Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITH MCC

Facility

$15,748.50

Service Code	MSDRG 553
Min. Negotiated Rate	$10,686.48
Max. Negotiated Rate	$15,748.50
Rate for Payer: Anthem Medicaid	$10,686.48
Rate for Payer: Anthem Medicare Advantage/PPO	$11,248.93
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,748.50
Rate for Payer: CareSource Just4Me Medicare	$15,186.06
Rate for Payer: Humana KY Medicaid	$10,686.48
Rate for Payer: Humana Medicare Advantage	$11,248.93
Rate for Payer: Kentucky WC Medicaid	$10,793.35
Rate for Payer: Molina Healthcare Benefit Exchange	$13,498.72
Rate for Payer: Molina Healthcare Medicaid	$10,900.21

MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC

Facility

$10,064.10

Service Code	MSDRG 554
Min. Negotiated Rate	$6,829.21
Max. Negotiated Rate	$10,064.10
Rate for Payer: Anthem Medicaid	$6,829.21
Rate for Payer: Anthem Medicare Advantage/PPO	$7,188.64
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,064.10
Rate for Payer: CareSource Just4Me Medicare	$9,704.66
Rate for Payer: Humana KY Medicaid	$6,829.21
Rate for Payer: Humana Medicare Advantage	$7,188.64
Rate for Payer: Kentucky WC Medicaid	$6,897.50
Rate for Payer: Molina Healthcare Benefit Exchange	$8,626.37
Rate for Payer: Molina Healthcare Medicaid	$6,965.79

MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC

Facility

$24,688.72

Service Code	MSDRG 584
Min. Negotiated Rate	$16,753.06
Max. Negotiated Rate	$24,688.72
Rate for Payer: Anthem Medicaid	$16,753.06
Rate for Payer: Anthem Medicare Advantage/PPO	$17,634.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$24,688.72
Rate for Payer: CareSource Just4Me Medicare	$23,806.98
Rate for Payer: Humana KY Medicaid	$16,753.06
Rate for Payer: Humana Medicare Advantage	$17,634.80
Rate for Payer: Kentucky WC Medicaid	$16,920.59
Rate for Payer: Molina Healthcare Benefit Exchange	$21,161.76
Rate for Payer: Molina Healthcare Medicaid	$17,088.12

MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC

Facility

$23,937.47

Service Code	MSDRG 585
Min. Negotiated Rate	$16,243.28
Max. Negotiated Rate	$23,937.47
Rate for Payer: Anthem Medicaid	$16,243.28
Rate for Payer: Anthem Medicare Advantage/PPO	$17,098.19
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,937.47
Rate for Payer: CareSource Just4Me Medicare	$23,082.56
Rate for Payer: Humana KY Medicaid	$16,243.28
Rate for Payer: Humana Medicare Advantage	$17,098.19
Rate for Payer: Kentucky WC Medicaid	$16,405.71
Rate for Payer: Molina Healthcare Benefit Exchange	$20,517.83
Rate for Payer: Molina Healthcare Medicaid	$16,568.15

MS-DRG 42.00: BRONCHITIS AND ASTHMA WITH CC/MCC

Facility

$11,656.99

Service Code	MSDRG 202
Min. Negotiated Rate	$7,910.10
Max. Negotiated Rate	$11,656.99
Rate for Payer: Anthem Medicaid	$7,910.10
Rate for Payer: Anthem Medicare Advantage/PPO	$8,326.42
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,656.99
Rate for Payer: CareSource Just4Me Medicare	$11,240.67
Rate for Payer: Humana KY Medicaid	$7,910.10
Rate for Payer: Humana Medicare Advantage	$8,326.42
Rate for Payer: Kentucky WC Medicaid	$7,989.20
Rate for Payer: Molina Healthcare Benefit Exchange	$9,991.70
Rate for Payer: Molina Healthcare Medicaid	$8,068.30

MS-DRG 42.00: BRONCHITIS AND ASTHMA WITHOUT CC/MCC

Facility

$8,399.99

Service Code	MSDRG 203
Min. Negotiated Rate	$5,699.99
Max. Negotiated Rate	$8,399.99
Rate for Payer: Anthem Medicaid	$5,699.99
Rate for Payer: Anthem Medicare Advantage/PPO	$5,999.99
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,399.99
Rate for Payer: CareSource Just4Me Medicare	$8,099.99
Rate for Payer: Humana KY Medicaid	$5,699.99
Rate for Payer: Humana Medicare Advantage	$5,999.99
Rate for Payer: Kentucky WC Medicaid	$5,756.99
Rate for Payer: Molina Healthcare Benefit Exchange	$7,199.99
Rate for Payer: Molina Healthcare Medicaid	$5,813.99

MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH CC

Facility

$8,494.04

Service Code	MSDRG 297
Min. Negotiated Rate	$5,763.81
Max. Negotiated Rate	$8,494.04
Rate for Payer: Anthem Medicaid	$5,763.81
Rate for Payer: Anthem Medicare Advantage/PPO	$6,067.17
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,494.04
Rate for Payer: CareSource Just4Me Medicare	$8,190.68
Rate for Payer: Humana KY Medicaid	$5,763.81
Rate for Payer: Humana Medicare Advantage	$6,067.17
Rate for Payer: Kentucky WC Medicaid	$5,821.45
Rate for Payer: Molina Healthcare Benefit Exchange	$7,280.60
Rate for Payer: Molina Healthcare Medicaid	$5,879.09

MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH MCC

Facility

$19,756.76

Service Code	MSDRG 296
Min. Negotiated Rate	$13,406.37
Max. Negotiated Rate	$19,756.76
Rate for Payer: Anthem Medicaid	$13,406.37
Rate for Payer: Anthem Medicare Advantage/PPO	$14,111.97
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,756.76
Rate for Payer: CareSource Just4Me Medicare	$19,051.16
Rate for Payer: Humana KY Medicaid	$13,406.37
Rate for Payer: Humana Medicare Advantage	$14,111.97
Rate for Payer: Kentucky WC Medicaid	$13,540.44
Rate for Payer: Molina Healthcare Benefit Exchange	$16,934.36
Rate for Payer: Molina Healthcare Medicaid	$13,674.50

MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC

Facility

$5,326.27

Service Code	MSDRG 298
Min. Negotiated Rate	$3,614.26
Max. Negotiated Rate	$5,326.27
Rate for Payer: Anthem Medicaid	$3,614.26
Rate for Payer: Anthem Medicare Advantage/PPO	$3,804.48
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$5,326.27
Rate for Payer: CareSource Just4Me Medicare	$5,136.05
Rate for Payer: Humana KY Medicaid	$3,614.26
Rate for Payer: Humana Medicare Advantage	$3,804.48
Rate for Payer: Kentucky WC Medicaid	$3,650.40
Rate for Payer: Molina Healthcare Benefit Exchange	$4,565.38
Rate for Payer: Molina Healthcare Medicaid	$3,686.54

MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC

Facility

$8,914.91

Service Code	MSDRG 309
Min. Negotiated Rate	$6,049.40
Max. Negotiated Rate	$8,914.91
Rate for Payer: Anthem Medicaid	$6,049.40
Rate for Payer: Anthem Medicare Advantage/PPO	$6,367.79
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,914.91
Rate for Payer: CareSource Just4Me Medicare	$8,596.52
Rate for Payer: Humana KY Medicaid	$6,049.40
Rate for Payer: Humana Medicare Advantage	$6,367.79
Rate for Payer: Kentucky WC Medicaid	$6,109.89
Rate for Payer: Molina Healthcare Benefit Exchange	$7,641.35
Rate for Payer: Molina Healthcare Medicaid	$6,170.39

MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC

Facility

$14,541.44

Service Code	MSDRG 308
Min. Negotiated Rate	$9,867.40
Max. Negotiated Rate	$14,541.44
Rate for Payer: Anthem Medicaid	$9,867.40
Rate for Payer: Anthem Medicare Advantage/PPO	$10,386.74
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,541.44
Rate for Payer: CareSource Just4Me Medicare	$14,022.10
Rate for Payer: Humana KY Medicaid	$9,867.40
Rate for Payer: Humana Medicare Advantage	$10,386.74
Rate for Payer: Kentucky WC Medicaid	$9,966.08
Rate for Payer: Molina Healthcare Benefit Exchange	$12,464.09
Rate for Payer: Molina Healthcare Medicaid	$10,064.75

MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC

Facility

$6,746.78

Service Code	MSDRG 310
Min. Negotiated Rate	$4,578.17
Max. Negotiated Rate	$6,746.78
Rate for Payer: Anthem Medicaid	$4,578.17
Rate for Payer: Anthem Medicare Advantage/PPO	$4,819.13
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$6,746.78
Rate for Payer: CareSource Just4Me Medicare	$6,505.83
Rate for Payer: Humana KY Medicaid	$4,578.17
Rate for Payer: Humana Medicare Advantage	$4,819.13
Rate for Payer: Kentucky WC Medicaid	$4,623.96
Rate for Payer: Molina Healthcare Benefit Exchange	$5,782.96
Rate for Payer: Molina Healthcare Medicaid	$4,669.74

MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC

Facility

$18,056.50

Service Code	MSDRG 306
Min. Negotiated Rate	$12,252.62
Max. Negotiated Rate	$18,056.50
Rate for Payer: Anthem Medicaid	$12,252.62
Rate for Payer: Anthem Medicare Advantage/PPO	$12,897.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,056.50
Rate for Payer: CareSource Just4Me Medicare	$17,411.62
Rate for Payer: Humana KY Medicaid	$12,252.62
Rate for Payer: Humana Medicare Advantage	$12,897.50
Rate for Payer: Kentucky WC Medicaid	$12,375.15
Rate for Payer: Molina Healthcare Benefit Exchange	$15,477.00
Rate for Payer: Molina Healthcare Medicaid	$12,497.68

MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC

Facility

$11,171.05

Service Code	MSDRG 307
Min. Negotiated Rate	$7,580.35
Max. Negotiated Rate	$11,171.05
Rate for Payer: Anthem Medicaid	$7,580.35
Rate for Payer: Anthem Medicare Advantage/PPO	$7,979.32
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,171.05
Rate for Payer: CareSource Just4Me Medicare	$10,772.08
Rate for Payer: Humana KY Medicaid	$7,580.35
Rate for Payer: Humana Medicare Advantage	$7,979.32
Rate for Payer: Kentucky WC Medicaid	$7,656.16
Rate for Payer: Molina Healthcare Benefit Exchange	$9,575.18
Rate for Payer: Molina Healthcare Medicaid	$7,731.96

MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC

Facility

$85,217.87

Service Code	MSDRG 275
Min. Negotiated Rate	$57,826.41
Max. Negotiated Rate	$85,217.87
Rate for Payer: Anthem Medicaid	$57,826.41
Rate for Payer: Anthem Medicare Advantage/PPO	$60,869.91
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$85,217.87
Rate for Payer: CareSource Just4Me Medicare	$82,174.38
Rate for Payer: Humana KY Medicaid	$57,826.41
Rate for Payer: Humana Medicare Advantage	$60,869.91
Rate for Payer: Kentucky WC Medicaid	$58,404.68
Rate for Payer: Molina Healthcare Benefit Exchange	$73,043.89
Rate for Payer: Molina Healthcare Medicaid	$58,982.94

MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR

Facility

$74,695.60

Service Code	MSDRG 276
Min. Negotiated Rate	$50,686.30
Max. Negotiated Rate	$74,695.60
Rate for Payer: Anthem Medicaid	$50,686.30
Rate for Payer: Anthem Medicare Advantage/PPO	$53,354.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$74,695.60
Rate for Payer: CareSource Just4Me Medicare	$72,027.90
Rate for Payer: Humana KY Medicaid	$50,686.30
Rate for Payer: Humana Medicare Advantage	$53,354.00
Rate for Payer: Kentucky WC Medicaid	$51,193.16
Rate for Payer: Molina Healthcare Benefit Exchange	$64,024.80
Rate for Payer: Molina Healthcare Medicaid	$51,700.03

MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC

Facility

$56,095.27

Service Code	MSDRG 277
Min. Negotiated Rate	$38,064.65
Max. Negotiated Rate	$56,095.27
Rate for Payer: Anthem Medicaid	$38,064.65
Rate for Payer: Anthem Medicare Advantage/PPO	$40,068.05
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$56,095.27
Rate for Payer: CareSource Just4Me Medicare	$54,091.87
Rate for Payer: Humana KY Medicaid	$38,064.65
Rate for Payer: Humana Medicare Advantage	$40,068.05
Rate for Payer: Kentucky WC Medicaid	$38,445.29
Rate for Payer: Molina Healthcare Benefit Exchange	$48,081.66
Rate for Payer: Molina Healthcare Medicaid	$38,825.94

MS-DRG 42.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC

Facility

$33,830.33

Service Code	MSDRG 258
Min. Negotiated Rate	$22,956.29
Max. Negotiated Rate	$33,830.33
Rate for Payer: Anthem Medicaid	$22,956.29
Rate for Payer: Anthem Medicare Advantage/PPO	$24,164.52
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$33,830.33
Rate for Payer: CareSource Just4Me Medicare	$32,622.10
Rate for Payer: Humana KY Medicaid	$22,956.29
Rate for Payer: Humana Medicare Advantage	$24,164.52
Rate for Payer: Kentucky WC Medicaid	$23,185.86
Rate for Payer: Molina Healthcare Benefit Exchange	$28,997.42
Rate for Payer: Molina Healthcare Medicaid	$23,415.42

MS-DRG 42.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC

Facility

$21,195.33

Service Code	MSDRG 259
Min. Negotiated Rate	$14,382.54
Max. Negotiated Rate	$21,195.33
Rate for Payer: Anthem Medicaid	$14,382.54
Rate for Payer: Anthem Medicare Advantage/PPO	$15,139.52
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,195.33
Rate for Payer: CareSource Just4Me Medicare	$20,438.35
Rate for Payer: Humana KY Medicaid	$14,382.54
Rate for Payer: Humana Medicare Advantage	$15,139.52
Rate for Payer: Kentucky WC Medicaid	$14,526.37
Rate for Payer: Molina Healthcare Benefit Exchange	$18,167.42
Rate for Payer: Molina Healthcare Medicaid	$14,670.19

MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC

Facility

$22,882.34

Service Code	MSDRG 261
Min. Negotiated Rate	$15,527.30
Max. Negotiated Rate	$22,882.34
Rate for Payer: Anthem Medicaid	$15,527.30
Rate for Payer: Anthem Medicare Advantage/PPO	$16,344.53
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,882.34
Rate for Payer: CareSource Just4Me Medicare	$22,065.12
Rate for Payer: Humana KY Medicaid	$15,527.30
Rate for Payer: Humana Medicare Advantage	$16,344.53
Rate for Payer: Kentucky WC Medicaid	$15,682.58
Rate for Payer: Molina Healthcare Benefit Exchange	$19,613.44
Rate for Payer: Molina Healthcare Medicaid	$15,837.85

MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC

Facility

$41,073.89

Service Code	MSDRG 260
Min. Negotiated Rate	$27,871.57
Max. Negotiated Rate	$41,073.89
Rate for Payer: Anthem Medicaid	$27,871.57
Rate for Payer: Anthem Medicare Advantage/PPO	$29,338.49
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$41,073.89
Rate for Payer: CareSource Just4Me Medicare	$39,606.96
Rate for Payer: Humana KY Medicaid	$27,871.57
Rate for Payer: Humana Medicare Advantage	$29,338.49
Rate for Payer: Kentucky WC Medicaid	$28,150.28
Rate for Payer: Molina Healthcare Benefit Exchange	$35,206.19
Rate for Payer: Molina Healthcare Medicaid	$28,429.00

MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC

Facility

$18,302.51

Service Code	MSDRG 262
Min. Negotiated Rate	$12,419.56
Max. Negotiated Rate	$18,302.51
Rate for Payer: Anthem Medicaid	$12,419.56
Rate for Payer: Anthem Medicare Advantage/PPO	$13,073.22
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,302.51
Rate for Payer: CareSource Just4Me Medicare	$17,648.85
Rate for Payer: Humana KY Medicaid	$12,419.56
Rate for Payer: Humana Medicare Advantage	$13,073.22
Rate for Payer: Kentucky WC Medicaid	$12,543.75
Rate for Payer: Molina Healthcare Benefit Exchange	$15,687.86
Rate for Payer: Molina Healthcare Medicaid	$12,667.95

MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC

Facility

$77,873.04

Service Code	MSDRG 217
Min. Negotiated Rate	$52,842.42
Max. Negotiated Rate	$77,873.04
Rate for Payer: Anthem Medicaid	$52,842.42
Rate for Payer: Anthem Medicare Advantage/PPO	$55,623.60
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$77,873.04
Rate for Payer: CareSource Just4Me Medicare	$75,091.86
Rate for Payer: Humana KY Medicaid	$52,842.42
Rate for Payer: Humana Medicare Advantage	$55,623.60
Rate for Payer: Kentucky WC Medicaid	$53,370.84
Rate for Payer: Molina Healthcare Benefit Exchange	$66,748.32
Rate for Payer: Molina Healthcare Medicaid	$53,899.27

MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC

Facility

$116,378.46

Service Code	MSDRG 216
Min. Negotiated Rate	$78,971.10
Max. Negotiated Rate	$116,378.46
Rate for Payer: Anthem Medicaid	$78,971.10
Rate for Payer: Anthem Medicare Advantage/PPO	$83,127.47
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$116,378.46
Rate for Payer: CareSource Just4Me Medicare	$112,222.08
Rate for Payer: Humana KY Medicaid	$78,971.10
Rate for Payer: Humana Medicare Advantage	$83,127.47
Rate for Payer: Kentucky WC Medicaid	$79,760.81
Rate for Payer: Molina Healthcare Benefit Exchange	$99,752.96
Rate for Payer: Molina Healthcare Medicaid	$80,550.52

MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

$71,740.03

Service Code	MSDRG 218
Min. Negotiated Rate	$48,680.74
Max. Negotiated Rate	$71,740.03
Rate for Payer: Anthem Medicaid	$48,680.74
Rate for Payer: Anthem Medicare Advantage/PPO	$51,242.88
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$71,740.03
Rate for Payer: CareSource Just4Me Medicare	$69,177.89
Rate for Payer: Humana KY Medicaid	$48,680.74
Rate for Payer: Humana Medicare Advantage	$51,242.88
Rate for Payer: Kentucky WC Medicaid	$49,167.54
Rate for Payer: Molina Healthcare Benefit Exchange	$61,491.46
Rate for Payer: Molina Healthcare Medicaid	$49,654.35

Know your out-of-pocket cost for care.

All Charges