Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$63,870.63

Service Code	MSDRG 220
Min. Negotiated Rate	$43,340.79
Max. Negotiated Rate	$63,870.63
Rate for Payer: Anthem Medicaid	$43,340.79
Rate for Payer: Anthem Medicare Advantage/PPO	$45,621.88
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$63,870.63
Rate for Payer: CareSource Just4Me Medicare	$61,589.54
Rate for Payer: Humana KY Medicaid	$43,340.79
Rate for Payer: Humana Medicare Advantage	$45,621.88
Rate for Payer: Kentucky WC Medicaid	$43,774.19
Rate for Payer: Molina Healthcare Benefit Exchange	$54,746.26
Rate for Payer: Molina Healthcare Medicaid	$44,207.60

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

Facility

$93,303.18

Service Code	MSDRG 219
Min. Negotiated Rate	$63,312.87
Max. Negotiated Rate	$93,303.18
Rate for Payer: Anthem Medicaid	$63,312.87
Rate for Payer: Anthem Medicare Advantage/PPO	$66,645.13
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$93,303.18
Rate for Payer: CareSource Just4Me Medicare	$89,970.93
Rate for Payer: Humana KY Medicaid	$63,312.87
Rate for Payer: Humana Medicare Advantage	$66,645.13
Rate for Payer: Kentucky WC Medicaid	$63,946.00
Rate for Payer: Molina Healthcare Benefit Exchange	$79,974.16
Rate for Payer: Molina Healthcare Medicaid	$64,579.13

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

Facility

$55,380.18

Service Code	MSDRG 221
Min. Negotiated Rate	$37,579.41
Max. Negotiated Rate	$55,380.18
Rate for Payer: Anthem Medicaid	$37,579.41
Rate for Payer: Anthem Medicare Advantage/PPO	$39,557.27
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$55,380.18
Rate for Payer: CareSource Just4Me Medicare	$53,402.31
Rate for Payer: Humana KY Medicaid	$37,579.41
Rate for Payer: Humana Medicare Advantage	$39,557.27
Rate for Payer: Kentucky WC Medicaid	$37,955.20
Rate for Payer: Molina Healthcare Benefit Exchange	$47,468.72
Rate for Payer: Molina Healthcare Medicaid	$38,330.99

MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH CC

Facility

$27,430.83

Service Code	MSDRG 035
Min. Negotiated Rate	$18,613.78
Max. Negotiated Rate	$27,430.83
Rate for Payer: Anthem Medicaid	$18,613.78
Rate for Payer: Anthem Medicare Advantage/PPO	$19,593.45
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$27,430.83
Rate for Payer: CareSource Just4Me Medicare	$26,451.16
Rate for Payer: Humana KY Medicaid	$18,613.78
Rate for Payer: Humana Medicare Advantage	$19,593.45
Rate for Payer: Kentucky WC Medicaid	$18,799.92
Rate for Payer: Molina Healthcare Benefit Exchange	$23,512.14
Rate for Payer: Molina Healthcare Medicaid	$18,986.05

MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH MCC

Facility

$46,892.15

Service Code	MSDRG 034
Min. Negotiated Rate	$31,819.67
Max. Negotiated Rate	$46,892.15
Rate for Payer: Anthem Medicaid	$31,819.67
Rate for Payer: Anthem Medicare Advantage/PPO	$33,494.39
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$46,892.15
Rate for Payer: CareSource Just4Me Medicare	$45,217.43
Rate for Payer: Humana KY Medicaid	$31,819.67
Rate for Payer: Humana Medicare Advantage	$33,494.39
Rate for Payer: Kentucky WC Medicaid	$32,137.87
Rate for Payer: Molina Healthcare Benefit Exchange	$40,193.27
Rate for Payer: Molina Healthcare Medicaid	$32,456.06

MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC

Facility

$22,104.56

Service Code	MSDRG 036
Min. Negotiated Rate	$14,999.52
Max. Negotiated Rate	$22,104.56
Rate for Payer: Anthem Medicaid	$14,999.52
Rate for Payer: Anthem Medicare Advantage/PPO	$15,788.97
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,104.56
Rate for Payer: CareSource Just4Me Medicare	$21,315.11
Rate for Payer: Humana KY Medicaid	$14,999.52
Rate for Payer: Humana Medicare Advantage	$15,788.97
Rate for Payer: Kentucky WC Medicaid	$15,149.52
Rate for Payer: Molina Healthcare Benefit Exchange	$18,946.76
Rate for Payer: Molina Healthcare Medicaid	$15,299.51

