Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC

Facility

$8,039.43

Service Code	MSDRG 079
Min. Negotiated Rate	$5,455.33
Max. Negotiated Rate	$8,039.43
Rate for Payer: Anthem Medicaid	$5,455.33
Rate for Payer: Anthem Medicare Advantage/PPO	$5,742.45
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,039.43
Rate for Payer: CareSource Just4Me Medicare	$7,752.31
Rate for Payer: Humana KY Medicaid	$5,455.33
Rate for Payer: Humana Medicare Advantage	$5,742.45
Rate for Payer: Kentucky WC Medicaid	$5,509.88
Rate for Payer: Molina Healthcare Benefit Exchange	$6,890.94
Rate for Payer: Molina Healthcare Medicaid	$5,564.43

MS-DRG 42.00: INBORN AND OTHER DISORDERS OF METABOLISM

Facility

$14,965.89

Service Code	MSDRG 642
Min. Negotiated Rate	$10,155.42
Max. Negotiated Rate	$14,965.89
Rate for Payer: Anthem Medicaid	$10,155.42
Rate for Payer: Anthem Medicare Advantage/PPO	$10,689.92
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,965.89
Rate for Payer: CareSource Just4Me Medicare	$14,431.39
Rate for Payer: Humana KY Medicaid	$10,155.42
Rate for Payer: Humana Medicare Advantage	$10,689.92
Rate for Payer: Kentucky WC Medicaid	$10,256.98
Rate for Payer: Molina Healthcare Benefit Exchange	$12,827.90
Rate for Payer: Molina Healthcare Medicaid	$10,358.53

MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$12,291.30

Service Code	MSDRG 758
Min. Negotiated Rate	$8,340.52
Max. Negotiated Rate	$12,291.30
Rate for Payer: Anthem Medicaid	$8,340.52
Rate for Payer: Anthem Medicare Advantage/PPO	$8,779.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,291.30
Rate for Payer: CareSource Just4Me Medicare	$11,852.33
Rate for Payer: Humana KY Medicaid	$8,340.52
Rate for Payer: Humana Medicare Advantage	$8,779.50
Rate for Payer: Kentucky WC Medicaid	$8,423.93
Rate for Payer: Molina Healthcare Benefit Exchange	$10,535.40
Rate for Payer: Molina Healthcare Medicaid	$8,507.34

MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$17,066.46

Service Code	MSDRG 757
Min. Negotiated Rate	$11,580.81
Max. Negotiated Rate	$17,066.46
Rate for Payer: Anthem Medicaid	$11,580.81
Rate for Payer: Anthem Medicare Advantage/PPO	$12,190.33
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,066.46
Rate for Payer: CareSource Just4Me Medicare	$16,456.95
Rate for Payer: Humana KY Medicaid	$11,580.81
Rate for Payer: Humana Medicare Advantage	$12,190.33
Rate for Payer: Kentucky WC Medicaid	$11,696.62
Rate for Payer: Molina Healthcare Benefit Exchange	$14,628.40
Rate for Payer: Molina Healthcare Medicaid	$11,812.43

MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$7,717.47

Service Code	MSDRG 759
Min. Negotiated Rate	$5,236.86
Max. Negotiated Rate	$7,717.47
Rate for Payer: Anthem Medicaid	$5,236.86
Rate for Payer: Anthem Medicare Advantage/PPO	$5,512.48
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$7,717.47
Rate for Payer: CareSource Just4Me Medicare	$7,441.85
Rate for Payer: Humana KY Medicaid	$5,236.86
Rate for Payer: Humana Medicare Advantage	$5,512.48
Rate for Payer: Kentucky WC Medicaid	$5,289.22
Rate for Payer: Molina Healthcare Benefit Exchange	$6,614.98
Rate for Payer: Molina Healthcare Medicaid	$5,341.59

MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC

Facility

$24,094.21

Service Code	MSDRG 854
Min. Negotiated Rate	$16,349.64
Max. Negotiated Rate	$24,094.21
Rate for Payer: Anthem Medicaid	$16,349.64
Rate for Payer: Anthem Medicare Advantage/PPO	$17,210.15
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$24,094.21
Rate for Payer: CareSource Just4Me Medicare	$23,233.70
Rate for Payer: Humana KY Medicaid	$16,349.64
Rate for Payer: Humana Medicare Advantage	$17,210.15
Rate for Payer: Kentucky WC Medicaid	$16,513.14
Rate for Payer: Molina Healthcare Benefit Exchange	$20,652.18
Rate for Payer: Molina Healthcare Medicaid	$16,676.64

MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC

Facility

$60,308.50

Service Code	MSDRG 853
Min. Negotiated Rate	$40,923.62
Max. Negotiated Rate	$60,308.50
Rate for Payer: Anthem Medicaid	$40,923.62
Rate for Payer: Anthem Medicare Advantage/PPO	$43,077.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$60,308.50
Rate for Payer: CareSource Just4Me Medicare	$58,154.62
Rate for Payer: Humana KY Medicaid	$40,923.62
Rate for Payer: Humana Medicare Advantage	$43,077.50
Rate for Payer: Kentucky WC Medicaid	$41,332.86
Rate for Payer: Molina Healthcare Benefit Exchange	$51,693.00
Rate for Payer: Molina Healthcare Medicaid	$41,742.10

MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC

Facility

$19,602.41

Service Code	MSDRG 855
Min. Negotiated Rate	$13,301.63
Max. Negotiated Rate	$19,602.41
Rate for Payer: Anthem Medicaid	$13,301.63
Rate for Payer: Anthem Medicare Advantage/PPO	$14,001.72
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,602.41
Rate for Payer: CareSource Just4Me Medicare	$18,902.32
Rate for Payer: Humana KY Medicaid	$13,301.63
Rate for Payer: Humana Medicare Advantage	$14,001.72
Rate for Payer: Kentucky WC Medicaid	$13,434.65
Rate for Payer: Molina Healthcare Benefit Exchange	$16,802.06
Rate for Payer: Molina Healthcare Medicaid	$13,567.67

MS-DRG 42.00: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$17,718.86

Service Code	MSDRG 727
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: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC

Facility

$9,853.05

Service Code	MSDRG 728
Min. Negotiated Rate	$6,686.00
Max. Negotiated Rate	$9,853.05
Rate for Payer: Anthem Medicaid	$6,686.00
Rate for Payer: Anthem Medicare Advantage/PPO	$7,037.89
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,853.05
Rate for Payer: CareSource Just4Me Medicare	$9,501.15
Rate for Payer: Humana KY Medicaid	$6,686.00
Rate for Payer: Humana Medicare Advantage	$7,037.89
Rate for Payer: Kentucky WC Medicaid	$6,752.86
Rate for Payer: Molina Healthcare Benefit Exchange	$8,445.47
Rate for Payer: Molina Healthcare Medicaid	$6,819.72

MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITH CC

Facility

$11,968.14

Service Code	MSDRG 386
Min. Negotiated Rate	$8,121.24
Max. Negotiated Rate	$11,968.14
Rate for Payer: Anthem Medicaid	$8,121.24
Rate for Payer: Anthem Medicare Advantage/PPO	$8,548.67
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,968.14
Rate for Payer: CareSource Just4Me Medicare	$11,540.70
Rate for Payer: Humana KY Medicaid	$8,121.24
Rate for Payer: Humana Medicare Advantage	$8,548.67
Rate for Payer: Kentucky WC Medicaid	$8,202.45
Rate for Payer: Molina Healthcare Benefit Exchange	$10,258.40
Rate for Payer: Molina Healthcare Medicaid	$8,283.66

MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITH MCC

Facility

$19,592.78

Service Code	MSDRG 385
Min. Negotiated Rate	$13,295.10
Max. Negotiated Rate	$19,592.78
Rate for Payer: Anthem Medicaid	$13,295.10
Rate for Payer: Anthem Medicare Advantage/PPO	$13,994.84
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,592.78
Rate for Payer: CareSource Just4Me Medicare	$18,893.03
Rate for Payer: Humana KY Medicaid	$13,295.10
Rate for Payer: Humana Medicare Advantage	$13,994.84
Rate for Payer: Kentucky WC Medicaid	$13,428.05
Rate for Payer: Molina Healthcare Benefit Exchange	$16,793.81
Rate for Payer: Molina Healthcare Medicaid	$13,561.00

MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC

Facility

$8,082.86

Service Code	MSDRG 387
Min. Negotiated Rate	$5,484.80
Max. Negotiated Rate	$8,082.86
Rate for Payer: Anthem Medicaid	$5,484.80
Rate for Payer: Anthem Medicare Advantage/PPO	$5,773.47
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,082.86
Rate for Payer: CareSource Just4Me Medicare	$7,794.18
Rate for Payer: Humana KY Medicaid	$5,484.80
Rate for Payer: Humana Medicare Advantage	$5,773.47
Rate for Payer: Kentucky WC Medicaid	$5,539.64
Rate for Payer: Molina Healthcare Benefit Exchange	$6,928.16
Rate for Payer: Molina Healthcare Medicaid	$5,594.49

