Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC

Facility

$23,853.06

Service Code	MSDRG 415
Min. Negotiated Rate	$16,186.00
Max. Negotiated Rate	$23,853.06
Rate for Payer: Anthem Medicaid	$16,186.00
Rate for Payer: Anthem Medicare Advantage/PPO	$17,037.90
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,853.06
Rate for Payer: CareSource Just4Me Medicare	$23,001.17
Rate for Payer: Humana KY Medicaid	$16,186.00
Rate for Payer: Humana Medicare Advantage	$17,037.90
Rate for Payer: Kentucky WC Medicaid	$16,347.87
Rate for Payer: Molina Healthcare Benefit Exchange	$20,445.48
Rate for Payer: Molina Healthcare Medicaid	$16,509.73

MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC

Facility

$42,250.81

Service Code	MSDRG 414
Min. Negotiated Rate	$28,670.19
Max. Negotiated Rate	$42,250.81
Rate for Payer: Anthem Medicaid	$28,670.19
Rate for Payer: Anthem Medicare Advantage/PPO	$30,179.15
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$42,250.81
Rate for Payer: CareSource Just4Me Medicare	$40,741.85
Rate for Payer: Humana KY Medicaid	$28,670.19
Rate for Payer: Humana Medicare Advantage	$30,179.15
Rate for Payer: Kentucky WC Medicaid	$28,956.89
Rate for Payer: Molina Healthcare Benefit Exchange	$36,214.98
Rate for Payer: Molina Healthcare Medicaid	$29,243.60

MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$16,522.66

Service Code	MSDRG 416
Min. Negotiated Rate	$11,211.81
Max. Negotiated Rate	$16,522.66
Rate for Payer: Anthem Medicaid	$11,211.81
Rate for Payer: Anthem Medicare Advantage/PPO	$11,801.90
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,522.66
Rate for Payer: CareSource Just4Me Medicare	$15,932.57
Rate for Payer: Humana KY Medicaid	$11,211.81
Rate for Payer: Humana Medicare Advantage	$11,801.90
Rate for Payer: Kentucky WC Medicaid	$11,323.92
Rate for Payer: Molina Healthcare Benefit Exchange	$14,162.28
Rate for Payer: Molina Healthcare Medicaid	$11,436.04

MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH CC

Facility

$25,704.03

Service Code	MSDRG 412
Min. Negotiated Rate	$17,442.02
Max. Negotiated Rate	$25,704.03
Rate for Payer: Anthem Medicaid	$17,442.02
Rate for Payer: Anthem Medicare Advantage/PPO	$18,360.02
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,704.03
Rate for Payer: CareSource Just4Me Medicare	$24,786.03
Rate for Payer: Humana KY Medicaid	$17,442.02
Rate for Payer: Humana Medicare Advantage	$18,360.02
Rate for Payer: Kentucky WC Medicaid	$17,616.44
Rate for Payer: Molina Healthcare Benefit Exchange	$22,032.02
Rate for Payer: Molina Healthcare Medicaid	$17,790.86

MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH MCC

Facility

$32,997.06

Service Code	MSDRG 411
Min. Negotiated Rate	$22,390.86
Max. Negotiated Rate	$32,997.06
Rate for Payer: Anthem Medicaid	$22,390.86
Rate for Payer: Anthem Medicare Advantage/PPO	$23,569.33
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$32,997.06
Rate for Payer: CareSource Just4Me Medicare	$31,818.60
Rate for Payer: Humana KY Medicaid	$22,390.86
Rate for Payer: Humana Medicare Advantage	$23,569.33
Rate for Payer: Kentucky WC Medicaid	$22,614.77
Rate for Payer: Molina Healthcare Benefit Exchange	$28,283.20
Rate for Payer: Molina Healthcare Medicaid	$22,838.68

MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC

Facility

$20,047.37

Service Code	MSDRG 413
Min. Negotiated Rate	$13,603.57
Max. Negotiated Rate	$20,047.37
Rate for Payer: Anthem Medicaid	$13,603.57
Rate for Payer: Anthem Medicare Advantage/PPO	$14,319.55
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,047.37
Rate for Payer: CareSource Just4Me Medicare	$19,331.39
Rate for Payer: Humana KY Medicaid	$13,603.57
Rate for Payer: Humana Medicare Advantage	$14,319.55
Rate for Payer: Kentucky WC Medicaid	$13,739.61
Rate for Payer: Molina Healthcare Benefit Exchange	$17,183.46
Rate for Payer: Molina Healthcare Medicaid	$13,875.64

MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC

Facility

$10,359.51

Service Code	MSDRG 191
Min. Negotiated Rate	$7,029.67
Max. Negotiated Rate	$10,359.51
Rate for Payer: Anthem Medicaid	$7,029.67
Rate for Payer: Anthem Medicare Advantage/PPO	$7,399.65
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,359.51
Rate for Payer: CareSource Just4Me Medicare	$9,989.53
Rate for Payer: Humana KY Medicaid	$7,029.67
Rate for Payer: Humana Medicare Advantage	$7,399.65
Rate for Payer: Kentucky WC Medicaid	$7,099.96
Rate for Payer: Molina Healthcare Benefit Exchange	$8,879.58
Rate for Payer: Molina Healthcare Medicaid	$7,170.26

MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC

Facility

$13,541.75

Service Code	MSDRG 190
Min. Negotiated Rate	$9,189.05
Max. Negotiated Rate	$13,541.75
Rate for Payer: Anthem Medicaid	$9,189.05
Rate for Payer: Anthem Medicare Advantage/PPO	$9,672.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,541.75
Rate for Payer: CareSource Just4Me Medicare	$13,058.12
Rate for Payer: Humana KY Medicaid	$9,189.05
Rate for Payer: Humana Medicare Advantage	$9,672.68
Rate for Payer: Kentucky WC Medicaid	$9,280.94
Rate for Payer: Molina Healthcare Benefit Exchange	$11,607.22
Rate for Payer: Molina Healthcare Medicaid	$9,372.83

MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC

Facility

$7,804.31

Service Code	MSDRG 192
Min. Negotiated Rate	$5,295.78
Max. Negotiated Rate	$7,804.31
Rate for Payer: Anthem Medicaid	$5,295.78
Rate for Payer: Anthem Medicare Advantage/PPO	$5,574.51
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$7,804.31
Rate for Payer: CareSource Just4Me Medicare	$7,525.59
Rate for Payer: Humana KY Medicaid	$5,295.78
Rate for Payer: Humana Medicare Advantage	$5,574.51
Rate for Payer: Kentucky WC Medicaid	$5,348.74
Rate for Payer: Molina Healthcare Benefit Exchange	$6,689.41
Rate for Payer: Molina Healthcare Medicaid	$5,401.70

MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC

Facility

$26,689.22

Service Code	MSDRG 286
Min. Negotiated Rate	$18,110.54
Max. Negotiated Rate	$26,689.22
Rate for Payer: Anthem Medicaid	$18,110.54
Rate for Payer: Anthem Medicare Advantage/PPO	$19,063.73
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$26,689.22
Rate for Payer: CareSource Just4Me Medicare	$25,736.04
Rate for Payer: Humana KY Medicaid	$18,110.54
Rate for Payer: Humana Medicare Advantage	$19,063.73
Rate for Payer: Kentucky WC Medicaid	$18,291.65
Rate for Payer: Molina Healthcare Benefit Exchange	$22,876.48
Rate for Payer: Molina Healthcare Medicaid	$18,472.75

MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC

Facility

$13,140.20

Service Code	MSDRG 287
Min. Negotiated Rate	$8,916.57
Max. Negotiated Rate	$13,140.20
Rate for Payer: Anthem Medicaid	$8,916.57
Rate for Payer: Anthem Medicare Advantage/PPO	$9,385.86
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,140.20
Rate for Payer: CareSource Just4Me Medicare	$12,670.91
Rate for Payer: Humana KY Medicaid	$8,916.57
Rate for Payer: Humana Medicare Advantage	$9,385.86
Rate for Payer: Kentucky WC Medicaid	$9,005.73
Rate for Payer: Molina Healthcare Benefit Exchange	$11,263.03
Rate for Payer: Molina Healthcare Medicaid	$9,094.90

MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC

Facility

$12,900.26

Service Code	MSDRG 433
Min. Negotiated Rate	$8,753.75
Max. Negotiated Rate	$12,900.26
Rate for Payer: Anthem Medicaid	$8,753.75
Rate for Payer: Anthem Medicare Advantage/PPO	$9,214.47
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,900.26
Rate for Payer: CareSource Just4Me Medicare	$12,439.53
Rate for Payer: Humana KY Medicaid	$8,753.75
Rate for Payer: Humana Medicare Advantage	$9,214.47
Rate for Payer: Kentucky WC Medicaid	$8,841.28
Rate for Payer: Molina Healthcare Benefit Exchange	$11,057.36
Rate for Payer: Molina Healthcare Medicaid	$8,928.82

MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC

Facility

$23,623.92

Service Code	MSDRG 432
Min. Negotiated Rate	$16,030.52
Max. Negotiated Rate	$23,623.92
Rate for Payer: Anthem Medicaid	$16,030.52
Rate for Payer: Anthem Medicare Advantage/PPO	$16,874.23
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,623.92
Rate for Payer: CareSource Just4Me Medicare	$22,780.21
Rate for Payer: Humana KY Medicaid	$16,030.52
Rate for Payer: Humana Medicare Advantage	$16,874.23
Rate for Payer: Kentucky WC Medicaid	$16,190.82
Rate for Payer: Molina Healthcare Benefit Exchange	$20,249.08
Rate for Payer: Molina Healthcare Medicaid	$16,351.13

MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC

Facility

$8,398.80

Service Code	MSDRG 434
Min. Negotiated Rate	$5,699.18
Max. Negotiated Rate	$8,398.80
Rate for Payer: Anthem Medicaid	$5,699.18
Rate for Payer: Anthem Medicare Advantage/PPO	$5,999.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,398.80
Rate for Payer: CareSource Just4Me Medicare	$8,098.84
Rate for Payer: Humana KY Medicaid	$5,699.18
Rate for Payer: Humana Medicare Advantage	$5,999.14
Rate for Payer: Kentucky WC Medicaid	$5,756.17
Rate for Payer: Molina Healthcare Benefit Exchange	$7,198.97
Rate for Payer: Molina Healthcare Medicaid	$5,813.17

MS-DRG 42.00: COAGULATION DISORDERS

Facility

$18,666.68

Service Code	MSDRG 813
Min. Negotiated Rate	$12,666.67
Max. Negotiated Rate	$18,666.68
Rate for Payer: Anthem Medicaid	$12,666.67
Rate for Payer: Anthem Medicare Advantage/PPO	$13,333.34
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,666.68
Rate for Payer: CareSource Just4Me Medicare	$18,000.01
Rate for Payer: Humana KY Medicaid	$12,666.67
Rate for Payer: Humana Medicare Advantage	$13,333.34
Rate for Payer: Kentucky WC Medicaid	$12,793.34
Rate for Payer: Molina Healthcare Benefit Exchange	$16,000.01
Rate for Payer: Molina Healthcare Medicaid	$12,920.01

MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC

Facility

$100,575.69

Service Code	MSDRG 429
Min. Negotiated Rate	$68,247.79
Max. Negotiated Rate	$100,575.69
Rate for Payer: Anthem Medicaid	$68,247.79
Rate for Payer: Anthem Medicare Advantage/PPO	$71,839.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$100,575.69
Rate for Payer: CareSource Just4Me Medicare	$96,983.70
Rate for Payer: Humana KY Medicaid	$68,247.79
Rate for Payer: Humana Medicare Advantage	$71,839.78
Rate for Payer: Kentucky WC Medicaid	$68,930.27
Rate for Payer: Molina Healthcare Benefit Exchange	$86,207.74
Rate for Payer: Molina Healthcare Medicaid	$69,612.75

MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC

Facility

$65,966.39

Service Code	MSDRG 430
Min. Negotiated Rate	$44,762.91
Max. Negotiated Rate	$65,966.39
Rate for Payer: Anthem Medicaid	$44,762.91
Rate for Payer: Anthem Medicare Advantage/PPO	$47,118.85
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$65,966.39
Rate for Payer: CareSource Just4Me Medicare	$63,610.45
Rate for Payer: Humana KY Medicaid	$44,762.91
Rate for Payer: Humana Medicare Advantage	$47,118.85
Rate for Payer: Kentucky WC Medicaid	$45,210.54
Rate for Payer: Molina Healthcare Benefit Exchange	$56,542.62
Rate for Payer: Molina Healthcare Medicaid	$45,658.17

MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC

Facility

$13,132.98

Service Code	MSDRG 381
Min. Negotiated Rate	$8,911.67
Max. Negotiated Rate	$13,132.98
Rate for Payer: Anthem Medicaid	$8,911.67
Rate for Payer: Anthem Medicare Advantage/PPO	$9,380.70
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,132.98
Rate for Payer: CareSource Just4Me Medicare	$12,663.94
Rate for Payer: Humana KY Medicaid	$8,911.67
Rate for Payer: Humana Medicare Advantage	$9,380.70
Rate for Payer: Kentucky WC Medicaid	$9,000.78
Rate for Payer: Molina Healthcare Benefit Exchange	$11,256.84
Rate for Payer: Molina Healthcare Medicaid	$9,089.90

MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH MCC

Facility

$23,204.30

Service Code	MSDRG 380
Min. Negotiated Rate	$15,745.77
Max. Negotiated Rate	$23,204.30
Rate for Payer: Anthem Medicaid	$15,745.77
Rate for Payer: Anthem Medicare Advantage/PPO	$16,574.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,204.30
Rate for Payer: CareSource Just4Me Medicare	$22,375.58
Rate for Payer: Humana KY Medicaid	$15,745.77
Rate for Payer: Humana Medicare Advantage	$16,574.50
Rate for Payer: Kentucky WC Medicaid	$15,903.23
Rate for Payer: Molina Healthcare Benefit Exchange	$19,889.40
Rate for Payer: Molina Healthcare Medicaid	$16,060.69

MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC

Facility

$9,035.47

Service Code	MSDRG 382
Min. Negotiated Rate	$6,131.21
Max. Negotiated Rate	$9,035.47
Rate for Payer: Anthem Medicaid	$6,131.21
Rate for Payer: Anthem Medicare Advantage/PPO	$6,453.91
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,035.47
Rate for Payer: CareSource Just4Me Medicare	$8,712.78
Rate for Payer: Humana KY Medicaid	$6,131.21
Rate for Payer: Humana Medicare Advantage	$6,453.91
Rate for Payer: Kentucky WC Medicaid	$6,192.53
Rate for Payer: Molina Healthcare Benefit Exchange	$7,744.69
Rate for Payer: Molina Healthcare Medicaid	$6,253.84

MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH CC

Facility

$12,250.29

Service Code	MSDRG 920
Min. Negotiated Rate	$8,312.70
Max. Negotiated Rate	$12,250.29
Rate for Payer: Anthem Medicaid	$8,312.70
Rate for Payer: Anthem Medicare Advantage/PPO	$8,750.21
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,250.29
Rate for Payer: CareSource Just4Me Medicare	$11,812.78
Rate for Payer: Humana KY Medicaid	$8,312.70
Rate for Payer: Humana Medicare Advantage	$8,750.21
Rate for Payer: Kentucky WC Medicaid	$8,395.83
Rate for Payer: Molina Healthcare Benefit Exchange	$10,500.25
Rate for Payer: Molina Healthcare Medicaid	$8,478.95

MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH MCC

Facility

$21,990.01

Service Code	MSDRG 919
Min. Negotiated Rate	$14,921.79
Max. Negotiated Rate	$21,990.01
Rate for Payer: Anthem Medicaid	$14,921.79
Rate for Payer: Anthem Medicare Advantage/PPO	$15,707.15
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,990.01
Rate for Payer: CareSource Just4Me Medicare	$21,204.65
Rate for Payer: Humana KY Medicaid	$14,921.79
Rate for Payer: Humana Medicare Advantage	$15,707.15
Rate for Payer: Kentucky WC Medicaid	$15,071.01
Rate for Payer: Molina Healthcare Benefit Exchange	$18,848.58
Rate for Payer: Molina Healthcare Medicaid	$15,220.23

MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC

Facility

$8,292.68

Service Code	MSDRG 921
Min. Negotiated Rate	$5,627.17
Max. Negotiated Rate	$8,292.68
Rate for Payer: Anthem Medicaid	$5,627.17
Rate for Payer: Anthem Medicare Advantage/PPO	$5,923.34
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,292.68
Rate for Payer: CareSource Just4Me Medicare	$7,996.51
Rate for Payer: Humana KY Medicaid	$5,627.17
Rate for Payer: Humana Medicare Advantage	$5,923.34
Rate for Payer: Kentucky WC Medicaid	$5,683.44
Rate for Payer: Molina Healthcare Benefit Exchange	$7,108.01
Rate for Payer: Molina Healthcare Medicaid	$5,739.72

MS-DRG 42.00: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES

Facility

$131,364.83

Service Code	MSDRG 212
Min. Negotiated Rate	$89,140.42
Max. Negotiated Rate	$131,364.83
Rate for Payer: Anthem Medicaid	$89,140.42
Rate for Payer: Anthem Medicare Advantage/PPO	$93,832.02
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$131,364.83
Rate for Payer: CareSource Just4Me Medicare	$126,673.23
Rate for Payer: Humana KY Medicaid	$89,140.42
Rate for Payer: Humana Medicare Advantage	$93,832.02
Rate for Payer: Kentucky WC Medicaid	$90,031.82
Rate for Payer: Molina Healthcare Benefit Exchange	$112,598.42
Rate for Payer: Molina Healthcare Medicaid	$90,923.23

MS-DRG 42.00: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION

Facility

$74,599.14

Service Code	MSDRG 317
Min. Negotiated Rate	$50,620.85
Max. Negotiated Rate	$74,599.14
Rate for Payer: Anthem Medicaid	$50,620.85
Rate for Payer: Anthem Medicare Advantage/PPO	$53,285.10
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$74,599.14
Rate for Payer: CareSource Just4Me Medicare	$71,934.88
Rate for Payer: Humana KY Medicaid	$50,620.85
Rate for Payer: Humana Medicare Advantage	$53,285.10
Rate for Payer: Kentucky WC Medicaid	$51,127.05
Rate for Payer: Molina Healthcare Benefit Exchange	$63,942.12
Rate for Payer: Molina Healthcare Medicaid	$51,633.26

Know your out-of-pocket cost for care.

All Charges