Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: INTRAOCULAR PROCEDURES WITH CC/MCC

Facility

$20,120.94

Service Code	MSDRG 116
Min. Negotiated Rate	$13,653.50
Max. Negotiated Rate	$20,120.94
Rate for Payer: Anthem Medicaid	$13,653.50
Rate for Payer: Anthem Medicare Advantage/PPO	$14,372.10
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,120.94
Rate for Payer: CareSource Just4Me Medicare	$19,402.33
Rate for Payer: Humana KY Medicaid	$13,653.50
Rate for Payer: Humana Medicare Advantage	$14,372.10
Rate for Payer: Kentucky WC Medicaid	$13,790.03
Rate for Payer: Molina Healthcare Benefit Exchange	$17,246.52
Rate for Payer: Molina Healthcare Medicaid	$13,926.56

MS-DRG 42.00: INTRAOCULAR PROCEDURES WITHOUT CC/MCC

Facility

$13,006.38

Service Code	MSDRG 117
Min. Negotiated Rate	$8,825.76
Max. Negotiated Rate	$13,006.38
Rate for Payer: Anthem Medicaid	$8,825.76
Rate for Payer: Anthem Medicare Advantage/PPO	$9,290.27
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,006.38
Rate for Payer: CareSource Just4Me Medicare	$12,541.86
Rate for Payer: Humana KY Medicaid	$8,825.76
Rate for Payer: Humana Medicare Advantage	$9,290.27
Rate for Payer: Kentucky WC Medicaid	$8,914.01
Rate for Payer: Molina Healthcare Benefit Exchange	$11,148.32
Rate for Payer: Molina Healthcare Medicaid	$9,002.27

MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC

Facility

$21,475.10

Service Code	MSDRG 062
Min. Negotiated Rate	$14,572.39
Max. Negotiated Rate	$21,475.10
Rate for Payer: Anthem Medicaid	$14,572.39
Rate for Payer: Anthem Medicare Advantage/PPO	$15,339.36
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,475.10
Rate for Payer: CareSource Just4Me Medicare	$20,708.14
Rate for Payer: Humana KY Medicaid	$14,572.39
Rate for Payer: Humana Medicare Advantage	$15,339.36
Rate for Payer: Kentucky WC Medicaid	$14,718.12
Rate for Payer: Molina Healthcare Benefit Exchange	$18,407.23
Rate for Payer: Molina Healthcare Medicaid	$14,863.84

MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC

Facility

$32,599.13

Service Code	MSDRG 061
Min. Negotiated Rate	$22,120.84
Max. Negotiated Rate	$32,599.13
Rate for Payer: Anthem Medicaid	$22,120.84
Rate for Payer: Anthem Medicare Advantage/PPO	$23,285.09
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$32,599.13
Rate for Payer: CareSource Just4Me Medicare	$31,434.87
Rate for Payer: Humana KY Medicaid	$22,120.84
Rate for Payer: Humana Medicare Advantage	$23,285.09
Rate for Payer: Kentucky WC Medicaid	$22,342.04
Rate for Payer: Molina Healthcare Benefit Exchange	$27,942.11
Rate for Payer: Molina Healthcare Medicaid	$22,563.25

MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC

Facility

$16,939.89

Service Code	MSDRG 063
Min. Negotiated Rate	$11,494.92
Max. Negotiated Rate	$16,939.89
Rate for Payer: Anthem Medicaid	$11,494.92
Rate for Payer: Anthem Medicare Advantage/PPO	$12,099.92
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,939.89
Rate for Payer: CareSource Just4Me Medicare	$16,334.89
Rate for Payer: Humana KY Medicaid	$11,494.92
Rate for Payer: Humana Medicare Advantage	$12,099.92
Rate for Payer: Kentucky WC Medicaid	$11,609.87
Rate for Payer: Molina Healthcare Benefit Exchange	$14,519.90
Rate for Payer: Molina Healthcare Medicaid	$11,724.82

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC

Facility

$22,044.27

Service Code	MSDRG 657
Min. Negotiated Rate	$14,958.61
Max. Negotiated Rate	$22,044.27
Rate for Payer: Anthem Medicaid	$14,958.61
Rate for Payer: Anthem Medicare Advantage/PPO	$15,745.91
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,044.27
Rate for Payer: CareSource Just4Me Medicare	$21,256.98
Rate for Payer: Humana KY Medicaid	$14,958.61
Rate for Payer: Humana Medicare Advantage	$15,745.91
Rate for Payer: Kentucky WC Medicaid	$15,108.20
Rate for Payer: Molina Healthcare Benefit Exchange	$18,895.09
Rate for Payer: Molina Healthcare Medicaid	$15,257.79

