Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC

Facility

$17,876.82

Service Code	MSDRG 708
Min. Negotiated Rate	$12,130.70
Max. Negotiated Rate	$17,876.82
Rate for Payer: Anthem Medicaid	$12,130.70
Rate for Payer: Anthem Medicare Advantage/PPO	$12,769.16
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,876.82
Rate for Payer: CareSource Just4Me Medicare	$17,238.37
Rate for Payer: Humana KY Medicaid	$12,130.70
Rate for Payer: Humana Medicare Advantage	$12,769.16
Rate for Payer: Kentucky WC Medicaid	$12,252.01
Rate for Payer: Molina Healthcare Benefit Exchange	$15,322.99
Rate for Payer: Molina Healthcare Medicaid	$12,373.32

MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC

Facility

$23,371.92

Service Code	MSDRG 507
Min. Negotiated Rate	$15,859.52
Max. Negotiated Rate	$23,371.92
Rate for Payer: Anthem Medicaid	$15,859.52
Rate for Payer: Anthem Medicare Advantage/PPO	$16,694.23
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,371.92
Rate for Payer: CareSource Just4Me Medicare	$22,537.21
Rate for Payer: Humana KY Medicaid	$15,859.52
Rate for Payer: Humana Medicare Advantage	$16,694.23
Rate for Payer: Kentucky WC Medicaid	$16,018.11
Rate for Payer: Molina Healthcare Benefit Exchange	$20,033.08
Rate for Payer: Molina Healthcare Medicaid	$16,176.71

MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC

Facility

$15,562.78

Service Code	MSDRG 508
Min. Negotiated Rate	$10,560.46
Max. Negotiated Rate	$15,562.78
Rate for Payer: Anthem Medicaid	$10,560.46
Rate for Payer: Anthem Medicare Advantage/PPO	$11,116.27
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,562.78
Rate for Payer: CareSource Just4Me Medicare	$15,006.96
Rate for Payer: Humana KY Medicaid	$10,560.46
Rate for Payer: Humana Medicare Advantage	$11,116.27
Rate for Payer: Kentucky WC Medicaid	$10,666.06
Rate for Payer: Molina Healthcare Benefit Exchange	$13,339.52
Rate for Payer: Molina Healthcare Medicaid	$10,771.67

MS-DRG 42.00: MAJOR SKIN DISORDERS WITH MCC

Facility

$25,505.09

Service Code	MSDRG 595
Min. Negotiated Rate	$17,307.02
Max. Negotiated Rate	$25,505.09
Rate for Payer: Anthem Medicaid	$17,307.02
Rate for Payer: Anthem Medicare Advantage/PPO	$18,217.92
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,505.09
Rate for Payer: CareSource Just4Me Medicare	$24,594.19
Rate for Payer: Humana KY Medicaid	$17,307.02
Rate for Payer: Humana Medicare Advantage	$18,217.92
Rate for Payer: Kentucky WC Medicaid	$17,480.09
Rate for Payer: Molina Healthcare Benefit Exchange	$21,861.50
Rate for Payer: Molina Healthcare Medicaid	$17,653.16

MS-DRG 42.00: MAJOR SKIN DISORDERS WITHOUT MCC

Facility

$13,036.51

Service Code	MSDRG 596
Min. Negotiated Rate	$8,846.20
Max. Negotiated Rate	$13,036.51
Rate for Payer: Anthem Medicaid	$8,846.20
Rate for Payer: Anthem Medicare Advantage/PPO	$9,311.79
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,036.51
Rate for Payer: CareSource Just4Me Medicare	$12,570.92
Rate for Payer: Humana KY Medicaid	$8,846.20
Rate for Payer: Humana Medicare Advantage	$9,311.79
Rate for Payer: Kentucky WC Medicaid	$8,934.66
Rate for Payer: Molina Healthcare Benefit Exchange	$11,174.15
Rate for Payer: Molina Healthcare Medicaid	$9,023.12

MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$28,502.85

Service Code	MSDRG 330
Min. Negotiated Rate	$19,341.22
Max. Negotiated Rate	$28,502.85
Rate for Payer: Anthem Medicaid	$19,341.22
Rate for Payer: Anthem Medicare Advantage/PPO	$20,359.18
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$28,502.85
Rate for Payer: CareSource Just4Me Medicare	$27,484.89
Rate for Payer: Humana KY Medicaid	$19,341.22
Rate for Payer: Humana Medicare Advantage	$20,359.18
Rate for Payer: Kentucky WC Medicaid	$19,534.63
Rate for Payer: Molina Healthcare Benefit Exchange	$24,431.02
Rate for Payer: Molina Healthcare Medicaid	$19,728.05

MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$55,371.74

Service Code	MSDRG 329
Min. Negotiated Rate	$37,573.68
Max. Negotiated Rate	$55,371.74
Rate for Payer: Anthem Medicaid	$37,573.68
Rate for Payer: Anthem Medicare Advantage/PPO	$39,551.24
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$55,371.74
Rate for Payer: CareSource Just4Me Medicare	$53,394.17
Rate for Payer: Humana KY Medicaid	$37,573.68
Rate for Payer: Humana Medicare Advantage	$39,551.24
Rate for Payer: Kentucky WC Medicaid	$37,949.41
Rate for Payer: Molina Healthcare Benefit Exchange	$47,461.49
Rate for Payer: Molina Healthcare Medicaid	$38,325.15

MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$19,908.70

Service Code	MSDRG 331
Min. Negotiated Rate	$13,509.48
Max. Negotiated Rate	$19,908.70
Rate for Payer: Anthem Medicaid	$13,509.48
Rate for Payer: Anthem Medicare Advantage/PPO	$14,220.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,908.70
Rate for Payer: CareSource Just4Me Medicare	$19,197.67
Rate for Payer: Humana KY Medicaid	$13,509.48
Rate for Payer: Humana Medicare Advantage	$14,220.50
Rate for Payer: Kentucky WC Medicaid	$13,644.57
Rate for Payer: Molina Healthcare Benefit Exchange	$17,064.60
Rate for Payer: Molina Healthcare Medicaid	$13,779.66

MS-DRG 42.00: MAJOR THUMB OR JOINT PROCEDURES

Facility

$18,077.00

Service Code	MSDRG 506
Min. Negotiated Rate	$12,266.53
Max. Negotiated Rate	$18,077.00
Rate for Payer: Anthem Medicaid	$12,266.53
Rate for Payer: Anthem Medicare Advantage/PPO	$12,912.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,077.00
Rate for Payer: CareSource Just4Me Medicare	$17,431.39
Rate for Payer: Humana KY Medicaid	$12,266.53
Rate for Payer: Humana Medicare Advantage	$12,912.14
Rate for Payer: Kentucky WC Medicaid	$12,389.20
Rate for Payer: Molina Healthcare Benefit Exchange	$15,494.57
Rate for Payer: Molina Healthcare Medicaid	$12,511.86

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

Facility

$13,386.21

Service Code	MSDRG 755
Min. Negotiated Rate	$9,083.50
Max. Negotiated Rate	$13,386.21
Rate for Payer: Anthem Medicaid	$9,083.50
Rate for Payer: Anthem Medicare Advantage/PPO	$9,561.58
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,386.21
Rate for Payer: CareSource Just4Me Medicare	$12,908.13
Rate for Payer: Humana KY Medicaid	$9,083.50
Rate for Payer: Humana Medicare Advantage	$9,561.58
Rate for Payer: Kentucky WC Medicaid	$9,174.34
Rate for Payer: Molina Healthcare Benefit Exchange	$11,473.90
Rate for Payer: Molina Healthcare Medicaid	$9,265.17

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

Facility

$21,817.56

Service Code	MSDRG 754
Min. Negotiated Rate	$14,804.77
Max. Negotiated Rate	$21,817.56
Rate for Payer: Anthem Medicaid	$14,804.77
Rate for Payer: Anthem Medicare Advantage/PPO	$15,583.97
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,817.56
Rate for Payer: CareSource Just4Me Medicare	$21,038.36
Rate for Payer: Humana KY Medicaid	$14,804.77
Rate for Payer: Humana Medicare Advantage	$15,583.97
Rate for Payer: Kentucky WC Medicaid	$14,952.82
Rate for Payer: Molina Healthcare Benefit Exchange	$18,700.76
Rate for Payer: Molina Healthcare Medicaid	$15,100.87

