Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITH CC

Facility

$34,030.49

Service Code	MSDRG 654
Min. Negotiated Rate	$23,092.12
Max. Negotiated Rate	$34,030.49
Rate for Payer: Anthem Medicaid	$23,092.12
Rate for Payer: Anthem Medicare Advantage/PPO	$24,307.49
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$34,030.49
Rate for Payer: CareSource Just4Me Medicare	$32,815.11
Rate for Payer: Humana KY Medicaid	$23,092.12
Rate for Payer: Humana Medicare Advantage	$24,307.49
Rate for Payer: Kentucky WC Medicaid	$23,323.04
Rate for Payer: Molina Healthcare Benefit Exchange	$29,168.99
Rate for Payer: Molina Healthcare Medicaid	$23,553.96

MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITH MCC

Facility

$67,221.67

Service Code	MSDRG 653
Min. Negotiated Rate	$45,614.71
Max. Negotiated Rate	$67,221.67
Rate for Payer: Anthem Medicaid	$45,614.71
Rate for Payer: Anthem Medicare Advantage/PPO	$48,015.48
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$67,221.67
Rate for Payer: CareSource Just4Me Medicare	$64,820.90
Rate for Payer: Humana KY Medicaid	$45,614.71
Rate for Payer: Humana Medicare Advantage	$48,015.48
Rate for Payer: Kentucky WC Medicaid	$46,070.85
Rate for Payer: Molina Healthcare Benefit Exchange	$57,618.58
Rate for Payer: Molina Healthcare Medicaid	$46,527.00

MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITHOUT CC/MCC

Facility

$25,049.26

Service Code	MSDRG 655
Min. Negotiated Rate	$16,997.71
Max. Negotiated Rate	$25,049.26
Rate for Payer: Anthem Medicaid	$16,997.71
Rate for Payer: Anthem Medicare Advantage/PPO	$17,892.33
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,049.26
Rate for Payer: CareSource Just4Me Medicare	$24,154.65
Rate for Payer: Humana KY Medicaid	$16,997.71
Rate for Payer: Humana Medicare Advantage	$17,892.33
Rate for Payer: Kentucky WC Medicaid	$17,167.69
Rate for Payer: Molina Healthcare Benefit Exchange	$21,470.80
Rate for Payer: Molina Healthcare Medicaid	$17,337.67

MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH CC

Facility

$30,351.40

Service Code	MSDRG 164
Min. Negotiated Rate	$20,595.59
Max. Negotiated Rate	$30,351.40
Rate for Payer: Anthem Medicaid	$20,595.59
Rate for Payer: Anthem Medicare Advantage/PPO	$21,679.57
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$30,351.40
Rate for Payer: CareSource Just4Me Medicare	$29,267.42
Rate for Payer: Humana KY Medicaid	$20,595.59
Rate for Payer: Humana Medicare Advantage	$21,679.57
Rate for Payer: Kentucky WC Medicaid	$20,801.55
Rate for Payer: Molina Healthcare Benefit Exchange	$26,015.48
Rate for Payer: Molina Healthcare Medicaid	$21,007.50

MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH MCC

Facility

$55,580.35

Service Code	MSDRG 163
Min. Negotiated Rate	$37,715.24
Max. Negotiated Rate	$55,580.35
Rate for Payer: Anthem Medicaid	$37,715.24
Rate for Payer: Anthem Medicare Advantage/PPO	$39,700.25
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$55,580.35
Rate for Payer: CareSource Just4Me Medicare	$53,595.34
Rate for Payer: Humana KY Medicaid	$37,715.24
Rate for Payer: Humana Medicare Advantage	$39,700.25
Rate for Payer: Kentucky WC Medicaid	$38,092.39
Rate for Payer: Molina Healthcare Benefit Exchange	$47,640.30
Rate for Payer: Molina Healthcare Medicaid	$38,469.54

