Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: FOOT PROCEDURES WITH CC

Facility

$21,162.79

Service Code	MSDRG 504
Min. Negotiated Rate	$14,360.47
Max. Negotiated Rate	$21,162.79
Rate for Payer: Anthem Medicaid	$14,360.47
Rate for Payer: Anthem Medicare Advantage/PPO	$15,116.28
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,162.79
Rate for Payer: CareSource Just4Me Medicare	$20,406.98
Rate for Payer: Humana KY Medicaid	$14,360.47
Rate for Payer: Humana Medicare Advantage	$15,116.28
Rate for Payer: Kentucky WC Medicaid	$14,504.07
Rate for Payer: Molina Healthcare Benefit Exchange	$18,139.54
Rate for Payer: Molina Healthcare Medicaid	$14,647.68

MS-DRG 42.00: FOOT PROCEDURES WITH MCC

Facility

$31,914.18

Service Code	MSDRG 503
Min. Negotiated Rate	$21,656.05
Max. Negotiated Rate	$31,914.18
Rate for Payer: Anthem Medicaid	$21,656.05
Rate for Payer: Anthem Medicare Advantage/PPO	$22,795.84
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$31,914.18
Rate for Payer: CareSource Just4Me Medicare	$30,774.38
Rate for Payer: Humana KY Medicaid	$21,656.05
Rate for Payer: Humana Medicare Advantage	$22,795.84
Rate for Payer: Kentucky WC Medicaid	$21,872.61
Rate for Payer: Molina Healthcare Benefit Exchange	$27,355.01
Rate for Payer: Molina Healthcare Medicaid	$22,089.17

MS-DRG 42.00: FOOT PROCEDURES WITHOUT CC/MCC

Facility

$21,162.79

Service Code	MSDRG 505
Min. Negotiated Rate	$14,360.47
Max. Negotiated Rate	$21,162.79
Rate for Payer: Anthem Medicaid	$14,360.47
Rate for Payer: Anthem Medicare Advantage/PPO	$15,116.28
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,162.79
Rate for Payer: CareSource Just4Me Medicare	$20,406.98
Rate for Payer: Humana KY Medicaid	$14,360.47
Rate for Payer: Humana Medicare Advantage	$15,116.28
Rate for Payer: Kentucky WC Medicaid	$14,504.07
Rate for Payer: Molina Healthcare Benefit Exchange	$18,139.54
Rate for Payer: Molina Healthcare Medicaid	$14,647.68

MS-DRG 42.00: FRACTURES OF FEMUR WITH MCC

Facility

$18,388.10

Service Code	MSDRG 533
Min. Negotiated Rate	$12,477.64
Max. Negotiated Rate	$18,388.10
Rate for Payer: Anthem Medicaid	$12,477.64
Rate for Payer: Anthem Medicare Advantage/PPO	$13,134.36
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,388.10
Rate for Payer: CareSource Just4Me Medicare	$17,731.39
Rate for Payer: Humana KY Medicaid	$12,477.64
Rate for Payer: Humana Medicare Advantage	$13,134.36
Rate for Payer: Kentucky WC Medicaid	$12,602.42
Rate for Payer: Molina Healthcare Benefit Exchange	$15,761.23
Rate for Payer: Molina Healthcare Medicaid	$12,727.19

MS-DRG 42.00: FRACTURES OF FEMUR WITHOUT MCC

Facility

$9,815.68

Service Code	MSDRG 534
Min. Negotiated Rate	$6,660.64
Max. Negotiated Rate	$9,815.68
Rate for Payer: Anthem Medicaid	$6,660.64
Rate for Payer: Anthem Medicare Advantage/PPO	$7,011.20
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,815.68
Rate for Payer: CareSource Just4Me Medicare	$9,465.12
Rate for Payer: Humana KY Medicaid	$6,660.64
Rate for Payer: Humana Medicare Advantage	$7,011.20
Rate for Payer: Kentucky WC Medicaid	$6,727.25
Rate for Payer: Molina Healthcare Benefit Exchange	$8,413.44
Rate for Payer: Molina Healthcare Medicaid	$6,793.85

MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITH MCC

Facility

$16,036.68

Service Code	MSDRG 535
Min. Negotiated Rate	$10,882.03
Max. Negotiated Rate	$16,036.68
Rate for Payer: Anthem Medicaid	$10,882.03
Rate for Payer: Anthem Medicare Advantage/PPO	$11,454.77
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,036.68
Rate for Payer: CareSource Just4Me Medicare	$15,463.94
Rate for Payer: Humana KY Medicaid	$10,882.03
Rate for Payer: Humana Medicare Advantage	$11,454.77
Rate for Payer: Kentucky WC Medicaid	$10,990.85
Rate for Payer: Molina Healthcare Benefit Exchange	$13,745.72
Rate for Payer: Molina Healthcare Medicaid	$11,099.67

MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITHOUT MCC

Facility

$9,778.30

Service Code	MSDRG 536
Min. Negotiated Rate	$6,635.27
Max. Negotiated Rate	$9,778.30
Rate for Payer: Anthem Medicaid	$6,635.27
Rate for Payer: Anthem Medicare Advantage/PPO	$6,984.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,778.30
Rate for Payer: CareSource Just4Me Medicare	$9,429.08
Rate for Payer: Humana KY Medicaid	$6,635.27
Rate for Payer: Humana Medicare Advantage	$6,984.50
Rate for Payer: Kentucky WC Medicaid	$6,701.63
Rate for Payer: Molina Healthcare Benefit Exchange	$8,381.40
Rate for Payer: Molina Healthcare Medicaid	$6,767.98

MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC

Facility

$17,647.70

Service Code	MSDRG 562
Min. Negotiated Rate	$11,975.23
Max. Negotiated Rate	$17,647.70
Rate for Payer: Anthem Medicaid	$11,975.23
Rate for Payer: Anthem Medicare Advantage/PPO	$12,605.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,647.70
Rate for Payer: CareSource Just4Me Medicare	$17,017.42
Rate for Payer: Humana KY Medicaid	$11,975.23
Rate for Payer: Humana Medicare Advantage	$12,605.50
Rate for Payer: Kentucky WC Medicaid	$12,094.98
Rate for Payer: Molina Healthcare Benefit Exchange	$15,126.60
Rate for Payer: Molina Healthcare Medicaid	$12,214.73

MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC

Facility

$10,777.96

Service Code	MSDRG 563
Min. Negotiated Rate	$7,313.61
Max. Negotiated Rate	$10,777.96
Rate for Payer: Anthem Medicaid	$7,313.61
Rate for Payer: Anthem Medicare Advantage/PPO	$7,698.54
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,777.96
Rate for Payer: CareSource Just4Me Medicare	$10,393.03
Rate for Payer: Humana KY Medicaid	$7,313.61
Rate for Payer: Humana Medicare Advantage	$7,698.54
Rate for Payer: Kentucky WC Medicaid	$7,386.75
Rate for Payer: Molina Healthcare Benefit Exchange	$9,238.25
Rate for Payer: Molina Healthcare Medicaid	$7,459.89

MS-DRG 42.00: FULL TERM NEONATE WITH MAJOR PROBLEMS

Facility

$50,290.25

Service Code	MSDRG 793
Min. Negotiated Rate	$34,125.53
Max. Negotiated Rate	$50,290.25
Rate for Payer: Anthem Medicaid	$34,125.53
Rate for Payer: Anthem Medicare Advantage/PPO	$35,921.61
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$50,290.25
Rate for Payer: CareSource Just4Me Medicare	$48,494.17
Rate for Payer: Humana KY Medicaid	$34,125.53
Rate for Payer: Humana Medicare Advantage	$35,921.61
Rate for Payer: Kentucky WC Medicaid	$34,466.78
Rate for Payer: Molina Healthcare Benefit Exchange	$43,105.93
Rate for Payer: Molina Healthcare Medicaid	$34,808.04

