Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: HEART FAILURE AND SHOCK WITH MCC

Facility

$15,734.01

Service Code	MSDRG 291
Min. Negotiated Rate	$10,676.65
Max. Negotiated Rate	$15,734.01
Rate for Payer: Anthem Medicaid	$10,676.65
Rate for Payer: Anthem Medicare Advantage/PPO	$11,238.58
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,734.01
Rate for Payer: CareSource Just4Me Medicare	$15,172.08
Rate for Payer: Humana KY Medicaid	$10,676.65
Rate for Payer: Humana Medicare Advantage	$11,238.58
Rate for Payer: Kentucky WC Medicaid	$10,783.42
Rate for Payer: Molina Healthcare Benefit Exchange	$13,486.30
Rate for Payer: Molina Healthcare Medicaid	$10,890.18

MS-DRG 42.00: HEART FAILURE AND SHOCK WITHOUT CC/MCC

Facility

$6,616.54

Service Code	MSDRG 293
Min. Negotiated Rate	$4,489.80
Max. Negotiated Rate	$6,616.54
Rate for Payer: Anthem Medicaid	$4,489.80
Rate for Payer: Anthem Medicare Advantage/PPO	$4,726.10
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$6,616.54
Rate for Payer: CareSource Just4Me Medicare	$6,380.23
Rate for Payer: Humana KY Medicaid	$4,489.80
Rate for Payer: Humana Medicare Advantage	$4,726.10
Rate for Payer: Kentucky WC Medicaid	$4,534.69
Rate for Payer: Molina Healthcare Benefit Exchange	$5,671.32
Rate for Payer: Molina Healthcare Medicaid	$4,579.59

MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC

Facility

$339,669.36

Service Code	MSDRG 001
Min. Negotiated Rate	$230,489.92
Max. Negotiated Rate	$339,669.36
Rate for Payer: Anthem Medicaid	$230,489.92
Rate for Payer: Anthem Medicare Advantage/PPO	$242,620.97
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$339,669.36
Rate for Payer: CareSource Just4Me Medicare	$327,538.31
Rate for Payer: Humana KY Medicaid	$230,489.92
Rate for Payer: Humana Medicare Advantage	$242,620.97
Rate for Payer: Kentucky WC Medicaid	$232,794.82
Rate for Payer: Molina Healthcare Benefit Exchange	$291,145.16
Rate for Payer: Molina Healthcare Medicaid	$235,099.72

MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC

Facility

$132,881.81

Service Code	MSDRG 002
Min. Negotiated Rate	$90,169.80
Max. Negotiated Rate	$132,881.81
Rate for Payer: Anthem Medicaid	$90,169.80
Rate for Payer: Anthem Medicare Advantage/PPO	$94,915.58
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$132,881.81
Rate for Payer: CareSource Just4Me Medicare	$128,136.03
Rate for Payer: Humana KY Medicaid	$90,169.80
Rate for Payer: Humana Medicare Advantage	$94,915.58
Rate for Payer: Kentucky WC Medicaid	$91,071.50
Rate for Payer: Molina Healthcare Benefit Exchange	$113,898.70
Rate for Payer: Molina Healthcare Medicaid	$91,973.20

MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC

Facility

$19,747.13

Service Code	MSDRG 421
Min. Negotiated Rate	$13,399.84
Max. Negotiated Rate	$19,747.13
Rate for Payer: Anthem Medicaid	$13,399.84
Rate for Payer: Anthem Medicare Advantage/PPO	$14,105.09
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,747.13
Rate for Payer: CareSource Just4Me Medicare	$19,041.87
Rate for Payer: Humana KY Medicaid	$13,399.84
Rate for Payer: Humana Medicare Advantage	$14,105.09
Rate for Payer: Kentucky WC Medicaid	$13,533.83
Rate for Payer: Molina Healthcare Benefit Exchange	$16,926.11
Rate for Payer: Molina Healthcare Medicaid	$13,667.83

MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC

Facility

$42,560.73

Service Code	MSDRG 420
Min. Negotiated Rate	$28,880.49
Max. Negotiated Rate	$42,560.73
Rate for Payer: Anthem Medicaid	$28,880.49
Rate for Payer: Anthem Medicare Advantage/PPO	$30,400.52
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$42,560.73
Rate for Payer: CareSource Just4Me Medicare	$41,040.70
Rate for Payer: Humana KY Medicaid	$28,880.49
Rate for Payer: Humana Medicare Advantage	$30,400.52
Rate for Payer: Kentucky WC Medicaid	$29,169.30
Rate for Payer: Molina Healthcare Benefit Exchange	$36,480.62
Rate for Payer: Molina Healthcare Medicaid	$29,458.10

MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC

Facility

$17,718.86

Service Code	MSDRG 422
Min. Negotiated Rate	$12,023.51
Max. Negotiated Rate	$17,718.86
Rate for Payer: Anthem Medicaid	$12,023.51
Rate for Payer: Anthem Medicare Advantage/PPO	$12,656.33
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,718.86
Rate for Payer: CareSource Just4Me Medicare	$17,086.05
Rate for Payer: Humana KY Medicaid	$12,023.51
Rate for Payer: Humana Medicare Advantage	$12,656.33
Rate for Payer: Kentucky WC Medicaid	$12,143.75
Rate for Payer: Molina Healthcare Benefit Exchange	$15,187.60
Rate for Payer: Molina Healthcare Medicaid	$12,263.98

MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC

Facility

$20,512.83

Service Code	MSDRG 354
Min. Negotiated Rate	$13,919.42
Max. Negotiated Rate	$20,512.83
Rate for Payer: Anthem Medicaid	$13,919.42
Rate for Payer: Anthem Medicare Advantage/PPO	$14,652.02
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,512.83
Rate for Payer: CareSource Just4Me Medicare	$19,780.23
Rate for Payer: Humana KY Medicaid	$13,919.42
Rate for Payer: Humana Medicare Advantage	$14,652.02
Rate for Payer: Kentucky WC Medicaid	$14,058.61
Rate for Payer: Molina Healthcare Benefit Exchange	$17,582.42
Rate for Payer: Molina Healthcare Medicaid	$14,197.81

MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC

Facility

$35,367.78

Service Code	MSDRG 353
Min. Negotiated Rate	$23,999.56
Max. Negotiated Rate	$35,367.78
Rate for Payer: Anthem Medicaid	$23,999.56
Rate for Payer: Anthem Medicare Advantage/PPO	$25,262.70
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$35,367.78
Rate for Payer: CareSource Just4Me Medicare	$34,104.64
Rate for Payer: Humana KY Medicaid	$23,999.56
Rate for Payer: Humana Medicare Advantage	$25,262.70
Rate for Payer: Kentucky WC Medicaid	$24,239.56
Rate for Payer: Molina Healthcare Benefit Exchange	$30,315.24
Rate for Payer: Molina Healthcare Medicaid	$24,479.56

MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC

Facility

$16,076.48

Service Code	MSDRG 355
Min. Negotiated Rate	$10,909.04
Max. Negotiated Rate	$16,076.48
Rate for Payer: Anthem Medicaid	$10,909.04
Rate for Payer: Anthem Medicare Advantage/PPO	$11,483.20
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,076.48
Rate for Payer: CareSource Just4Me Medicare	$15,502.32
Rate for Payer: Humana KY Medicaid	$10,909.04
Rate for Payer: Humana Medicare Advantage	$11,483.20
Rate for Payer: Kentucky WC Medicaid	$11,018.13
Rate for Payer: Molina Healthcare Benefit Exchange	$13,779.84
Rate for Payer: Molina Healthcare Medicaid	$11,127.22

MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC

Facility

$25,020.31

Service Code	MSDRG 481
Min. Negotiated Rate	$16,978.07
Max. Negotiated Rate	$25,020.31
Rate for Payer: Anthem Medicaid	$16,978.07
Rate for Payer: Anthem Medicare Advantage/PPO	$17,871.65
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,020.31
Rate for Payer: CareSource Just4Me Medicare	$24,126.73
Rate for Payer: Humana KY Medicaid	$16,978.07
Rate for Payer: Humana Medicare Advantage	$17,871.65
Rate for Payer: Kentucky WC Medicaid	$17,147.85
Rate for Payer: Molina Healthcare Benefit Exchange	$21,445.98
Rate for Payer: Molina Healthcare Medicaid	$17,317.63

MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC

Facility

$35,464.25

Service Code	MSDRG 480
Min. Negotiated Rate	$24,065.03
Max. Negotiated Rate	$35,464.25
Rate for Payer: Anthem Medicaid	$24,065.03
Rate for Payer: Anthem Medicare Advantage/PPO	$25,331.61
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$35,464.25
Rate for Payer: CareSource Just4Me Medicare	$34,197.67
Rate for Payer: Humana KY Medicaid	$24,065.03
Rate for Payer: Humana Medicare Advantage	$25,331.61
Rate for Payer: Kentucky WC Medicaid	$24,305.68
Rate for Payer: Molina Healthcare Benefit Exchange	$30,397.93
Rate for Payer: Molina Healthcare Medicaid	$24,546.33

MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

Facility

$19,129.73

Service Code	MSDRG 482
Min. Negotiated Rate	$12,980.89
Max. Negotiated Rate	$19,129.73
Rate for Payer: Anthem Medicaid	$12,980.89
Rate for Payer: Anthem Medicare Advantage/PPO	$13,664.09
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,129.73
Rate for Payer: CareSource Just4Me Medicare	$18,446.52
Rate for Payer: Humana KY Medicaid	$12,980.89
Rate for Payer: Humana Medicare Advantage	$13,664.09
Rate for Payer: Kentucky WC Medicaid	$13,110.69
Rate for Payer: Molina Healthcare Benefit Exchange	$16,396.91
Rate for Payer: Molina Healthcare Medicaid	$13,240.50

MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC

Facility

$35,147.11

Service Code	MSDRG 521
Min. Negotiated Rate	$23,849.83
Max. Negotiated Rate	$35,147.11
Rate for Payer: Anthem Medicaid	$23,849.83
Rate for Payer: Anthem Medicare Advantage/PPO	$25,105.08
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$35,147.11
Rate for Payer: CareSource Just4Me Medicare	$33,891.86
Rate for Payer: Humana KY Medicaid	$23,849.83
Rate for Payer: Humana Medicare Advantage	$25,105.08
Rate for Payer: Kentucky WC Medicaid	$24,088.32
Rate for Payer: Molina Healthcare Benefit Exchange	$30,126.10
Rate for Payer: Molina Healthcare Medicaid	$24,326.82

MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC

Facility

$25,420.65

Service Code	MSDRG 522
Min. Negotiated Rate	$17,249.73
Max. Negotiated Rate	$25,420.65
Rate for Payer: Anthem Medicaid	$17,249.73
Rate for Payer: Anthem Medicare Advantage/PPO	$18,157.61
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,420.65
Rate for Payer: CareSource Just4Me Medicare	$24,512.77
Rate for Payer: Humana KY Medicaid	$17,249.73
Rate for Payer: Humana Medicare Advantage	$18,157.61
Rate for Payer: Kentucky WC Medicaid	$17,422.23
Rate for Payer: Molina Healthcare Benefit Exchange	$21,789.13
Rate for Payer: Molina Healthcare Medicaid	$17,594.72

MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC

Facility

$76,262.00

Service Code	MSDRG 969
Min. Negotiated Rate	$51,749.22
Max. Negotiated Rate	$76,262.00
Rate for Payer: Anthem Medicaid	$51,749.22
Rate for Payer: Anthem Medicare Advantage/PPO	$54,472.86
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$76,262.00
Rate for Payer: CareSource Just4Me Medicare	$73,538.36
Rate for Payer: Humana KY Medicaid	$51,749.22
Rate for Payer: Humana Medicare Advantage	$54,472.86
Rate for Payer: Kentucky WC Medicaid	$52,266.71
Rate for Payer: Molina Healthcare Benefit Exchange	$65,367.43
Rate for Payer: Molina Healthcare Medicaid	$52,784.20

MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC

Facility

$31,995.00

Service Code	MSDRG 970
Min. Negotiated Rate	$21,710.89
Max. Negotiated Rate	$31,995.00
Rate for Payer: Anthem Medicaid	$21,710.89
Rate for Payer: Anthem Medicare Advantage/PPO	$22,853.57
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$31,995.00
Rate for Payer: CareSource Just4Me Medicare	$30,852.32
Rate for Payer: Humana KY Medicaid	$21,710.89
Rate for Payer: Humana Medicare Advantage	$22,853.57
Rate for Payer: Kentucky WC Medicaid	$21,928.00
Rate for Payer: Molina Healthcare Benefit Exchange	$27,424.28
Rate for Payer: Molina Healthcare Medicaid	$22,145.11

MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH CC

Facility

$17,140.05

Service Code	MSDRG 975
Min. Negotiated Rate	$11,630.75
Max. Negotiated Rate	$17,140.05
Rate for Payer: Anthem Medicaid	$11,630.75
Rate for Payer: Anthem Medicare Advantage/PPO	$12,242.89
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,140.05
Rate for Payer: CareSource Just4Me Medicare	$16,527.90
Rate for Payer: Humana KY Medicaid	$11,630.75
Rate for Payer: Humana Medicare Advantage	$12,242.89
Rate for Payer: Kentucky WC Medicaid	$11,747.05
Rate for Payer: Molina Healthcare Benefit Exchange	$14,691.47
Rate for Payer: Molina Healthcare Medicaid	$11,863.36

MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH MCC

Facility

$36,009.29

Service Code	MSDRG 974
Min. Negotiated Rate	$24,434.87
Max. Negotiated Rate	$36,009.29
Rate for Payer: Anthem Medicaid	$24,434.87
Rate for Payer: Anthem Medicare Advantage/PPO	$25,720.92
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$36,009.29
Rate for Payer: CareSource Just4Me Medicare	$34,723.24
Rate for Payer: Humana KY Medicaid	$24,434.87
Rate for Payer: Humana Medicare Advantage	$25,720.92
Rate for Payer: Kentucky WC Medicaid	$24,679.22
Rate for Payer: Molina Healthcare Benefit Exchange	$30,865.10
Rate for Payer: Molina Healthcare Medicaid	$24,923.57

MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC

Facility

$12,094.74

Service Code	MSDRG 976
Min. Negotiated Rate	$8,207.15
Max. Negotiated Rate	$12,094.74
Rate for Payer: Anthem Medicaid	$8,207.15
Rate for Payer: Anthem Medicare Advantage/PPO	$8,639.10
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,094.74
Rate for Payer: CareSource Just4Me Medicare	$11,662.78
Rate for Payer: Humana KY Medicaid	$8,207.15
Rate for Payer: Humana Medicare Advantage	$8,639.10
Rate for Payer: Kentucky WC Medicaid	$8,289.22
Rate for Payer: Molina Healthcare Benefit Exchange	$10,366.92
Rate for Payer: Molina Healthcare Medicaid	$8,371.29

