthem Medicaid	$20,274.83
Rate for Payer: Anthem Medicare Advantage/PPO	$21,341.93
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$29,878.70
Rate for Payer: CareSource Just4Me Medicare	$28,811.61
Rate for Payer: Humana KY Medicaid	$20,274.83
Rate for Payer: Humana Medicare Advantage	$21,341.93
Rate for Payer: Kentucky WC Medicaid	$20,477.58
Rate for Payer: Molina Healthcare Benefit Exchange	$25,610.32
Rate for Payer: Molina Healthcare Medicaid	$20,680.33

MS-DRG 42.00: APPENDIX PROCEDURES WITHOUT CC/MCC

Facility

$13,551.41

Service Code	MSDRG 399
Min. Negotiated Rate	$9,195.60
Max. Negotiated Rate	$13,551.41
Rate for Payer: Anthem Medicaid	$9,195.60
Rate for Payer: Anthem Medicare Advantage/PPO	$9,679.58
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,551.41
Rate for Payer: CareSource Just4Me Medicare	$13,067.43
Rate for Payer: Humana KY Medicaid	$9,195.60
Rate for Payer: Humana Medicare Advantage	$9,679.58
Rate for Payer: Kentucky WC Medicaid	$9,287.56
Rate for Payer: Molina Healthcare Benefit Exchange	$11,615.50
Rate for Payer: Molina Healthcare Medicaid	$9,379.51

MS-DRG 42.00: ARTHROSCOPY

Facility

$21,183.29

Service Code	MSDRG 509
Min. Negotiated Rate	$14,374.37
Max. Negotiated Rate	$21,183.29
Rate for Payer: Anthem Medicaid	$14,374.37
Rate for Payer: Anthem Medicare Advantage/PPO	$15,130.92
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,183.29
Rate for Payer: CareSource Just4Me Medicare	$20,426.74
Rate for Payer: Humana KY Medicaid	$14,374.37
Rate for Payer: Humana Medicare Advantage	$15,130.92
Rate for Payer: Kentucky WC Medicaid	$14,518.12
Rate for Payer: Molina Healthcare Benefit Exchange	$18,157.10
Rate for Payer: Molina Healthcare Medicaid	$14,661.86

MS-DRG 42.00: ATHEROSCLEROSIS WITH MCC

Facility

$14,027.76

Service Code	MSDRG 302
Min. Negotiated Rate	$9,518.84
Max. Negotiated Rate	$14,027.76
Rate for Payer: Anthem Medicaid	$9,518.84
Rate for Payer: Anthem Medicare Advantage/PPO	$10,019.83
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,027.76
Rate for Payer: CareSource Just4Me Medicare	$13,526.77
Rate for Payer: Humana KY Medicaid	$9,518.84
Rate for Payer: Humana Medicare Advantage	$10,019.83
Rate for Payer: Kentucky WC Medicaid	$9,614.03
Rate for Payer: Molina Healthcare Benefit Exchange	$12,023.80
Rate for Payer: Molina Healthcare Medicaid	$9,709.22

MS-DRG 42.00: ATHEROSCLEROSIS WITHOUT MCC

Facility

$8,108.18

Service Code	MSDRG 303
Min. Negotiated Rate	$5,501.98
Max. Negotiated Rate	$8,108.18
Rate for Payer: Anthem Medicaid	$5,501.98
Rate for Payer: Anthem Medicare Advantage/PPO	$5,791.56
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,108.18
Rate for Payer: CareSource Just4Me Medicare	$7,818.61
Rate for Payer: Humana KY Medicaid	$5,501.98
Rate for Payer: Humana Medicare Advantage	$5,791.56
Rate for Payer: Kentucky WC Medicaid	$5,557.00
Rate for Payer: Molina Healthcare Benefit Exchange	$6,949.87
Rate for Payer: Molina Healthcare Medicaid	$5,612.02

MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC

Facility

$72,784.29

Service Code	MSDRG 016
Min. Negotiated Rate	$49,389.34
Max. Negotiated Rate	$72,784.29
Rate for Payer: Anthem Medicaid	$49,389.34
Rate for Payer: Anthem Medicare Advantage/PPO	$51,988.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$72,784.29
Rate for Payer: CareSource Just4Me Medicare	$70,184.85
Rate for Payer: Humana KY Medicaid	$49,389.34
Rate for Payer: Humana Medicare Advantage	$51,988.78
Rate for Payer: Kentucky WC Medicaid	$49,883.23
Rate for Payer: Molina Healthcare Benefit Exchange	$62,386.54
Rate for Payer: Molina Healthcare Medicaid	$50,377.13

MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC

Facility

$72,784.29

Service Code	MSDRG 017
Min. Negotiated Rate	$49,389.34
Max. Negotiated Rate	$72,784.29
Rate for Payer: Anthem Medicaid	$49,389.34
Rate for Payer: Anthem Medicare Advantage/PPO	$51,988.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$72,784.29
Rate for Payer: CareSource Just4Me Medicare	$70,184.85
Rate for Payer: Humana KY Medicaid	$49,389.34
Rate for Payer: Humana Medicare Advantage	$51,988.78
Rate for Payer: Kentucky WC Medicaid	$49,883.23
Rate for Payer: Molina Healthcare Benefit Exchange	$62,386.54
Rate for Payer: Molina Healthcare Medicaid	$50,377.13

MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC

Facility

$23,778.30

Service Code	MSDRG 519
Min. Negotiated Rate	$16,135.27
Max. Negotiated Rate	$23,778.30
Rate for Payer: Anthem Medicaid	$16,135.27
Rate for Payer: Anthem Medicare Advantage/PPO	$16,984.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,778.30
Rate for Payer: CareSource Just4Me Medicare	$22,929.08
Rate for Payer: Humana KY Medicaid	$16,135.27
Rate for Payer: Humana Medicare Advantage	$16,984.50
Rate for Payer: Kentucky WC Medicaid	$16,296.63
Rate for Payer: Molina Healthcare Benefit Exchange	$20,381.40
Rate for Payer: Molina Healthcare Medicaid	$16,457.98

MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR

Facility

$43,217.92

Service Code	MSDRG 518
Min. Negotiated Rate	$29,326.44
Max. Negotiated Rate	$43,217.92
Rate for Payer: Anthem Medicaid	$29,326.44
Rate for Payer: Anthem Medicare Advantage/PPO	$30,869.94
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$43,217.92
Rate for Payer: CareSource Just4Me Medicare	$41,674.42
Rate for Payer: Humana KY Medicaid	$29,326.44
Rate for Payer: Humana Medicare Advantage	$30,869.94
Rate for Payer: Kentucky WC Medicaid	$29,619.71
Rate for Payer: Molina Healthcare Benefit Exchange	$37,043.93
Rate for Payer: Molina Healthcare Medicaid	$29,912.97

MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC

Facility

$17,282.34

Service Code	MSDRG 520
Min. Negotiated Rate	$11,727.30
Max. Negotiated Rate	$17,282.34
Rate for Payer: Anthem Medicaid	$11,727.30
Rate for Payer: Anthem Medicare Advantage/PPO	$12,344.53
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,282.34
Rate for Payer: CareSource Just4Me Medicare	$16,665.12
Rate for Payer: Humana KY Medicaid	$11,727.30
Rate for Payer: Humana Medicare Advantage	$12,344.53
Rate for Payer: Kentucky WC Medicaid	$11,844.58
Rate for Payer: Molina Healthcare Benefit Exchange	$14,813.44
Rate for Payer: Molina Healthcare Medicaid	$11,961.85

MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC

Facility

$28,906.81

Service Code	MSDRG 095
Min. Negotiated Rate	$19,615.33
Max. Negotiated Rate	$28,906.81
Rate for Payer: Anthem Medicaid	$19,615.33
Rate for Payer: Anthem Medicare Advantage/PPO	$20,647.72
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$28,906.81
Rate for Payer: CareSource Just4Me Medicare	$27,874.42
Rate for Payer: Humana KY Medicaid	$19,615.33
Rate for Payer: Humana Medicare Advantage	$20,647.72
Rate for Payer: Kentucky WC Medicaid	$19,811.49
Rate for Payer: Molina Healthcare Benefit Exchange	$24,777.26
Rate for Payer: Molina Healthcare Medicaid	$20,007.64

MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC

Facility

$43,998.12

Service Code	MSDRG 094
Min. Negotiated Rate	$29,855.87
Max. Negotiated Rate	$43,998.12
Rate for Payer: Anthem Medicaid	$29,855.87
Rate for Payer: Anthem Medicare Advantage/PPO	$31,427.23
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$43,998.12
Rate for Payer: CareSource Just4Me Medicare	$42,426.76
Rate for Payer: Humana KY Medicaid	$29,855.87
Rate for Payer: Humana Medicare Advantage	$31,427.23
Rate for Payer: Kentucky WC Medicaid	$30,154.43
Rate for Payer: Molina Healthcare Benefit Exchange	$37,712.68
Rate for Payer: Molina Healthcare Medicaid	$30,452.99

MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC

Facility

$28,906.81

Service Code	MSDRG 096
Min. Negotiated Rate	$19,615.33
Max. Negotiated Rate	$28,906.81
Rate for Payer: Anthem Medicaid	$19,615.33
Rate for Payer: Anthem Medicare Advantage/PPO	$20,647.72
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$28,906.81
Rate for Payer: CareSource Just4Me Medicare	$27,874.42
Rate for Payer: Humana KY Medicaid	$19,615.33
Rate for Payer: Humana Medicare Advantage	$20,647.72
Rate for Payer: Kentucky WC Medicaid	$19,811.49
Rate for Payer: Molina Healthcare Benefit Exchange	$24,777.26
Rate for Payer: Molina Healthcare Medicaid	$20,007.64

MS-DRG 42.00: BEHAVIORAL AND DEVELOPMENTAL DISORDERS

Facility

$21,663.22

Service Code	MSDRG 886
Min. Negotiated Rate	$14,700.04
Max. Negotiated Rate	$21,663.22
Rate for Payer: Anthem Medicaid	$14,700.04
Rate for Payer: Anthem Medicare Advantage/PPO	$15,473.73
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,663.22
Rate for Payer: CareSource Just4Me Medicare	$20,889.54
Rate for Payer: Humana KY Medicaid	$14,700.04
Rate for Payer: Humana Medicare Advantage	$15,473.73
Rate for Payer: Kentucky WC Medicaid	$14,847.04
Rate for Payer: Molina Healthcare Benefit Exchange	$18,568.48
Rate for Payer: Molina Healthcare Medicaid	$14,994.04

MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITH MCC

Facility

$15,225.15

Service Code	MSDRG 725
Min. Negotiated Rate	$10,331.35
Max. Negotiated Rate	$15,225.15
Rate for Payer: Anthem Medicaid	$10,331.35
Rate for Payer: Anthem Medicare Advantage/PPO	$10,875.11
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,225.15
Rate for Payer: CareSource Just4Me Medicare	$14,681.40
Rate for Payer: Humana KY Medicaid	$10,331.35
Rate for Payer: Humana Medicare Advantage	$10,875.11
Rate for Payer: Kentucky WC Medicaid	$10,434.67
Rate for Payer: Molina Healthcare Benefit Exchange	$13,050.13
Rate for Payer: Molina Healthcare Medicaid	$10,537.98

MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC

Facility

$8,976.39

Service Code	MSDRG 726
Min. Negotiated Rate	$6,091.12
Max. Negotiated Rate	$8,976.39
Rate for Payer: Anthem Medicaid	$6,091.12
Rate for Payer: Anthem Medicare Advantage/PPO	$6,411.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,976.39
Rate for Payer: CareSource Just4Me Medicare	$8,655.81
Rate for Payer: Humana KY Medicaid	$6,091.12
Rate for Payer: Humana Medicare Advantage	$6,411.71
Rate for Payer: Kentucky WC Medicaid	$6,152.04
Rate for Payer: Molina Healthcare Benefit Exchange	$7,694.05
Rate for Payer: Molina Healthcare Medicaid	$6,212.95

MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC

Facility

$73,999.81

Service Code	MSDRG 461
Min. Negotiated Rate	$50,214.16
Max. Negotiated Rate	$73,999.81
Rate for Payer: Anthem Medicaid	$50,214.16
Rate for Payer: Anthem Medicare Advantage/PPO	$52,857.01
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$73,999.81
Rate for Payer: CareSource Just4Me Medicare	$71,356.96
Rate for Payer: Humana KY Medicaid	$50,214.16
Rate for Payer: Humana Medicare Advantage	$52,857.01
Rate for Payer: Kentucky WC Medicaid	$50,716.30
Rate for Payer: Molina Healthcare Benefit Exchange	$63,428.41
Rate for Payer: Molina Healthcare Medicaid	$51,218.44

MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC

Facility

$34,533.32

Service Code	MSDRG 462
Min. Negotiated Rate	$23,433.33
Max. Negotiated Rate	$34,533.32
Rate for Payer: Anthem Medicaid	$23,433.33
Rate for Payer: Anthem Medicare Advantage/PPO	$24,666.66
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$34,533.32
Rate for Payer: CareSource Just4Me Medicare	$33,299.99
Rate for Payer: Humana KY Medicaid	$23,433.33
Rate for Payer: Humana Medicare Advantage	$24,666.66
Rate for Payer: Kentucky WC Medicaid	$23,667.66
Rate for Payer: Molina Healthcare Benefit Exchange	$29,599.99
Rate for Payer: Molina Healthcare Medicaid	$23,901.99

MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC

Facility

$25,280.78

Service Code	MSDRG 409
Min. Negotiated Rate	$17,154.81
Max. Negotiated Rate	$25,280.78
Rate for Payer: Anthem Medicaid	$17,154.81
Rate for Payer: Anthem Medicare Advantage/PPO	$18,057.70
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,280.78
Rate for Payer: CareSource Just4Me Medicare	$24,377.90
Rate for Payer: Humana KY Medicaid	$17,154.81
Rate for Payer: Humana Medicare Advantage	$18,057.70
Rate for Payer: Kentucky WC Medicaid	$17,326.36
Rate for Payer: Molina Healthcare Benefit Exchange	$21,669.24
Rate for Payer: Molina Healthcare Medicaid	$17,497.91

MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC

Facility

$42,220.64

Service Code	MSDRG 408
Min. Negotiated Rate	$28,649.72
Max. Negotiated Rate	$42,220.64
Rate for Payer: Anthem Medicaid	$28,649.72
Rate for Payer: Anthem Medicare Advantage/PPO	$30,157.60
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$42,220.64
Rate for Payer: CareSource Just4Me Medicare	$40,712.76
Rate for Payer: Humana KY Medicaid	$28,649.72
Rate for Payer: Humana Medicare Advantage	$30,157.60
Rate for Payer: Kentucky WC Medicaid	$28,936.22
Rate for Payer: Molina Healthcare Benefit Exchange	$36,189.12
Rate for Payer: Molina Healthcare Medicaid	$29,222.71

MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$18,704.03

Service Code	MSDRG 410
Min. Negotiated Rate	$12,692.02
Max. Negotiated Rate	$18,704.03
Rate for Payer: Anthem Medicaid	$12,692.02
Rate for Payer: Anthem Medicare Advantage/PPO	$13,360.02
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,704.03
Rate for Payer: CareSource Just4Me Medicare	$18,036.03
Rate for Payer: Humana KY Medicaid	$12,692.02
Rate for Payer: Humana Medicare Advantage	$13,360.02
Rate for Payer: Kentucky WC Medicaid	$12,818.94
Rate for Payer: Molina Healthcare Benefit Exchange	$16,032.02
Rate for Payer: Molina Healthcare Medicaid	$12,945.86

MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$28,200.17

Service Code	MSDRG 478
Min. Negotiated Rate	$19,135.83
Max. Negotiated Rate	$28,200.17
Rate for Payer: Anthem Medicaid	$19,135.83
Rate for Payer: Anthem Medicare Advantage/PPO	$20,142.98
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$28,200.17
Rate for Payer: CareSource Just4Me Medicare	$27,193.02
Rate for Payer: Humana KY Medicaid	$19,135.83
Rate for Payer: Humana Medicare Advantage	$20,142.98
Rate for Payer: Kentucky WC Medicaid	$19,327.19
Rate for Payer: Molina Healthcare Benefit Exchange	$24,171.58
Rate for Payer: Molina Healthcare Medicaid	$19,518.55

MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$41,469.41

Service Code	MSDRG 477
Min. Negotiated Rate	$28,139.96
Max. Negotiated Rate	$41,469.41
Rate for Payer: Anthem Medicaid	$28,139.96
Rate for Payer: Anthem Medicare Advantage/PPO	$29,621.01
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$41,469.41
Rate for Payer: CareSource Just4Me Medicare	$39,988.36
Rate for Payer: Humana KY Medicaid	$28,139.96
Rate for Payer: Humana Medicare Advantage	$29,621.01
Rate for Payer: Kentucky WC Medicaid	$28,421.36
Rate for Payer: Molina Healthcare Benefit Exchange	$35,545.21
Rate for Payer: Molina Healthcare Medicaid	$28,702.76

MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

Facility

$21,413.60

Service Code	MSDRG 479
Min. Negotiated Rate	$14,530.66
Max. Negotiated Rate	$21,413.60
Rate for Payer: Anthem Medicaid	$14,530.66
Rate for Payer: Anthem Medicare Advantage/PPO	$15,295.43
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,413.60
Rate for Payer: CareSource Just4Me Medicare	$20,648.83
Rate for Payer: Humana KY Medicaid	$14,530.66
Rate for Payer: Humana Medicare Advantage	$15,295.43
Rate for Payer: Kentucky WC Medicaid	$14,675.97
Rate for Payer: Molina Healthcare Benefit Exchange	$18,354.52
Rate for Payer: Molina Healthcare Medicaid	$14,821.27

Know your out-of-pocket cost for care.

All Charges