MS-DRG 42.00: FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY

Facility

$25,875.28

Service Code	MSDRG 934
Min. Negotiated Rate	$17,558.22
Max. Negotiated Rate	$25,875.28
Rate for Payer: Anthem Medicaid	$17,558.22
Rate for Payer: Anthem Medicare Advantage/PPO	$18,482.34
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,875.28
Rate for Payer: CareSource Just4Me Medicare	$24,951.16
Rate for Payer: Humana KY Medicaid	$17,558.22
Rate for Payer: Humana Medicare Advantage	$18,482.34
Rate for Payer: Kentucky WC Medicaid	$17,733.81
Rate for Payer: Molina Healthcare Benefit Exchange	$22,178.81
Rate for Payer: Molina Healthcare Medicaid	$17,909.39

MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC

Facility

$80,537.98

Service Code	MSDRG 928
Min. Negotiated Rate	$54,650.77
Max. Negotiated Rate	$80,537.98
Rate for Payer: Anthem Medicaid	$54,650.77
Rate for Payer: Anthem Medicare Advantage/PPO	$57,527.13
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$80,537.98
Rate for Payer: CareSource Just4Me Medicare	$77,661.63
Rate for Payer: Humana KY Medicaid	$54,650.77
Rate for Payer: Humana Medicare Advantage	$57,527.13
Rate for Payer: Kentucky WC Medicaid	$55,197.28
Rate for Payer: Molina Healthcare Benefit Exchange	$69,032.56
Rate for Payer: Molina Healthcare Medicaid	$55,743.79

MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC

Facility

$38,351.05

Service Code	MSDRG 929
Min. Negotiated Rate	$26,023.93
Max. Negotiated Rate	$38,351.05
Rate for Payer: Anthem Medicaid	$26,023.93
Rate for Payer: Anthem Medicare Advantage/PPO	$27,393.61
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$38,351.05
Rate for Payer: CareSource Just4Me Medicare	$36,981.37
Rate for Payer: Humana KY Medicaid	$26,023.93
Rate for Payer: Humana Medicare Advantage	$27,393.61
Rate for Payer: Kentucky WC Medicaid	$26,284.17
Rate for Payer: Molina Healthcare Benefit Exchange	$32,872.33
Rate for Payer: Molina Healthcare Medicaid	$26,544.41

MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH CC

Facility

$11,888.52

Service Code	MSDRG 378
Min. Negotiated Rate	$8,067.21
Max. Negotiated Rate	$11,888.52
Rate for Payer: Anthem Medicaid	$8,067.21
Rate for Payer: Anthem Medicare Advantage/PPO	$8,491.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,888.52
Rate for Payer: CareSource Just4Me Medicare	$11,463.93
Rate for Payer: Humana KY Medicaid	$8,067.21
Rate for Payer: Humana Medicare Advantage	$8,491.80
Rate for Payer: Kentucky WC Medicaid	$8,147.88
Rate for Payer: Molina Healthcare Benefit Exchange	$10,190.16
Rate for Payer: Molina Healthcare Medicaid	$8,228.55

MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH MCC

Facility

$21,924.88

Service Code	MSDRG 377
Min. Negotiated Rate	$14,877.60
Max. Negotiated Rate	$21,924.88
Rate for Payer: Anthem Medicaid	$14,877.60
Rate for Payer: Anthem Medicare Advantage/PPO	$15,660.63
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,924.88
Rate for Payer: CareSource Just4Me Medicare	$21,141.85
Rate for Payer: Humana KY Medicaid	$14,877.60
Rate for Payer: Humana Medicare Advantage	$15,660.63
Rate for Payer: Kentucky WC Medicaid	$15,026.37
Rate for Payer: Molina Healthcare Benefit Exchange	$18,792.76
Rate for Payer: Molina Healthcare Medicaid	$15,175.15

MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC

Facility

$7,677.70

Service Code	MSDRG 379
Min. Negotiated Rate	$5,209.87
Max. Negotiated Rate	$7,677.70
Rate for Payer: Anthem Medicaid	$5,209.87
Rate for Payer: Anthem Medicare Advantage/PPO	$5,484.07
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$7,677.70
Rate for Payer: CareSource Just4Me Medicare	$7,403.49
Rate for Payer: Humana KY Medicaid	$5,209.87
Rate for Payer: Humana Medicare Advantage	$5,484.07
Rate for Payer: Kentucky WC Medicaid	$5,261.97
Rate for Payer: Molina Healthcare Benefit Exchange	$6,580.88
Rate for Payer: Molina Healthcare Medicaid	$5,314.06

MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH CC

Facility

$9,666.16

Service Code	MSDRG 389
Min. Negotiated Rate	$6,559.18
Max. Negotiated Rate	$9,666.16
Rate for Payer: Anthem Medicaid	$6,559.18
Rate for Payer: Anthem Medicare Advantage/PPO	$6,904.40
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,666.16
Rate for Payer: CareSource Just4Me Medicare	$9,320.94
Rate for Payer: Humana KY Medicaid	$6,559.18
Rate for Payer: Humana Medicare Advantage	$6,904.40
Rate for Payer: Kentucky WC Medicaid	$6,624.77
Rate for Payer: Molina Healthcare Benefit Exchange	$8,285.28
Rate for Payer: Molina Healthcare Medicaid	$6,690.36

MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH MCC

Facility

$17,724.90

Service Code	MSDRG 388
Min. Negotiated Rate	$12,027.61
Max. Negotiated Rate	$17,724.90
Rate for Payer: Anthem Medicaid	$12,027.61
Rate for Payer: Anthem Medicare Advantage/PPO	$12,660.64
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,724.90
Rate for Payer: CareSource Just4Me Medicare	$17,091.86
Rate for Payer: Humana KY Medicaid	$12,027.61
Rate for Payer: Humana Medicare Advantage	$12,660.64
Rate for Payer: Kentucky WC Medicaid	$12,147.88
Rate for Payer: Molina Healthcare Benefit Exchange	$15,192.77
Rate for Payer: Molina Healthcare Medicaid	$12,268.16

MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC

Facility

$6,598.44

Service Code	MSDRG 390
Min. Negotiated Rate	$4,477.51
Max. Negotiated Rate	$6,598.44
Rate for Payer: Anthem Medicaid	$4,477.51
Rate for Payer: Anthem Medicare Advantage/PPO	$4,713.17
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$6,598.44
Rate for Payer: CareSource Just4Me Medicare	$6,362.78
Rate for Payer: Humana KY Medicaid	$4,477.51
Rate for Payer: Humana Medicare Advantage	$4,713.17
Rate for Payer: Kentucky WC Medicaid	$4,522.29
Rate for Payer: Molina Healthcare Benefit Exchange	$5,655.80
Rate for Payer: Molina Healthcare Medicaid	$4,567.06

MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC

Facility

$18,155.38

Service Code	MSDRG 513
Min. Negotiated Rate	$12,319.72
Max. Negotiated Rate	$18,155.38
Rate for Payer: Anthem Medicaid	$12,319.72
Rate for Payer: Anthem Medicare Advantage/PPO	$12,968.13
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,155.38
Rate for Payer: CareSource Just4Me Medicare	$17,506.98
Rate for Payer: Humana KY Medicaid	$12,319.72
Rate for Payer: Humana Medicare Advantage	$12,968.13
Rate for Payer: Kentucky WC Medicaid	$12,442.92
Rate for Payer: Molina Healthcare Benefit Exchange	$15,561.76
Rate for Payer: Molina Healthcare Medicaid	$12,566.12

MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC

Facility

$12,294.93

Service Code	MSDRG 514
Min. Negotiated Rate	$8,342.99
Max. Negotiated Rate	$12,294.93
Rate for Payer: Anthem Medicaid	$8,342.99
Rate for Payer: Anthem Medicare Advantage/PPO	$8,782.09
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,294.93
Rate for Payer: CareSource Just4Me Medicare	$11,855.82
Rate for Payer: Humana KY Medicaid	$8,342.99
Rate for Payer: Humana Medicare Advantage	$8,782.09
Rate for Payer: Kentucky WC Medicaid	$8,426.42
Rate for Payer: Molina Healthcare Benefit Exchange	$10,538.51
Rate for Payer: Molina Healthcare Medicaid	$8,509.85

MS-DRG 42.00: HAND PROCEDURES FOR INJURIES

Facility

$26,317.83

Service Code	MSDRG 906
Min. Negotiated Rate	$17,858.53
Max. Negotiated Rate	$26,317.83
Rate for Payer: Anthem Medicaid	$17,858.53
Rate for Payer: Anthem Medicare Advantage/PPO	$18,798.45
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$26,317.83
Rate for Payer: CareSource Just4Me Medicare	$25,377.91
Rate for Payer: Humana KY Medicaid	$17,858.53
Rate for Payer: Humana Medicare Advantage	$18,798.45
Rate for Payer: Kentucky WC Medicaid	$18,037.11
Rate for Payer: Molina Healthcare Benefit Exchange	$22,558.14
Rate for Payer: Molina Healthcare Medicaid	$18,215.70

MS-DRG 42.00: HEADACHES WITH MCC

Facility

$13,981.90

Service Code	MSDRG 102
Min. Negotiated Rate	$9,487.72
Max. Negotiated Rate	$13,981.90
Rate for Payer: Anthem Medicaid	$9,487.72
Rate for Payer: Anthem Medicare Advantage/PPO	$9,987.07
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,981.90
Rate for Payer: CareSource Just4Me Medicare	$13,482.54
Rate for Payer: Humana KY Medicaid	$9,487.72
Rate for Payer: Humana Medicare Advantage	$9,987.07
Rate for Payer: Kentucky WC Medicaid	$9,582.59
Rate for Payer: Molina Healthcare Benefit Exchange	$11,984.48
Rate for Payer: Molina Healthcare Medicaid	$9,677.47

MS-DRG 42.00: HEADACHES WITHOUT MCC

Facility

$10,252.21

Service Code	MSDRG 103
Min. Negotiated Rate	$6,956.86
Max. Negotiated Rate	$10,252.21
Rate for Payer: Anthem Medicaid	$6,956.86
Rate for Payer: Anthem Medicare Advantage/PPO	$7,323.01
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,252.21
Rate for Payer: CareSource Just4Me Medicare	$9,886.06
Rate for Payer: Humana KY Medicaid	$6,956.86
Rate for Payer: Humana Medicare Advantage	$7,323.01
Rate for Payer: Kentucky WC Medicaid	$7,026.43
Rate for Payer: Molina Healthcare Benefit Exchange	$8,787.61
Rate for Payer: Molina Healthcare Medicaid	$7,096.00

MS-DRG 42.00: HEART FAILURE AND SHOCK WITH CC

Facility

$10,384.84

Service Code	MSDRG 292
Min. Negotiated Rate	$7,046.85
Max. Negotiated Rate	$10,384.84
Rate for Payer: Anthem Medicaid	$7,046.85
Rate for Payer: Anthem Medicare Advantage/PPO	$7,417.74
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,384.84
Rate for Payer: CareSource Just4Me Medicare	$10,013.95
Rate for Payer: Humana KY Medicaid	$7,046.85
Rate for Payer: Humana Medicare Advantage	$7,417.74
Rate for Payer: Kentucky WC Medicaid	$7,117.32
Rate for Payer: Molina Healthcare Benefit Exchange	$8,901.29
Rate for Payer: Molina Healthcare Medicaid	$7,187.79

Know your out-of-pocket cost for care.

All Charges