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

Facility

$18,142.11

Service Code	MSDRG 351
Min. Negotiated Rate	$12,310.72
Max. Negotiated Rate	$18,142.11
Rate for Payer: Anthem Medicaid	$12,310.72
Rate for Payer: Anthem Medicare Advantage/PPO	$12,958.65
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,142.11
Rate for Payer: CareSource Just4Me Medicare	$17,494.18
Rate for Payer: Humana KY Medicaid	$12,310.72
Rate for Payer: Humana Medicare Advantage	$12,958.65
Rate for Payer: Kentucky WC Medicaid	$12,433.82
Rate for Payer: Molina Healthcare Benefit Exchange	$15,550.38
Rate for Payer: Molina Healthcare Medicaid	$12,556.93

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

Facility

$29,166.06

Service Code	MSDRG 350
Min. Negotiated Rate	$19,791.26
Max. Negotiated Rate	$29,166.06
Rate for Payer: Anthem Medicaid	$19,791.26
Rate for Payer: Anthem Medicare Advantage/PPO	$20,832.90
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$29,166.06
Rate for Payer: CareSource Just4Me Medicare	$28,124.42
Rate for Payer: Humana KY Medicaid	$19,791.26
Rate for Payer: Humana Medicare Advantage	$20,832.90
Rate for Payer: Kentucky WC Medicaid	$19,989.17
Rate for Payer: Molina Healthcare Benefit Exchange	$24,999.48
Rate for Payer: Molina Healthcare Medicaid	$20,187.08

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

Facility

$13,295.79

Service Code	MSDRG 352
Min. Negotiated Rate	$9,022.14
Max. Negotiated Rate	$13,295.79
Rate for Payer: Anthem Medicaid	$9,022.14
Rate for Payer: Anthem Medicare Advantage/PPO	$9,496.99
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,295.79
Rate for Payer: CareSource Just4Me Medicare	$12,820.94
Rate for Payer: Humana KY Medicaid	$9,022.14
Rate for Payer: Humana Medicare Advantage	$9,496.99
Rate for Payer: Kentucky WC Medicaid	$9,112.36
Rate for Payer: Molina Healthcare Benefit Exchange	$11,396.39
Rate for Payer: Molina Healthcare Medicaid	$9,202.58

MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH CC

Facility

$11,937.97

Service Code	MSDRG 197
Min. Negotiated Rate	$8,100.76
Max. Negotiated Rate	$11,937.97
Rate for Payer: Anthem Medicaid	$8,100.76
Rate for Payer: Anthem Medicare Advantage/PPO	$8,527.12
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,937.97
Rate for Payer: CareSource Just4Me Medicare	$11,511.61
Rate for Payer: Humana KY Medicaid	$8,100.76
Rate for Payer: Humana Medicare Advantage	$8,527.12
Rate for Payer: Kentucky WC Medicaid	$8,181.77
Rate for Payer: Molina Healthcare Benefit Exchange	$10,232.54
Rate for Payer: Molina Healthcare Medicaid	$8,262.78

MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH MCC

Facility

$22,719.56

Service Code	MSDRG 196
Min. Negotiated Rate	$15,416.85
Max. Negotiated Rate	$22,719.56
Rate for Payer: Anthem Medicaid	$15,416.85
Rate for Payer: Anthem Medicare Advantage/PPO	$16,228.26
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,719.56
Rate for Payer: CareSource Just4Me Medicare	$21,908.15
Rate for Payer: Humana KY Medicaid	$15,416.85
Rate for Payer: Humana Medicare Advantage	$16,228.26
Rate for Payer: Kentucky WC Medicaid	$15,571.02
Rate for Payer: Molina Healthcare Benefit Exchange	$19,473.91
Rate for Payer: Molina Healthcare Medicaid	$15,725.18

MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC

Facility

$8,445.82

Service Code	MSDRG 198
Min. Negotiated Rate	$5,731.09
Max. Negotiated Rate	$8,445.82
Rate for Payer: Anthem Medicaid	$5,731.09
Rate for Payer: Anthem Medicare Advantage/PPO	$6,032.73
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,445.82
Rate for Payer: CareSource Just4Me Medicare	$8,144.19
Rate for Payer: Humana KY Medicaid	$5,731.09
Rate for Payer: Humana Medicare Advantage	$6,032.73
Rate for Payer: Kentucky WC Medicaid	$5,788.40
Rate for Payer: Molina Healthcare Benefit Exchange	$7,239.28
Rate for Payer: Molina Healthcare Medicaid	$5,845.72

MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS

Facility

$12,262.35

Service Code	MSDRG 065
Min. Negotiated Rate	$8,320.88
Max. Negotiated Rate	$12,262.35
Rate for Payer: Anthem Medicaid	$8,320.88
Rate for Payer: Anthem Medicare Advantage/PPO	$8,758.82
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,262.35
Rate for Payer: CareSource Just4Me Medicare	$11,824.41
Rate for Payer: Humana KY Medicaid	$8,320.88
Rate for Payer: Humana Medicare Advantage	$8,758.82
Rate for Payer: Kentucky WC Medicaid	$8,404.09
Rate for Payer: Molina Healthcare Benefit Exchange	$10,510.58
Rate for Payer: Molina Healthcare Medicaid	$8,487.30

MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC

Facility

$23,986.90

Service Code	MSDRG 064
Min. Negotiated Rate	$16,276.83
Max. Negotiated Rate	$23,986.90
Rate for Payer: Anthem Medicaid	$16,276.83
Rate for Payer: Anthem Medicare Advantage/PPO	$17,133.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,986.90
Rate for Payer: CareSource Just4Me Medicare	$23,130.22
Rate for Payer: Humana KY Medicaid	$16,276.83
Rate for Payer: Humana Medicare Advantage	$17,133.50
Rate for Payer: Kentucky WC Medicaid	$16,439.59
Rate for Payer: Molina Healthcare Benefit Exchange	$20,560.20
Rate for Payer: Molina Healthcare Medicaid	$16,602.36

MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC

Facility

$8,299.90

Service Code	MSDRG 066
Min. Negotiated Rate	$5,632.07
Max. Negotiated Rate	$8,299.90
Rate for Payer: Anthem Medicaid	$5,632.07
Rate for Payer: Anthem Medicare Advantage/PPO	$5,928.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,299.90
Rate for Payer: CareSource Just4Me Medicare	$8,003.48
Rate for Payer: Humana KY Medicaid	$5,632.07
Rate for Payer: Humana Medicare Advantage	$5,928.50
Rate for Payer: Kentucky WC Medicaid	$5,688.40
Rate for Payer: Molina Healthcare Benefit Exchange	$7,114.20
Rate for Payer: Molina Healthcare Medicaid	$5,744.72

MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC

Facility

$66,651.33

Service Code	MSDRG 021
Min. Negotiated Rate	$45,227.69
Max. Negotiated Rate	$66,651.33
Rate for Payer: Anthem Medicaid	$45,227.69
Rate for Payer: Anthem Medicare Advantage/PPO	$47,608.09
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$66,651.33
Rate for Payer: CareSource Just4Me Medicare	$64,270.92
Rate for Payer: Humana KY Medicaid	$45,227.69
Rate for Payer: Humana Medicare Advantage	$47,608.09
Rate for Payer: Kentucky WC Medicaid	$45,679.96
Rate for Payer: Molina Healthcare Benefit Exchange	$57,129.71
Rate for Payer: Molina Healthcare Medicaid	$46,132.24

MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC

Facility

$97,205.32

Service Code	MSDRG 020
Min. Negotiated Rate	$65,960.75
Max. Negotiated Rate	$97,205.32
Rate for Payer: Anthem Medicaid	$65,960.75
Rate for Payer: Anthem Medicare Advantage/PPO	$69,432.37
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$97,205.32
Rate for Payer: CareSource Just4Me Medicare	$93,733.70
Rate for Payer: Humana KY Medicaid	$65,960.75
Rate for Payer: Humana Medicare Advantage	$69,432.37
Rate for Payer: Kentucky WC Medicaid	$66,620.36
Rate for Payer: Molina Healthcare Benefit Exchange	$83,318.84
Rate for Payer: Molina Healthcare Medicaid	$67,279.97

MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC

Facility

$42,571.56

Service Code	MSDRG 022
Min. Negotiated Rate	$28,887.85
Max. Negotiated Rate	$42,571.56
Rate for Payer: Anthem Medicaid	$28,887.85
Rate for Payer: Anthem Medicare Advantage/PPO	$30,408.26
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$42,571.56
Rate for Payer: CareSource Just4Me Medicare	$41,051.15
Rate for Payer: Humana KY Medicaid	$28,887.85
Rate for Payer: Humana Medicare Advantage	$30,408.26
Rate for Payer: Kentucky WC Medicaid	$29,176.73
Rate for Payer: Molina Healthcare Benefit Exchange	$36,489.91
Rate for Payer: Molina Healthcare Medicaid	$29,465.60

Know your out-of-pocket cost for care.

All Charges