Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$19,054.94

Service Code	MSDRG 487
Min. Negotiated Rate	$12,930.14
Max. Negotiated Rate	$19,054.94
Rate for Payer: Anthem Medicaid	$12,930.14
Rate for Payer: Anthem Medicare Advantage/PPO	$13,610.67
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,054.94
Rate for Payer: CareSource Just4Me Medicare	$18,374.40
Rate for Payer: Humana KY Medicaid	$12,930.14
Rate for Payer: Humana Medicare Advantage	$13,610.67
Rate for Payer: Kentucky WC Medicaid	$13,059.44
Rate for Payer: Molina Healthcare Benefit Exchange	$16,332.80
Rate for Payer: Molina Healthcare Medicaid	$13,188.74

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

Facility

$19,997.91

Service Code	MSDRG 418
Min. Negotiated Rate	$13,570.01
Max. Negotiated Rate	$19,997.91
Rate for Payer: Anthem Medicaid	$13,570.01
Rate for Payer: Anthem Medicare Advantage/PPO	$14,284.22
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,997.91
Rate for Payer: CareSource Just4Me Medicare	$19,283.70
Rate for Payer: Humana KY Medicaid	$13,570.01
Rate for Payer: Humana Medicare Advantage	$14,284.22
Rate for Payer: Kentucky WC Medicaid	$13,705.71
Rate for Payer: Molina Healthcare Benefit Exchange	$17,141.06
Rate for Payer: Molina Healthcare Medicaid	$13,841.41

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

Facility

$28,657.20

Service Code	MSDRG 417
Min. Negotiated Rate	$19,445.96
Max. Negotiated Rate	$28,657.20
Rate for Payer: Anthem Medicaid	$19,445.96
Rate for Payer: Anthem Medicare Advantage/PPO	$20,469.43
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$28,657.20
Rate for Payer: CareSource Just4Me Medicare	$27,633.73
Rate for Payer: Humana KY Medicaid	$19,445.96
Rate for Payer: Humana Medicare Advantage	$20,469.43
Rate for Payer: Kentucky WC Medicaid	$19,640.42
Rate for Payer: Molina Healthcare Benefit Exchange	$24,563.32
Rate for Payer: Molina Healthcare Medicaid	$19,834.88

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

Facility

$15,888.38

Service Code	MSDRG 419
Min. Negotiated Rate	$10,781.40
Max. Negotiated Rate	$15,888.38
Rate for Payer: Anthem Medicaid	$10,781.40
Rate for Payer: Anthem Medicare Advantage/PPO	$11,348.84
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,888.38
Rate for Payer: CareSource Just4Me Medicare	$15,320.93
Rate for Payer: Humana KY Medicaid	$10,781.40
Rate for Payer: Humana Medicare Advantage	$11,348.84
Rate for Payer: Kentucky WC Medicaid	$10,889.21
Rate for Payer: Molina Healthcare Benefit Exchange	$13,618.61
Rate for Payer: Molina Healthcare Medicaid	$10,997.03

MS-DRG 42.00: LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$46,092.65

Service Code	MSDRG 956
Min. Negotiated Rate	$31,277.15
Max. Negotiated Rate	$46,092.65
Rate for Payer: Anthem Medicaid	$31,277.15
Rate for Payer: Anthem Medicare Advantage/PPO	$32,923.32
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$46,092.65
Rate for Payer: CareSource Just4Me Medicare	$44,446.48
Rate for Payer: Humana KY Medicaid	$31,277.15
Rate for Payer: Humana Medicare Advantage	$32,923.32
Rate for Payer: Kentucky WC Medicaid	$31,589.93
Rate for Payer: Molina Healthcare Benefit Exchange	$39,507.98
Rate for Payer: Molina Healthcare Medicaid	$31,902.70

MS-DRG 42.00: LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT

Facility

$128,416.51

Service Code	MSDRG 005
Min. Negotiated Rate	$87,139.78
Max. Negotiated Rate	$128,416.51
Rate for Payer: Anthem Medicaid	$87,139.78
Rate for Payer: Anthem Medicare Advantage/PPO	$91,726.08
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$128,416.51
Rate for Payer: CareSource Just4Me Medicare	$123,830.21
Rate for Payer: Humana KY Medicaid	$87,139.78
Rate for Payer: Humana Medicare Advantage	$91,726.08
Rate for Payer: Kentucky WC Medicaid	$88,011.17
Rate for Payer: Molina Healthcare Benefit Exchange	$110,071.30
Rate for Payer: Molina Healthcare Medicaid	$88,882.57