MS-DRG 42.00: HIV WITH OR WITHOUT OTHER RELATED CONDITION

Facility

$17,387.23

Service Code	MSDRG 977
Min. Negotiated Rate	$11,798.48
Max. Negotiated Rate	$17,387.23
Rate for Payer: Anthem Medicaid	$11,798.48
Rate for Payer: Anthem Medicare Advantage/PPO	$12,419.45
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,387.23
Rate for Payer: CareSource Just4Me Medicare	$16,766.26
Rate for Payer: Humana KY Medicaid	$11,798.48
Rate for Payer: Humana Medicare Advantage	$12,419.45
Rate for Payer: Kentucky WC Medicaid	$11,916.46
Rate for Payer: Molina Healthcare Benefit Exchange	$14,903.34
Rate for Payer: Molina Healthcare Medicaid	$12,034.45

MS-DRG 42.00: HYPERTENSION WITH MCC

Facility

$14,166.42

Service Code	MSDRG 304
Min. Negotiated Rate	$9,612.93
Max. Negotiated Rate	$14,166.42
Rate for Payer: Anthem Medicaid	$9,612.93
Rate for Payer: Anthem Medicare Advantage/PPO	$10,118.87
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,166.42
Rate for Payer: CareSource Just4Me Medicare	$13,660.47
Rate for Payer: Humana KY Medicaid	$9,612.93
Rate for Payer: Humana Medicare Advantage	$10,118.87
Rate for Payer: Kentucky WC Medicaid	$9,709.06
Rate for Payer: Molina Healthcare Benefit Exchange	$12,142.64
Rate for Payer: Molina Healthcare Medicaid	$9,805.19

MS-DRG 42.00: HYPERTENSION WITHOUT MCC

Facility

$9,052.36

Service Code	MSDRG 305
Min. Negotiated Rate	$6,142.67
Max. Negotiated Rate	$9,052.36
Rate for Payer: Anthem Medicaid	$6,142.67
Rate for Payer: Anthem Medicare Advantage/PPO	$6,465.97
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,052.36
Rate for Payer: CareSource Just4Me Medicare	$8,729.06
Rate for Payer: Humana KY Medicaid	$6,142.67
Rate for Payer: Humana Medicare Advantage	$6,465.97
Rate for Payer: Kentucky WC Medicaid	$6,204.10
Rate for Payer: Molina Healthcare Benefit Exchange	$7,759.16
Rate for Payer: Molina Healthcare Medicaid	$6,265.52

MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH CC

Facility

$12,033.24

Service Code	MSDRG 078
Min. Negotiated Rate	$8,165.41
Max. Negotiated Rate	$12,033.24
Rate for Payer: Anthem Medicaid	$8,165.41
Rate for Payer: Anthem Medicare Advantage/PPO	$8,595.17
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,033.24
Rate for Payer: CareSource Just4Me Medicare	$11,603.48
Rate for Payer: Humana KY Medicaid	$8,165.41
Rate for Payer: Humana Medicare Advantage	$8,595.17
Rate for Payer: Kentucky WC Medicaid	$8,247.07
Rate for Payer: Molina Healthcare Benefit Exchange	$10,314.20
Rate for Payer: Molina Healthcare Medicaid	$8,328.72

MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH MCC

Facility

$18,646.15

Service Code	MSDRG 077
Min. Negotiated Rate	$12,652.75
Max. Negotiated Rate	$18,646.15
Rate for Payer: Anthem Medicaid	$12,652.75
Rate for Payer: Anthem Medicare Advantage/PPO	$13,318.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,646.15
Rate for Payer: CareSource Just4Me Medicare	$17,980.22
Rate for Payer: Humana KY Medicaid	$12,652.75
Rate for Payer: Humana Medicare Advantage	$13,318.68
Rate for Payer: Kentucky WC Medicaid	$12,779.27
Rate for Payer: Molina Healthcare Benefit Exchange	$15,982.42
Rate for Payer: Molina Healthcare Medicaid	$12,905.80

Know your out-of-pocket cost for care.

All Charges