MS-DRG 42.00: MAJOR CHEST PROCEDURES WITHOUT CC/MCC

Facility

$22,477.17

Service Code	MSDRG 165
Min. Negotiated Rate	$15,252.36
Max. Negotiated Rate	$22,477.17
Rate for Payer: Anthem Medicaid	$15,252.36
Rate for Payer: Anthem Medicare Advantage/PPO	$16,055.12
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,477.17
Rate for Payer: CareSource Just4Me Medicare	$21,674.41
Rate for Payer: Humana KY Medicaid	$15,252.36
Rate for Payer: Humana Medicare Advantage	$16,055.12
Rate for Payer: Kentucky WC Medicaid	$15,404.89
Rate for Payer: Molina Healthcare Benefit Exchange	$19,266.14
Rate for Payer: Molina Healthcare Medicaid	$15,557.41

MS-DRG 42.00: MAJOR CHEST TRAUMA WITH CC

Facility

$12,879.78

Service Code	MSDRG 184
Min. Negotiated Rate	$8,739.85
Max. Negotiated Rate	$12,879.78
Rate for Payer: Anthem Medicaid	$8,739.85
Rate for Payer: Anthem Medicare Advantage/PPO	$9,199.84
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,879.78
Rate for Payer: CareSource Just4Me Medicare	$12,419.78
Rate for Payer: Humana KY Medicaid	$8,739.85
Rate for Payer: Humana Medicare Advantage	$9,199.84
Rate for Payer: Kentucky WC Medicaid	$8,827.25
Rate for Payer: Molina Healthcare Benefit Exchange	$11,039.81
Rate for Payer: Molina Healthcare Medicaid	$8,914.64

MS-DRG 42.00: MAJOR CHEST TRAUMA WITH MCC

Facility

$19,140.58

Service Code	MSDRG 183
Min. Negotiated Rate	$12,988.25
Max. Negotiated Rate	$19,140.58
Rate for Payer: Anthem Medicaid	$12,988.25
Rate for Payer: Anthem Medicare Advantage/PPO	$13,671.84
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,140.58
Rate for Payer: CareSource Just4Me Medicare	$18,456.98
Rate for Payer: Humana KY Medicaid	$12,988.25
Rate for Payer: Humana Medicare Advantage	$13,671.84
Rate for Payer: Kentucky WC Medicaid	$13,118.13
Rate for Payer: Molina Healthcare Benefit Exchange	$16,406.21
Rate for Payer: Molina Healthcare Medicaid	$13,248.01

MS-DRG 42.00: MAJOR CHEST TRAUMA WITHOUT CC/MCC

Facility

$9,377.96

Service Code	MSDRG 185
Min. Negotiated Rate	$6,363.61
Max. Negotiated Rate	$9,377.96
Rate for Payer: Anthem Medicaid	$6,363.61
Rate for Payer: Anthem Medicare Advantage/PPO	$6,698.54
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,377.96
Rate for Payer: CareSource Just4Me Medicare	$9,043.03
Rate for Payer: Humana KY Medicaid	$6,363.61
Rate for Payer: Humana Medicare Advantage	$6,698.54
Rate for Payer: Kentucky WC Medicaid	$6,427.25
Rate for Payer: Molina Healthcare Benefit Exchange	$8,038.25
Rate for Payer: Molina Healthcare Medicaid	$6,490.89

MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH CC

Facility

$12,270.82

Service Code	MSDRG 369
Min. Negotiated Rate	$8,326.63
Max. Negotiated Rate	$12,270.82
Rate for Payer: Anthem Medicaid	$8,326.63
Rate for Payer: Anthem Medicare Advantage/PPO	$8,764.87
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,270.82
Rate for Payer: CareSource Just4Me Medicare	$11,832.57
Rate for Payer: Humana KY Medicaid	$8,326.63
Rate for Payer: Humana Medicare Advantage	$8,764.87
Rate for Payer: Kentucky WC Medicaid	$8,409.89
Rate for Payer: Molina Healthcare Benefit Exchange	$10,517.84
Rate for Payer: Molina Healthcare Medicaid	$8,493.16

MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH MCC

Facility

$20,137.81

Service Code	MSDRG 368
Min. Negotiated Rate	$13,664.94
Max. Negotiated Rate	$20,137.81
Rate for Payer: Anthem Medicaid	$13,664.94
Rate for Payer: Anthem Medicare Advantage/PPO	$14,384.15
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,137.81
Rate for Payer: CareSource Just4Me Medicare	$19,418.60
Rate for Payer: Humana KY Medicaid	$13,664.94
Rate for Payer: Humana Medicare Advantage	$14,384.15
Rate for Payer: Kentucky WC Medicaid	$13,801.59
Rate for Payer: Molina Healthcare Benefit Exchange	$17,260.98
Rate for Payer: Molina Healthcare Medicaid	$13,938.24

MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC

Facility

$8,416.87

Service Code	MSDRG 370
Min. Negotiated Rate	$5,711.45
Max. Negotiated Rate	$8,416.87
Rate for Payer: Anthem Medicaid	$5,711.45
Rate for Payer: Anthem Medicare Advantage/PPO	$6,012.05
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,416.87
Rate for Payer: CareSource Just4Me Medicare	$8,116.27
Rate for Payer: Humana KY Medicaid	$5,711.45
Rate for Payer: Humana Medicare Advantage	$6,012.05
Rate for Payer: Kentucky WC Medicaid	$5,768.56
Rate for Payer: Molina Healthcare Benefit Exchange	$7,214.46
Rate for Payer: Molina Healthcare Medicaid	$5,825.68

MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC

Facility

$12,411.90

Service Code	MSDRG 372
Min. Negotiated Rate	$8,422.36
Max. Negotiated Rate	$12,411.90
Rate for Payer: Anthem Medicaid	$8,422.36
Rate for Payer: Anthem Medicare Advantage/PPO	$8,865.64
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,411.90
Rate for Payer: CareSource Just4Me Medicare	$11,968.61
Rate for Payer: Humana KY Medicaid	$8,422.36
Rate for Payer: Humana Medicare Advantage	$8,865.64
Rate for Payer: Kentucky WC Medicaid	$8,506.58
Rate for Payer: Molina Healthcare Benefit Exchange	$10,638.77
Rate for Payer: Molina Healthcare Medicaid	$8,590.81

MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC

Facility

$21,078.40

Service Code	MSDRG 371
Min. Negotiated Rate	$14,303.20
Max. Negotiated Rate	$21,078.40
Rate for Payer: Anthem Medicaid	$14,303.20
Rate for Payer: Anthem Medicare Advantage/PPO	$15,056.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,078.40
Rate for Payer: CareSource Just4Me Medicare	$20,325.60
Rate for Payer: Humana KY Medicaid	$14,303.20
Rate for Payer: Humana Medicare Advantage	$15,056.00
Rate for Payer: Kentucky WC Medicaid	$14,446.23
Rate for Payer: Molina Healthcare Benefit Exchange	$18,067.20
Rate for Payer: Molina Healthcare Medicaid	$14,589.26

MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC

Facility

$8,747.28

Service Code	MSDRG 373
Min. Negotiated Rate	$5,935.66
Max. Negotiated Rate	$8,747.28
Rate for Payer: Anthem Medicaid	$5,935.66
Rate for Payer: Anthem Medicare Advantage/PPO	$6,248.06
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,747.28
Rate for Payer: CareSource Just4Me Medicare	$8,434.88
Rate for Payer: Humana KY Medicaid	$5,935.66
Rate for Payer: Humana Medicare Advantage	$6,248.06
Rate for Payer: Kentucky WC Medicaid	$5,995.01
Rate for Payer: Molina Healthcare Benefit Exchange	$7,497.67
Rate for Payer: Molina Healthcare Medicaid	$6,054.37

MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH CC

Facility

$25,907.84

Service Code	MSDRG 141
Min. Negotiated Rate	$17,580.32
Max. Negotiated Rate	$25,907.84
Rate for Payer: Anthem Medicaid	$17,580.32
Rate for Payer: Anthem Medicare Advantage/PPO	$18,505.60
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,907.84
Rate for Payer: CareSource Just4Me Medicare	$24,982.56
Rate for Payer: Humana KY Medicaid	$17,580.32
Rate for Payer: Humana Medicare Advantage	$18,505.60
Rate for Payer: Kentucky WC Medicaid	$17,756.12
Rate for Payer: Molina Healthcare Benefit Exchange	$22,206.72
Rate for Payer: Molina Healthcare Medicaid	$17,931.93

MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH MCC

Facility

$50,998.09

Service Code	MSDRG 140
Min. Negotiated Rate	$34,605.85
Max. Negotiated Rate	$50,998.09
Rate for Payer: Anthem Medicaid	$34,605.85
Rate for Payer: Anthem Medicare Advantage/PPO	$36,427.21
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$50,998.09
Rate for Payer: CareSource Just4Me Medicare	$49,176.73
Rate for Payer: Humana KY Medicaid	$34,605.85
Rate for Payer: Humana Medicare Advantage	$36,427.21
Rate for Payer: Kentucky WC Medicaid	$34,951.91
Rate for Payer: Molina Healthcare Benefit Exchange	$43,712.65
Rate for Payer: Molina Healthcare Medicaid	$35,297.97

MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC

Facility

$18,960.90

Service Code	MSDRG 142
Min. Negotiated Rate	$12,866.33
Max. Negotiated Rate	$18,960.90
Rate for Payer: Anthem Medicaid	$12,866.33
Rate for Payer: Anthem Medicare Advantage/PPO	$13,543.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,960.90
Rate for Payer: CareSource Just4Me Medicare	$18,283.72
Rate for Payer: Humana KY Medicaid	$12,866.33
Rate for Payer: Humana Medicare Advantage	$13,543.50
Rate for Payer: Kentucky WC Medicaid	$12,994.99
Rate for Payer: Molina Healthcare Benefit Exchange	$16,252.20
Rate for Payer: Molina Healthcare Medicaid	$13,123.65

MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC

Facility

$14,934.53

Service Code	MSDRG 809
Min. Negotiated Rate	$10,134.14
Max. Negotiated Rate	$14,934.53
Rate for Payer: Anthem Medicaid	$10,134.14
Rate for Payer: Anthem Medicare Advantage/PPO	$10,667.52
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,934.53
Rate for Payer: CareSource Just4Me Medicare	$14,401.15
Rate for Payer: Humana KY Medicaid	$10,134.14
Rate for Payer: Humana Medicare Advantage	$10,667.52
Rate for Payer: Kentucky WC Medicaid	$10,235.49
Rate for Payer: Molina Healthcare Benefit Exchange	$12,801.02
Rate for Payer: Molina Healthcare Medicaid	$10,336.83

MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC

Facility

$27,617.73

Service Code	MSDRG 808
Min. Negotiated Rate	$18,740.60
Max. Negotiated Rate	$27,617.73
Rate for Payer: Anthem Medicaid	$18,740.60
Rate for Payer: Anthem Medicare Advantage/PPO	$19,726.95
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$27,617.73
Rate for Payer: CareSource Just4Me Medicare	$26,631.38
Rate for Payer: Humana KY Medicaid	$18,740.60
Rate for Payer: Humana Medicare Advantage	$19,726.95
Rate for Payer: Kentucky WC Medicaid	$18,928.01
Rate for Payer: Molina Healthcare Benefit Exchange	$23,672.34
Rate for Payer: Molina Healthcare Medicaid	$19,115.41

MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC

Facility

$11,477.34

Service Code	MSDRG 810
Min. Negotiated Rate	$7,788.19
Max. Negotiated Rate	$11,477.34
Rate for Payer: Anthem Medicaid	$7,788.19
Rate for Payer: Anthem Medicare Advantage/PPO	$8,198.10
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,477.34
Rate for Payer: CareSource Just4Me Medicare	$11,067.43
Rate for Payer: Humana KY Medicaid	$7,788.19
Rate for Payer: Humana Medicare Advantage	$8,198.10
Rate for Payer: Kentucky WC Medicaid	$7,866.08
Rate for Payer: Molina Healthcare Benefit Exchange	$9,837.72
Rate for Payer: Molina Healthcare Medicaid	$7,943.96

MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT

Facility

$39,415.82

Service Code	MSDRG 469
Min. Negotiated Rate	$26,746.45
Max. Negotiated Rate	$39,415.82
Rate for Payer: Anthem Medicaid	$26,746.45
Rate for Payer: Anthem Medicare Advantage/PPO	$28,154.16
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$39,415.82
Rate for Payer: CareSource Just4Me Medicare	$38,008.12
Rate for Payer: Humana KY Medicaid	$26,746.45
Rate for Payer: Humana Medicare Advantage	$28,154.16
Rate for Payer: Kentucky WC Medicaid	$27,013.92
Rate for Payer: Molina Healthcare Benefit Exchange	$33,784.99
Rate for Payer: Molina Healthcare Medicaid	$27,281.38

MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC

Facility

$22,736.43

Service Code	MSDRG 470
Min. Negotiated Rate	$15,428.29
Max. Negotiated Rate	$22,736.43
Rate for Payer: Anthem Medicaid	$15,428.29
Rate for Payer: Anthem Medicare Advantage/PPO	$16,240.31
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,736.43
Rate for Payer: CareSource Just4Me Medicare	$21,924.42
Rate for Payer: Humana KY Medicaid	$15,428.29
Rate for Payer: Humana Medicare Advantage	$16,240.31
Rate for Payer: Kentucky WC Medicaid	$15,582.58
Rate for Payer: Molina Healthcare Benefit Exchange	$19,488.37
Rate for Payer: Molina Healthcare Medicaid	$15,736.86

MS-DRG 42.00: MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES

Facility

$30,727.65

Service Code	MSDRG 483
Min. Negotiated Rate	$20,850.90
Max. Negotiated Rate	$30,727.65
Rate for Payer: Anthem Medicaid	$20,850.90
Rate for Payer: Anthem Medicare Advantage/PPO	$21,948.32
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$30,727.65
Rate for Payer: CareSource Just4Me Medicare	$29,630.23
Rate for Payer: Humana KY Medicaid	$20,850.90
Rate for Payer: Humana Medicare Advantage	$21,948.32
Rate for Payer: Kentucky WC Medicaid	$21,059.41
Rate for Payer: Molina Healthcare Benefit Exchange	$26,337.98
Rate for Payer: Molina Healthcare Medicaid	$21,267.92

MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC

Facility

$23,400.85

Service Code	MSDRG 707
Min. Negotiated Rate	$15,879.15
Max. Negotiated Rate	$23,400.85
Rate for Payer: Anthem Medicaid	$15,879.15
Rate for Payer: Anthem Medicare Advantage/PPO	$16,714.89
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,400.85
Rate for Payer: CareSource Just4Me Medicare	$22,565.10
Rate for Payer: Humana KY Medicaid	$15,879.15
Rate for Payer: Humana Medicare Advantage	$16,714.89
Rate for Payer: Kentucky WC Medicaid	$16,037.94
Rate for Payer: Molina Healthcare Benefit Exchange	$20,057.87
Rate for Payer: Molina Healthcare Medicaid	$16,196.73

Know your out-of-pocket cost for care.

All Charges