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC

Facility

$39,286.81

Service Code	MSDRG 656
Min. Negotiated Rate	$26,658.91
Max. Negotiated Rate	$39,286.81
Rate for Payer: Anthem Medicaid	$26,658.91
Rate for Payer: Anthem Medicare Advantage/PPO	$28,062.01
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$39,286.81
Rate for Payer: CareSource Just4Me Medicare	$37,883.71
Rate for Payer: Humana KY Medicaid	$26,658.91
Rate for Payer: Humana Medicare Advantage	$28,062.01
Rate for Payer: Kentucky WC Medicaid	$26,925.50
Rate for Payer: Molina Healthcare Benefit Exchange	$33,674.41
Rate for Payer: Molina Healthcare Medicaid	$27,192.09

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC

Facility

$18,136.09

Service Code	MSDRG 658
Min. Negotiated Rate	$12,306.63
Max. Negotiated Rate	$18,136.09
Rate for Payer: Anthem Medicaid	$12,306.63
Rate for Payer: Anthem Medicare Advantage/PPO	$12,954.35
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,136.09
Rate for Payer: CareSource Just4Me Medicare	$17,488.37
Rate for Payer: Humana KY Medicaid	$12,306.63
Rate for Payer: Humana Medicare Advantage	$12,954.35
Rate for Payer: Kentucky WC Medicaid	$12,429.70
Rate for Payer: Molina Healthcare Benefit Exchange	$15,545.22
Rate for Payer: Molina Healthcare Medicaid	$12,552.77

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC

Facility

$16,158.48

Service Code	MSDRG 660
Min. Negotiated Rate	$10,964.68
Max. Negotiated Rate	$16,158.48
Rate for Payer: Anthem Medicaid	$10,964.68
Rate for Payer: Anthem Medicare Advantage/PPO	$11,541.77
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,158.48
Rate for Payer: CareSource Just4Me Medicare	$15,581.39
Rate for Payer: Humana KY Medicaid	$10,964.68
Rate for Payer: Humana Medicare Advantage	$11,541.77
Rate for Payer: Kentucky WC Medicaid	$11,074.33
Rate for Payer: Molina Healthcare Benefit Exchange	$13,850.12
Rate for Payer: Molina Healthcare Medicaid	$11,183.98

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC

Facility

$31,162.96

Service Code	MSDRG 659
Min. Negotiated Rate	$21,146.30
Max. Negotiated Rate	$31,162.96
Rate for Payer: Anthem Medicaid	$21,146.30
Rate for Payer: Anthem Medicare Advantage/PPO	$22,259.26
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$31,162.96
Rate for Payer: CareSource Just4Me Medicare	$30,050.00
Rate for Payer: Humana KY Medicaid	$21,146.30
Rate for Payer: Humana Medicare Advantage	$22,259.26
Rate for Payer: Kentucky WC Medicaid	$21,357.76
Rate for Payer: Molina Healthcare Benefit Exchange	$26,711.11
Rate for Payer: Molina Healthcare Medicaid	$21,569.22

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC

Facility

$12,379.33

Service Code	MSDRG 661
Min. Negotiated Rate	$8,400.26
Max. Negotiated Rate	$12,379.33
Rate for Payer: Anthem Medicaid	$8,400.26
Rate for Payer: Anthem Medicare Advantage/PPO	$8,842.38
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,379.33
Rate for Payer: CareSource Just4Me Medicare	$11,937.21
Rate for Payer: Humana KY Medicaid	$8,400.26
Rate for Payer: Humana Medicare Advantage	$8,842.38
Rate for Payer: Kentucky WC Medicaid	$8,484.26
Rate for Payer: Molina Healthcare Benefit Exchange	$10,610.86
Rate for Payer: Molina Healthcare Medicaid	$8,568.27

MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITH MCC

Facility

$14,112.14

Service Code	MSDRG 689
Min. Negotiated Rate	$9,576.09
Max. Negotiated Rate	$14,112.14
Rate for Payer: Anthem Medicaid	$9,576.09
Rate for Payer: Anthem Medicare Advantage/PPO	$10,080.10
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,112.14
Rate for Payer: CareSource Just4Me Medicare	$13,608.14
Rate for Payer: Humana KY Medicaid	$9,576.09
Rate for Payer: Humana Medicare Advantage	$10,080.10
Rate for Payer: Kentucky WC Medicaid	$9,671.86
Rate for Payer: Molina Healthcare Benefit Exchange	$12,096.12
Rate for Payer: Molina Healthcare Medicaid	$9,767.62

MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC

Facility

$9,678.20

Service Code	MSDRG 690
Min. Negotiated Rate	$6,567.35
Max. Negotiated Rate	$9,678.20
Rate for Payer: Anthem Medicaid	$6,567.35
Rate for Payer: Anthem Medicare Advantage/PPO	$6,913.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,678.20
Rate for Payer: CareSource Just4Me Medicare	$9,332.55
Rate for Payer: Humana KY Medicaid	$6,567.35
Rate for Payer: Humana Medicare Advantage	$6,913.00
Rate for Payer: Kentucky WC Medicaid	$6,633.02
Rate for Payer: Molina Healthcare Benefit Exchange	$8,295.60
Rate for Payer: Molina Healthcare Medicaid	$6,698.70

MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$12,694.04

Service Code	MSDRG 687
Min. Negotiated Rate	$8,613.81
Max. Negotiated Rate	$12,694.04
Rate for Payer: Anthem Medicaid	$8,613.81
Rate for Payer: Anthem Medicare Advantage/PPO	$9,067.17
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,694.04
Rate for Payer: CareSource Just4Me Medicare	$12,240.68
Rate for Payer: Humana KY Medicaid	$8,613.81
Rate for Payer: Humana Medicare Advantage	$9,067.17
Rate for Payer: Kentucky WC Medicaid	$8,699.95
Rate for Payer: Molina Healthcare Benefit Exchange	$10,880.60
Rate for Payer: Molina Healthcare Medicaid	$8,786.09

MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$22,738.86

Service Code	MSDRG 686
Min. Negotiated Rate	$15,429.94
Max. Negotiated Rate	$22,738.86
Rate for Payer: Anthem Medicaid	$15,429.94
Rate for Payer: Anthem Medicare Advantage/PPO	$16,242.04
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,738.86
Rate for Payer: CareSource Just4Me Medicare	$21,926.75
Rate for Payer: Humana KY Medicaid	$15,429.94
Rate for Payer: Humana Medicare Advantage	$16,242.04
Rate for Payer: Kentucky WC Medicaid	$15,584.24
Rate for Payer: Molina Healthcare Benefit Exchange	$19,490.45
Rate for Payer: Molina Healthcare Medicaid	$15,738.54

MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$8,732.82

Service Code	MSDRG 688
Min. Negotiated Rate	$5,925.84
Max. Negotiated Rate	$8,732.82
Rate for Payer: Anthem Medicaid	$5,925.84
Rate for Payer: Anthem Medicare Advantage/PPO	$6,237.73
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,732.82
Rate for Payer: CareSource Just4Me Medicare	$8,420.94
Rate for Payer: Humana KY Medicaid	$5,925.84
Rate for Payer: Humana Medicare Advantage	$6,237.73
Rate for Payer: Kentucky WC Medicaid	$5,985.10
Rate for Payer: Molina Healthcare Benefit Exchange	$7,485.28
Rate for Payer: Molina Healthcare Medicaid	$6,044.36

MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$13,599.66

Service Code	MSDRG 695
Min. Negotiated Rate	$9,228.34
Max. Negotiated Rate	$13,599.66
Rate for Payer: Anthem Medicaid	$9,228.34
Rate for Payer: Anthem Medicare Advantage/PPO	$9,714.04
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,599.66
Rate for Payer: CareSource Just4Me Medicare	$13,113.95
Rate for Payer: Humana KY Medicaid	$9,228.34
Rate for Payer: Humana Medicare Advantage	$9,714.04
Rate for Payer: Kentucky WC Medicaid	$9,320.62
Rate for Payer: Molina Healthcare Benefit Exchange	$11,656.85
Rate for Payer: Molina Healthcare Medicaid	$9,412.90

MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$8,342.11

Service Code	MSDRG 696
Min. Negotiated Rate	$5,660.72
Max. Negotiated Rate	$8,342.11
Rate for Payer: Anthem Medicaid	$5,660.72
Rate for Payer: Anthem Medicare Advantage/PPO	$5,958.65
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,342.11
Rate for Payer: CareSource Just4Me Medicare	$8,044.18
Rate for Payer: Humana KY Medicaid	$5,660.72
Rate for Payer: Humana Medicare Advantage	$5,958.65
Rate for Payer: Kentucky WC Medicaid	$5,717.32
Rate for Payer: Molina Healthcare Benefit Exchange	$7,150.38
Rate for Payer: Molina Healthcare Medicaid	$5,773.93

MS-DRG 42.00: KIDNEY TRANSPLANT

Facility

$37,036.69

Service Code	MSDRG 652
Min. Negotiated Rate	$25,132.04
Max. Negotiated Rate	$37,036.69
Rate for Payer: Anthem Medicaid	$25,132.04
Rate for Payer: Anthem Medicare Advantage/PPO	$26,454.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$37,036.69
Rate for Payer: CareSource Just4Me Medicare	$35,713.95
Rate for Payer: Humana KY Medicaid	$25,132.04
Rate for Payer: Humana Medicare Advantage	$26,454.78
Rate for Payer: Kentucky WC Medicaid	$25,383.36
Rate for Payer: Molina Healthcare Benefit Exchange	$31,745.74
Rate for Payer: Molina Healthcare Medicaid	$25,634.68

MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC

Facility

$55,557.45

Service Code	MSDRG 650
Min. Negotiated Rate	$37,699.70
Max. Negotiated Rate	$55,557.45
Rate for Payer: Anthem Medicaid	$37,699.70
Rate for Payer: Anthem Medicare Advantage/PPO	$39,683.89
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$55,557.45
Rate for Payer: CareSource Just4Me Medicare	$53,573.25
Rate for Payer: Humana KY Medicaid	$37,699.70
Rate for Payer: Humana Medicare Advantage	$39,683.89
Rate for Payer: Kentucky WC Medicaid	$38,076.69
Rate for Payer: Molina Healthcare Benefit Exchange	$47,620.67
Rate for Payer: Molina Healthcare Medicaid	$38,453.69

MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC

Facility

$41,873.38

Service Code	MSDRG 651
Min. Negotiated Rate	$28,414.08
Max. Negotiated Rate	$41,873.38
Rate for Payer: Anthem Medicaid	$28,414.08
Rate for Payer: Anthem Medicare Advantage/PPO	$29,909.56
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$41,873.38
Rate for Payer: CareSource Just4Me Medicare	$40,377.91
Rate for Payer: Humana KY Medicaid	$28,414.08
Rate for Payer: Humana Medicare Advantage	$29,909.56
Rate for Payer: Kentucky WC Medicaid	$28,698.22
Rate for Payer: Molina Healthcare Benefit Exchange	$35,891.47
Rate for Payer: Molina Healthcare Medicaid	$28,982.36

MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC

Facility

$23,699.93

Service Code	MSDRG 488
Min. Negotiated Rate	$16,082.09
Max. Negotiated Rate	$23,699.93
Rate for Payer: Anthem Medicaid	$16,082.09
Rate for Payer: Anthem Medicare Advantage/PPO	$16,928.52
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,699.93
Rate for Payer: CareSource Just4Me Medicare	$22,853.50
Rate for Payer: Humana KY Medicaid	$16,082.09
Rate for Payer: Humana Medicare Advantage	$16,928.52
Rate for Payer: Kentucky WC Medicaid	$16,242.91
Rate for Payer: Molina Healthcare Benefit Exchange	$20,314.22
Rate for Payer: Molina Healthcare Medicaid	$16,403.74

MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC

Facility

$14,933.34

Service Code	MSDRG 489
Min. Negotiated Rate	$10,133.34
Max. Negotiated Rate	$14,933.34
Rate for Payer: Anthem Medicaid	$10,133.34
Rate for Payer: Anthem Medicare Advantage/PPO	$10,666.67
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,933.34
Rate for Payer: CareSource Just4Me Medicare	$14,400.00
Rate for Payer: Humana KY Medicaid	$10,133.34
Rate for Payer: Humana Medicare Advantage	$10,666.67
Rate for Payer: Kentucky WC Medicaid	$10,234.67
Rate for Payer: Molina Healthcare Benefit Exchange	$12,800.00
Rate for Payer: Molina Healthcare Medicaid	$10,336.00

MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC

Facility

$25,575.03

Service Code	MSDRG 486
Min. Negotiated Rate	$17,354.49
Max. Negotiated Rate	$25,575.03
Rate for Payer: Anthem Medicaid	$17,354.49
Rate for Payer: Anthem Medicare Advantage/PPO	$18,267.88
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,575.03
Rate for Payer: CareSource Just4Me Medicare	$24,661.64
Rate for Payer: Humana KY Medicaid	$17,354.49
Rate for Payer: Humana Medicare Advantage	$18,267.88
Rate for Payer: Kentucky WC Medicaid	$17,528.03
Rate for Payer: Molina Healthcare Benefit Exchange	$21,921.46
Rate for Payer: Molina Healthcare Medicaid	$17,701.58

MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC

Facility

$38,820.15

Service Code	MSDRG 485
Min. Negotiated Rate	$26,342.25
Max. Negotiated Rate	$38,820.15
Rate for Payer: Anthem Medicaid	$26,342.25
Rate for Payer: Anthem Medicare Advantage/PPO	$27,728.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$38,820.15
Rate for Payer: CareSource Just4Me Medicare	$37,433.72
Rate for Payer: Humana KY Medicaid	$26,342.25
Rate for Payer: Humana Medicare Advantage	$27,728.68
Rate for Payer: Kentucky WC Medicaid	$26,605.67
Rate for Payer: Molina Healthcare Benefit Exchange	$33,274.42
Rate for Payer: Molina Healthcare Medicaid	$26,869.09

Know your out-of-pocket cost for care.

All Charges