MS-DRG 42.00: CELLULITIS WITH MCC

Facility

$17,716.45

Service Code	MSDRG 602
Min. Negotiated Rate	$12,021.88
Max. Negotiated Rate	$17,716.45
Rate for Payer: Anthem Medicaid	$12,021.88
Rate for Payer: Anthem Medicare Advantage/PPO	$12,654.61
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,716.45
Rate for Payer: CareSource Just4Me Medicare	$17,083.72
Rate for Payer: Humana KY Medicaid	$12,021.88
Rate for Payer: Humana Medicare Advantage	$12,654.61
Rate for Payer: Kentucky WC Medicaid	$12,142.10
Rate for Payer: Molina Healthcare Benefit Exchange	$15,185.53
Rate for Payer: Molina Healthcare Medicaid	$12,262.32

MS-DRG 42.00: CELLULITIS WITHOUT MCC

Facility

$10,621.17

Service Code	MSDRG 603
Min. Negotiated Rate	$7,207.22
Max. Negotiated Rate	$10,621.17
Rate for Payer: Anthem Medicaid	$7,207.22
Rate for Payer: Anthem Medicare Advantage/PPO	$7,586.55
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,621.17
Rate for Payer: CareSource Just4Me Medicare	$10,241.84
Rate for Payer: Humana KY Medicaid	$7,207.22
Rate for Payer: Humana Medicare Advantage	$7,586.55
Rate for Payer: Kentucky WC Medicaid	$7,279.29
Rate for Payer: Molina Healthcare Benefit Exchange	$9,103.86
Rate for Payer: Molina Healthcare Medicaid	$7,351.37

MS-DRG 42.00: CERVICAL SPINAL FUSION WITH CC

Facility

$34,936.08

Service Code	MSDRG 472
Min. Negotiated Rate	$23,706.62
Max. Negotiated Rate	$34,936.08
Rate for Payer: Anthem Medicaid	$23,706.62
Rate for Payer: Anthem Medicare Advantage/PPO	$24,954.34
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$34,936.08
Rate for Payer: CareSource Just4Me Medicare	$33,688.36
Rate for Payer: Humana KY Medicaid	$23,706.62
Rate for Payer: Humana Medicare Advantage	$24,954.34
Rate for Payer: Kentucky WC Medicaid	$23,943.69
Rate for Payer: Molina Healthcare Benefit Exchange	$29,945.21
Rate for Payer: Molina Healthcare Medicaid	$24,180.76

MS-DRG 42.00: CERVICAL SPINAL FUSION WITH MCC

Facility

$58,572.08

Service Code	MSDRG 471
Min. Negotiated Rate	$39,745.34
Max. Negotiated Rate	$58,572.08
Rate for Payer: Anthem Medicaid	$39,745.34
Rate for Payer: Anthem Medicare Advantage/PPO	$41,837.20
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$58,572.08
Rate for Payer: CareSource Just4Me Medicare	$56,480.22
Rate for Payer: Humana KY Medicaid	$39,745.34
Rate for Payer: Humana Medicare Advantage	$41,837.20
Rate for Payer: Kentucky WC Medicaid	$40,142.79
Rate for Payer: Molina Healthcare Benefit Exchange	$50,204.64
Rate for Payer: Molina Healthcare Medicaid	$40,540.25

MS-DRG 42.00: CERVICAL SPINAL FUSION WITHOUT CC/MCC

Facility

$28,547.44

Service Code	MSDRG 473
Min. Negotiated Rate	$19,371.48
Max. Negotiated Rate	$28,547.44
Rate for Payer: Anthem Medicaid	$19,371.48
Rate for Payer: Anthem Medicare Advantage/PPO	$20,391.03
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$28,547.44
Rate for Payer: CareSource Just4Me Medicare	$27,527.89
Rate for Payer: Humana KY Medicaid	$19,371.48
Rate for Payer: Humana Medicare Advantage	$20,391.03
Rate for Payer: Kentucky WC Medicaid	$19,565.19
Rate for Payer: Molina Healthcare Benefit Exchange	$24,469.24
Rate for Payer: Molina Healthcare Medicaid	$19,758.91

MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH CC

Facility

$12,803.78

Service Code	MSDRG 787
Min. Negotiated Rate	$7,620.00
Max. Negotiated Rate	$12,803.78
Rate for Payer: Anthem Medicaid	$8,688.28
Rate for Payer: Anthem Medicare Advantage/PPO	$9,145.56
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,803.78
Rate for Payer: CareSource Just4Me Medicare	$12,346.51
Rate for Payer: Humana KY Medicaid	$8,688.28
Rate for Payer: Humana Medicare Advantage	$9,145.56
Rate for Payer: Kentucky WC Medicaid	$8,775.16
Rate for Payer: Molina Healthcare Benefit Exchange	$7,620.00
Rate for Payer: Molina Healthcare Medicaid	$8,862.05

MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC

Facility

$19,485.41

Service Code	MSDRG 786
Min. Negotiated Rate	$7,620.00
Max. Negotiated Rate	$19,485.41
Rate for Payer: Anthem Medicaid	$13,222.24
Rate for Payer: Anthem Medicare Advantage/PPO	$13,918.15
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,485.41
Rate for Payer: CareSource Just4Me Medicare	$18,789.50
Rate for Payer: Humana KY Medicaid	$13,222.24
Rate for Payer: Humana Medicare Advantage	$13,918.15
Rate for Payer: Kentucky WC Medicaid	$13,354.46
Rate for Payer: Molina Healthcare Benefit Exchange	$7,620.00
Rate for Payer: Molina Healthcare Medicaid	$13,486.69

MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC

Facility

$10,909.37

Service Code	MSDRG 788
Min. Negotiated Rate	$7,402.79
Max. Negotiated Rate	$10,909.37
Rate for Payer: Anthem Medicaid	$7,402.79
Rate for Payer: Anthem Medicare Advantage/PPO	$7,792.41
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,909.37
Rate for Payer: CareSource Just4Me Medicare	$10,519.75
Rate for Payer: Humana KY Medicaid	$7,402.79
Rate for Payer: Humana Medicare Advantage	$7,792.41
Rate for Payer: Kentucky WC Medicaid	$7,476.82
Rate for Payer: Molina Healthcare Benefit Exchange	$7,620.00
Rate for Payer: Molina Healthcare Medicaid	$7,550.85

MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH CC

Facility

$13,059.42

Service Code	MSDRG 784
Min. Negotiated Rate	$7,620.00
Max. Negotiated Rate	$13,059.42
Rate for Payer: Anthem Medicaid	$8,861.75
Rate for Payer: Anthem Medicare Advantage/PPO	$9,328.16
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,059.42
Rate for Payer: CareSource Just4Me Medicare	$12,593.02
Rate for Payer: Humana KY Medicaid	$8,861.75
Rate for Payer: Humana Medicare Advantage	$9,328.16
Rate for Payer: Kentucky WC Medicaid	$8,950.37
Rate for Payer: Molina Healthcare Benefit Exchange	$7,620.00
Rate for Payer: Molina Healthcare Medicaid	$9,038.99

MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH MCC

Facility

$22,213.10

Service Code	MSDRG 783
Min. Negotiated Rate	$7,620.00
Max. Negotiated Rate	$22,213.10
Rate for Payer: Anthem Medicaid	$15,073.17
Rate for Payer: Anthem Medicare Advantage/PPO	$15,866.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,213.10
Rate for Payer: CareSource Just4Me Medicare	$21,419.78
Rate for Payer: Humana KY Medicaid	$15,073.17
Rate for Payer: Humana Medicare Advantage	$15,866.50
Rate for Payer: Kentucky WC Medicaid	$15,223.91
Rate for Payer: Molina Healthcare Benefit Exchange	$7,620.00
Rate for Payer: Molina Healthcare Medicaid	$15,374.64

MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC

Facility

$10,533.15

Service Code	MSDRG 785
Min. Negotiated Rate	$7,147.50
Max. Negotiated Rate	$10,533.15
Rate for Payer: Anthem Medicaid	$7,147.50
Rate for Payer: Anthem Medicare Advantage/PPO	$7,523.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,533.15
Rate for Payer: CareSource Just4Me Medicare	$10,156.97
Rate for Payer: Humana KY Medicaid	$7,147.50
Rate for Payer: Humana Medicare Advantage	$7,523.68
Rate for Payer: Kentucky WC Medicaid	$7,218.97
Rate for Payer: Molina Healthcare Benefit Exchange	$7,620.00
Rate for Payer: Molina Healthcare Medicaid	$7,290.45

MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC

Facility

$60,379.66

Service Code	MSDRG 837
Min. Negotiated Rate	$40,971.91
Max. Negotiated Rate	$60,379.66
Rate for Payer: Anthem Medicaid	$40,971.91
Rate for Payer: Anthem Medicare Advantage/PPO	$43,128.33
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$60,379.66
Rate for Payer: CareSource Just4Me Medicare	$58,223.25
Rate for Payer: Humana KY Medicaid	$40,971.91
Rate for Payer: Humana Medicare Advantage	$43,128.33
Rate for Payer: Kentucky WC Medicaid	$41,381.63
Rate for Payer: Molina Healthcare Benefit Exchange	$51,754.00
Rate for Payer: Molina Healthcare Medicaid	$41,791.35

MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT

Facility

$24,457.19

Service Code	MSDRG 838
Min. Negotiated Rate	$16,595.95
Max. Negotiated Rate	$24,457.19
Rate for Payer: Anthem Medicaid	$16,595.95
Rate for Payer: Anthem Medicare Advantage/PPO	$17,469.42
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$24,457.19
Rate for Payer: CareSource Just4Me Medicare	$23,583.72
Rate for Payer: Humana KY Medicaid	$16,595.95
Rate for Payer: Humana Medicare Advantage	$17,469.42
Rate for Payer: Kentucky WC Medicaid	$16,761.91
Rate for Payer: Molina Healthcare Benefit Exchange	$20,963.30
Rate for Payer: Molina Healthcare Medicaid	$16,927.87

MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC

Facility

$16,525.07

Service Code	MSDRG 839
Min. Negotiated Rate	$11,213.44
Max. Negotiated Rate	$16,525.07
Rate for Payer: Anthem Medicaid	$11,213.44
Rate for Payer: Anthem Medicare Advantage/PPO	$11,803.62
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,525.07
Rate for Payer: CareSource Just4Me Medicare	$15,934.89
Rate for Payer: Humana KY Medicaid	$11,213.44
Rate for Payer: Humana Medicare Advantage	$11,803.62
Rate for Payer: Kentucky WC Medicaid	$11,325.57
Rate for Payer: Molina Healthcare Benefit Exchange	$14,164.34
Rate for Payer: Molina Healthcare Medicaid	$11,437.71

MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC

Facility

$15,322.82

Service Code	MSDRG 847
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: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC

Facility

$30,795.17

Service Code	MSDRG 846
Min. Negotiated Rate	$20,896.72
Max. Negotiated Rate	$30,795.17
Rate for Payer: Anthem Medicaid	$20,896.72
Rate for Payer: Anthem Medicare Advantage/PPO	$21,996.55
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$30,795.17
Rate for Payer: CareSource Just4Me Medicare	$29,695.34
Rate for Payer: Humana KY Medicaid	$20,896.72
Rate for Payer: Humana Medicare Advantage	$21,996.55
Rate for Payer: Kentucky WC Medicaid	$21,105.69
Rate for Payer: Molina Healthcare Benefit Exchange	$26,395.86
Rate for Payer: Molina Healthcare Medicaid	$21,314.66

MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC

Facility

$9,874.77

Service Code	MSDRG 848
Min. Negotiated Rate	$6,700.74
Max. Negotiated Rate	$9,874.77
Rate for Payer: Anthem Medicaid	$6,700.74
Rate for Payer: Anthem Medicare Advantage/PPO	$7,053.41
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,874.77
Rate for Payer: CareSource Just4Me Medicare	$9,522.10
Rate for Payer: Humana KY Medicaid	$6,700.74
Rate for Payer: Humana Medicare Advantage	$7,053.41
Rate for Payer: Kentucky WC Medicaid	$6,767.75
Rate for Payer: Molina Healthcare Benefit Exchange	$8,464.09
Rate for Payer: Molina Healthcare Medicaid	$6,834.75

MS-DRG 42.00: CHEST PAIN

Facility

$8,602.59

Service Code	MSDRG 313
Min. Negotiated Rate	$5,837.47
Max. Negotiated Rate	$8,602.59
Rate for Payer: Anthem Medicaid	$5,837.47
Rate for Payer: Anthem Medicare Advantage/PPO	$6,144.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,602.59
Rate for Payer: CareSource Just4Me Medicare	$8,295.36
Rate for Payer: Humana KY Medicaid	$5,837.47
Rate for Payer: Humana Medicare Advantage	$6,144.71
Rate for Payer: Kentucky WC Medicaid	$5,895.85
Rate for Payer: Molina Healthcare Benefit Exchange	$7,373.65
Rate for Payer: Molina Healthcare Medicaid	$5,954.22

MS-DRG 42.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES

Facility

$454,762.38

Service Code	MSDRG 018
Min. Negotiated Rate	$308,588.76
Max. Negotiated Rate	$454,762.38
Rate for Payer: Anthem Medicaid	$308,588.76
Rate for Payer: Anthem Medicare Advantage/PPO	$324,830.27
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$454,762.38
Rate for Payer: CareSource Just4Me Medicare	$438,520.86
Rate for Payer: Humana KY Medicaid	$308,588.76
Rate for Payer: Humana Medicare Advantage	$324,830.27
Rate for Payer: Kentucky WC Medicaid	$311,674.64
Rate for Payer: Molina Healthcare Benefit Exchange	$389,796.32
Rate for Payer: Molina Healthcare Medicaid	$314,760.53

Know your out-of-pocket cost for care.

All Charges