MS-DRG 42.00: LIVER TRANSPLANT WITHOUT MCC

Facility

$58,474.42

Service Code	MSDRG 006
Min. Negotiated Rate	$39,679.07
Max. Negotiated Rate	$58,474.42
Rate for Payer: Anthem Medicaid	$39,679.07
Rate for Payer: Anthem Medicare Advantage/PPO	$41,767.44
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$58,474.42
Rate for Payer: CareSource Just4Me Medicare	$56,386.04
Rate for Payer: Humana KY Medicaid	$39,679.07
Rate for Payer: Humana Medicare Advantage	$41,767.44
Rate for Payer: Kentucky WC Medicaid	$40,075.86
Rate for Payer: Molina Healthcare Benefit Exchange	$50,120.93
Rate for Payer: Molina Healthcare Medicaid	$40,472.65

MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC

Facility

$23,791.56

Service Code	MSDRG 496
Min. Negotiated Rate	$16,144.27
Max. Negotiated Rate	$23,791.56
Rate for Payer: Anthem Medicaid	$16,144.27
Rate for Payer: Anthem Medicare Advantage/PPO	$16,993.97
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,791.56
Rate for Payer: CareSource Just4Me Medicare	$22,941.86
Rate for Payer: Humana KY Medicaid	$16,144.27
Rate for Payer: Humana Medicare Advantage	$16,993.97
Rate for Payer: Kentucky WC Medicaid	$16,305.71
Rate for Payer: Molina Healthcare Benefit Exchange	$20,392.76
Rate for Payer: Molina Healthcare Medicaid	$16,467.16

MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC

Facility

$42,453.39

Service Code	MSDRG 495
Min. Negotiated Rate	$28,807.66
Max. Negotiated Rate	$42,453.39
Rate for Payer: Anthem Medicaid	$28,807.66
Rate for Payer: Anthem Medicare Advantage/PPO	$30,323.85
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$42,453.39
Rate for Payer: CareSource Just4Me Medicare	$40,937.20
Rate for Payer: Humana KY Medicaid	$28,807.66
Rate for Payer: Humana Medicare Advantage	$30,323.85
Rate for Payer: Kentucky WC Medicaid	$29,095.73
Rate for Payer: Molina Healthcare Benefit Exchange	$36,388.62
Rate for Payer: Molina Healthcare Medicaid	$29,383.81

MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC

Facility

$16,189.84

Service Code	MSDRG 497
Min. Negotiated Rate	$10,985.96
Max. Negotiated Rate	$16,189.84
Rate for Payer: Anthem Medicaid	$10,985.96
Rate for Payer: Anthem Medicare Advantage/PPO	$11,564.17
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,189.84
Rate for Payer: CareSource Just4Me Medicare	$15,611.63
Rate for Payer: Humana KY Medicaid	$10,985.96
Rate for Payer: Humana Medicare Advantage	$11,564.17
Rate for Payer: Kentucky WC Medicaid	$11,095.82
Rate for Payer: Molina Healthcare Benefit Exchange	$13,877.00
Rate for Payer: Molina Healthcare Medicaid	$11,205.68

MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC

Facility

$30,446.67

Service Code	MSDRG 498
Min. Negotiated Rate	$20,660.24
Max. Negotiated Rate	$30,446.67
Rate for Payer: Anthem Medicaid	$20,660.24
Rate for Payer: Anthem Medicare Advantage/PPO	$21,747.62
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$30,446.67
Rate for Payer: CareSource Just4Me Medicare	$29,359.29
Rate for Payer: Humana KY Medicaid	$20,660.24
Rate for Payer: Humana Medicare Advantage	$21,747.62
Rate for Payer: Kentucky WC Medicaid	$20,866.84
Rate for Payer: Molina Healthcare Benefit Exchange	$26,097.14
Rate for Payer: Molina Healthcare Medicaid	$21,073.44

MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC

Facility

$13,997.58

Service Code	MSDRG 499
Min. Negotiated Rate	$9,498.36
Max. Negotiated Rate	$13,997.58
Rate for Payer: Anthem Medicaid	$9,498.36
Rate for Payer: Anthem Medicare Advantage/PPO	$9,998.27
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,997.58
Rate for Payer: CareSource Just4Me Medicare	$13,497.66
Rate for Payer: Humana KY Medicaid	$9,498.36
Rate for Payer: Humana Medicare Advantage	$9,998.27
Rate for Payer: Kentucky WC Medicaid	$9,593.34
Rate for Payer: Molina Healthcare Benefit Exchange	$11,997.92
Rate for Payer: Molina Healthcare Medicaid	$9,688.32

MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC

Facility

$28,952.62

Service Code	MSDRG 493
Min. Negotiated Rate	$19,646.42
Max. Negotiated Rate	$28,952.62
Rate for Payer: Anthem Medicaid	$19,646.42
Rate for Payer: Anthem Medicare Advantage/PPO	$20,680.44
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$28,952.62
Rate for Payer: CareSource Just4Me Medicare	$27,918.59
Rate for Payer: Humana KY Medicaid	$19,646.42
Rate for Payer: Humana Medicare Advantage	$20,680.44
Rate for Payer: Kentucky WC Medicaid	$19,842.88
Rate for Payer: Molina Healthcare Benefit Exchange	$24,816.53
Rate for Payer: Molina Healthcare Medicaid	$20,039.35

MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC

Facility

$42,822.40

Service Code	MSDRG 492
Min. Negotiated Rate	$29,058.06
Max. Negotiated Rate	$42,822.40
Rate for Payer: Anthem Medicaid	$29,058.06
Rate for Payer: Anthem Medicare Advantage/PPO	$30,587.43
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$42,822.40
Rate for Payer: CareSource Just4Me Medicare	$41,293.03
Rate for Payer: Humana KY Medicaid	$29,058.06
Rate for Payer: Humana Medicare Advantage	$30,587.43
Rate for Payer: Kentucky WC Medicaid	$29,348.64
Rate for Payer: Molina Healthcare Benefit Exchange	$36,704.92
Rate for Payer: Molina Healthcare Medicaid	$29,639.22

MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC

Facility

$22,735.23

Service Code	MSDRG 494
Min. Negotiated Rate	$15,427.48
Max. Negotiated Rate	$22,735.23
Rate for Payer: Anthem Medicaid	$15,427.48
Rate for Payer: Anthem Medicare Advantage/PPO	$16,239.45
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,735.23
Rate for Payer: CareSource Just4Me Medicare	$21,923.26
Rate for Payer: Humana KY Medicaid	$15,427.48
Rate for Payer: Humana Medicare Advantage	$16,239.45
Rate for Payer: Kentucky WC Medicaid	$15,581.75
Rate for Payer: Molina Healthcare Benefit Exchange	$19,487.34
Rate for Payer: Molina Healthcare Medicaid	$15,736.03

MS-DRG 42.00: LUNG TRANSPLANT

Facility

$157,591.03

Service Code	MSDRG 007
Min. Negotiated Rate	$106,936.77
Max. Negotiated Rate	$157,591.03
Rate for Payer: Anthem Medicaid	$106,936.77
Rate for Payer: Anthem Medicare Advantage/PPO	$112,565.02
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$157,591.03
Rate for Payer: CareSource Just4Me Medicare	$151,962.78
Rate for Payer: Humana KY Medicaid	$106,936.77
Rate for Payer: Humana Medicare Advantage	$112,565.02
Rate for Payer: Kentucky WC Medicaid	$108,006.14
Rate for Payer: Molina Healthcare Benefit Exchange	$135,078.02
Rate for Payer: Molina Healthcare Medicaid	$109,075.50

MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC

Facility

$26,919.56

Service Code	MSDRG 821
Min. Negotiated Rate	$18,266.85
Max. Negotiated Rate	$26,919.56
Rate for Payer: Anthem Medicaid	$18,266.85
Rate for Payer: Anthem Medicare Advantage/PPO	$19,228.26
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$26,919.56
Rate for Payer: CareSource Just4Me Medicare	$25,958.15
Rate for Payer: Humana KY Medicaid	$18,266.85
Rate for Payer: Humana Medicare Advantage	$19,228.26
Rate for Payer: Kentucky WC Medicaid	$18,449.52
Rate for Payer: Molina Healthcare Benefit Exchange	$23,073.91
Rate for Payer: Molina Healthcare Medicaid	$18,632.18

MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC

Facility

$70,208.59

Service Code	MSDRG 820
Min. Negotiated Rate	$47,641.54
Max. Negotiated Rate	$70,208.59
Rate for Payer: Anthem Medicaid	$47,641.54
Rate for Payer: Anthem Medicare Advantage/PPO	$50,148.99
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$70,208.59
Rate for Payer: CareSource Just4Me Medicare	$67,701.14
Rate for Payer: Humana KY Medicaid	$47,641.54
Rate for Payer: Humana Medicare Advantage	$50,148.99
Rate for Payer: Kentucky WC Medicaid	$48,117.96
Rate for Payer: Molina Healthcare Benefit Exchange	$60,178.79
Rate for Payer: Molina Healthcare Medicaid	$48,594.37

MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC

Facility

$13,791.40

Service Code	MSDRG 822
Min. Negotiated Rate	$9,358.45
Max. Negotiated Rate	$13,791.40
Rate for Payer: Anthem Medicaid	$9,358.45
Rate for Payer: Anthem Medicare Advantage/PPO	$9,851.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,791.40
Rate for Payer: CareSource Just4Me Medicare	$13,298.85
Rate for Payer: Humana KY Medicaid	$9,358.45
Rate for Payer: Humana Medicare Advantage	$9,851.00
Rate for Payer: Kentucky WC Medicaid	$9,452.03
Rate for Payer: Molina Healthcare Benefit Exchange	$11,821.20
Rate for Payer: Molina Healthcare Medicaid	$9,545.62

MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC

Facility

$18,907.83

Service Code	MSDRG 841
Min. Negotiated Rate	$12,830.31
Max. Negotiated Rate	$18,907.83
Rate for Payer: Anthem Medicaid	$12,830.31
Rate for Payer: Anthem Medicare Advantage/PPO	$13,505.59
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,907.83
Rate for Payer: CareSource Just4Me Medicare	$18,232.55
Rate for Payer: Humana KY Medicaid	$12,830.31
Rate for Payer: Humana Medicare Advantage	$13,505.59
Rate for Payer: Kentucky WC Medicaid	$12,958.61
Rate for Payer: Molina Healthcare Benefit Exchange	$16,206.71
Rate for Payer: Molina Healthcare Medicaid	$13,086.92

MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC

Facility

$38,454.77

Service Code	MSDRG 840
Min. Negotiated Rate	$26,094.31
Max. Negotiated Rate	$38,454.77
Rate for Payer: Anthem Medicaid	$26,094.31
Rate for Payer: Anthem Medicare Advantage/PPO	$27,467.69
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$38,454.77
Rate for Payer: CareSource Just4Me Medicare	$37,081.38
Rate for Payer: Humana KY Medicaid	$26,094.31
Rate for Payer: Humana Medicare Advantage	$27,467.69
Rate for Payer: Kentucky WC Medicaid	$26,355.25
Rate for Payer: Molina Healthcare Benefit Exchange	$32,961.23
Rate for Payer: Molina Healthcare Medicaid	$26,616.19

MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC

Facility

$26,521.60

Service Code	MSDRG 824
Min. Negotiated Rate	$17,996.80
Max. Negotiated Rate	$26,521.60
Rate for Payer: Anthem Medicaid	$17,996.80
Rate for Payer: Anthem Medicare Advantage/PPO	$18,944.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$26,521.60
Rate for Payer: CareSource Just4Me Medicare	$25,574.40
Rate for Payer: Humana KY Medicaid	$17,996.80
Rate for Payer: Humana Medicare Advantage	$18,944.00
Rate for Payer: Kentucky WC Medicaid	$18,176.77
Rate for Payer: Molina Healthcare Benefit Exchange	$22,732.80
Rate for Payer: Molina Healthcare Medicaid	$18,356.74

MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC

Facility

$56,428.06

Service Code	MSDRG 823
Min. Negotiated Rate	$38,290.47
Max. Negotiated Rate	$56,428.06
Rate for Payer: Anthem Medicaid	$38,290.47
Rate for Payer: Anthem Medicare Advantage/PPO	$40,305.76
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$56,428.06
Rate for Payer: CareSource Just4Me Medicare	$54,412.78
Rate for Payer: Humana KY Medicaid	$38,290.47
Rate for Payer: Humana Medicare Advantage	$40,305.76
Rate for Payer: Kentucky WC Medicaid	$38,673.38
Rate for Payer: Molina Healthcare Benefit Exchange	$48,366.91
Rate for Payer: Molina Healthcare Medicaid	$39,056.28

MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC

Facility

$14,841.71

Service Code	MSDRG 825
Min. Negotiated Rate	$10,071.16
Max. Negotiated Rate	$14,841.71
Rate for Payer: Anthem Medicaid	$10,071.16
Rate for Payer: Anthem Medicare Advantage/PPO	$10,601.22
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,841.71
Rate for Payer: CareSource Just4Me Medicare	$14,311.65
Rate for Payer: Humana KY Medicaid	$10,071.16
Rate for Payer: Humana Medicare Advantage	$10,601.22
Rate for Payer: Kentucky WC Medicaid	$10,171.87
Rate for Payer: Molina Healthcare Benefit Exchange	$12,721.46
Rate for Payer: Molina Healthcare Medicaid	$10,272.58

MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$12,684.42

Service Code	MSDRG 842
Min. Negotiated Rate	$8,607.28
Max. Negotiated Rate	$12,684.42
Rate for Payer: Anthem Medicaid	$8,607.28
Rate for Payer: Anthem Medicare Advantage/PPO	$9,060.30
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,684.42
Rate for Payer: CareSource Just4Me Medicare	$12,231.41
Rate for Payer: Humana KY Medicaid	$8,607.28
Rate for Payer: Humana Medicare Advantage	$9,060.30
Rate for Payer: Kentucky WC Medicaid	$8,693.36
Rate for Payer: Molina Healthcare Benefit Exchange	$10,872.36
Rate for Payer: Molina Healthcare Medicaid	$8,779.43

Know your out-of-pocket cost for care.

All Charges