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

Facility

$11,515.94

Service Code	MSDRG 756
Min. Negotiated Rate	$7,814.39
Max. Negotiated Rate	$11,515.94
Rate for Payer: Anthem Medicaid	$7,814.39
Rate for Payer: Anthem Medicare Advantage/PPO	$8,225.67
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,515.94
Rate for Payer: CareSource Just4Me Medicare	$11,104.65
Rate for Payer: Humana KY Medicaid	$7,814.39
Rate for Payer: Humana Medicare Advantage	$8,225.67
Rate for Payer: Kentucky WC Medicaid	$7,892.53
Rate for Payer: Molina Healthcare Benefit Exchange	$9,870.80
Rate for Payer: Molina Healthcare Medicaid	$7,970.67

MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

Facility

$13,540.55

Service Code	MSDRG 723
Min. Negotiated Rate	$9,188.23
Max. Negotiated Rate	$13,540.55
Rate for Payer: Anthem Medicaid	$9,188.23
Rate for Payer: Anthem Medicare Advantage/PPO	$9,671.82
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,540.55
Rate for Payer: CareSource Just4Me Medicare	$13,056.96
Rate for Payer: Humana KY Medicaid	$9,188.23
Rate for Payer: Humana Medicare Advantage	$9,671.82
Rate for Payer: Kentucky WC Medicaid	$9,280.11
Rate for Payer: Molina Healthcare Benefit Exchange	$11,606.18
Rate for Payer: Molina Healthcare Medicaid	$9,371.99

MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$20,848.06

Service Code	MSDRG 722
Min. Negotiated Rate	$14,146.90
Max. Negotiated Rate	$20,848.06
Rate for Payer: Anthem Medicaid	$14,146.90
Rate for Payer: Anthem Medicare Advantage/PPO	$14,891.47
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,848.06
Rate for Payer: CareSource Just4Me Medicare	$20,103.48
Rate for Payer: Humana KY Medicaid	$14,146.90
Rate for Payer: Humana Medicare Advantage	$14,891.47
Rate for Payer: Kentucky WC Medicaid	$14,288.37
Rate for Payer: Molina Healthcare Benefit Exchange	$17,869.76
Rate for Payer: Molina Healthcare Medicaid	$14,429.83

MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$8,785.88

Service Code	MSDRG 724
Min. Negotiated Rate	$5,961.85
Max. Negotiated Rate	$8,785.88
Rate for Payer: Anthem Medicaid	$5,961.85
Rate for Payer: Anthem Medicare Advantage/PPO	$6,275.63
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,785.88
Rate for Payer: CareSource Just4Me Medicare	$8,472.10
Rate for Payer: Humana KY Medicaid	$5,961.85
Rate for Payer: Humana Medicare Advantage	$6,275.63
Rate for Payer: Kentucky WC Medicaid	$6,021.47
Rate for Payer: Molina Healthcare Benefit Exchange	$7,530.76
Rate for Payer: Molina Healthcare Medicaid	$6,081.09

MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC

Facility

$13,598.44

Service Code	MSDRG 436
Min. Negotiated Rate	$9,227.51
Max. Negotiated Rate	$13,598.44
Rate for Payer: Anthem Medicaid	$9,227.51
Rate for Payer: Anthem Medicare Advantage/PPO	$9,713.17
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,598.44
Rate for Payer: CareSource Just4Me Medicare	$13,112.78
Rate for Payer: Humana KY Medicaid	$9,227.51
Rate for Payer: Humana Medicare Advantage	$9,713.17
Rate for Payer: Kentucky WC Medicaid	$9,319.79
Rate for Payer: Molina Healthcare Benefit Exchange	$11,655.80
Rate for Payer: Molina Healthcare Medicaid	$9,412.06

MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC

Facility

$22,002.05

Service Code	MSDRG 435
Min. Negotiated Rate	$14,929.96
Max. Negotiated Rate	$22,002.05
Rate for Payer: Anthem Medicaid	$14,929.96
Rate for Payer: Anthem Medicare Advantage/PPO	$15,715.75
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,002.05
Rate for Payer: CareSource Just4Me Medicare	$21,216.26
Rate for Payer: Humana KY Medicaid	$14,929.96
Rate for Payer: Humana Medicare Advantage	$15,715.75
Rate for Payer: Kentucky WC Medicaid	$15,079.26
Rate for Payer: Molina Healthcare Benefit Exchange	$18,858.90
Rate for Payer: Molina Healthcare Medicaid	$15,228.56

MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC

Facility

$9,468.40

Service Code	MSDRG 437
Min. Negotiated Rate	$6,424.98
Max. Negotiated Rate	$9,468.40
Rate for Payer: Anthem Medicaid	$6,424.98
Rate for Payer: Anthem Medicare Advantage/PPO	$6,763.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,468.40
Rate for Payer: CareSource Just4Me Medicare	$9,130.24
Rate for Payer: Humana KY Medicaid	$6,424.98
Rate for Payer: Humana Medicare Advantage	$6,763.14
Rate for Payer: Kentucky WC Medicaid	$6,489.23
Rate for Payer: Molina Healthcare Benefit Exchange	$8,115.77
Rate for Payer: Molina Healthcare Medicaid	$6,553.48

MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH CC

Facility

$13,009.99

Service Code	MSDRG 598
Min. Negotiated Rate	$8,828.21
Max. Negotiated Rate	$13,009.99
Rate for Payer: Anthem Medicaid	$8,828.21
Rate for Payer: Anthem Medicare Advantage/PPO	$9,292.85
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,009.99
Rate for Payer: CareSource Just4Me Medicare	$12,545.35
Rate for Payer: Humana KY Medicaid	$8,828.21
Rate for Payer: Humana Medicare Advantage	$9,292.85
Rate for Payer: Kentucky WC Medicaid	$8,916.49
Rate for Payer: Molina Healthcare Benefit Exchange	$11,151.42
Rate for Payer: Molina Healthcare Medicaid	$9,004.77

MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH MCC

Facility

$21,183.29

Service Code	MSDRG 597
Min. Negotiated Rate	$14,374.37
Max. Negotiated Rate	$21,183.29
Rate for Payer: Anthem Medicaid	$14,374.37
Rate for Payer: Anthem Medicare Advantage/PPO	$15,130.92
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,183.29
Rate for Payer: CareSource Just4Me Medicare	$20,426.74
Rate for Payer: Humana KY Medicaid	$14,374.37
Rate for Payer: Humana Medicare Advantage	$15,130.92
Rate for Payer: Kentucky WC Medicaid	$14,518.12
Rate for Payer: Molina Healthcare Benefit Exchange	$18,157.10
Rate for Payer: Molina Healthcare Medicaid	$14,661.86

MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$10,308.89

Service Code	MSDRG 599
Min. Negotiated Rate	$6,995.32
Max. Negotiated Rate	$10,308.89
Rate for Payer: Anthem Medicaid	$6,995.32
Rate for Payer: Anthem Medicare Advantage/PPO	$7,363.49
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,308.89
Rate for Payer: CareSource Just4Me Medicare	$9,940.71
Rate for Payer: Humana KY Medicaid	$6,995.32
Rate for Payer: Humana Medicare Advantage	$7,363.49
Rate for Payer: Kentucky WC Medicaid	$7,065.27
Rate for Payer: Molina Healthcare Benefit Exchange	$8,836.19
Rate for Payer: Molina Healthcare Medicaid	$7,135.22

MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITH CC/MCC

Facility

$21,116.97

Service Code	MSDRG 582
Min. Negotiated Rate	$14,329.37
Max. Negotiated Rate	$21,116.97
Rate for Payer: Anthem Medicaid	$14,329.37
Rate for Payer: Anthem Medicare Advantage/PPO	$15,083.55
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$21,116.97
Rate for Payer: CareSource Just4Me Medicare	$20,362.79
Rate for Payer: Humana KY Medicaid	$14,329.37
Rate for Payer: Humana Medicare Advantage	$15,083.55
Rate for Payer: Kentucky WC Medicaid	$14,472.67
Rate for Payer: Molina Healthcare Benefit Exchange	$18,100.26
Rate for Payer: Molina Healthcare Medicaid	$14,615.96

MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC

Facility

$19,808.60

Service Code	MSDRG 583
Min. Negotiated Rate	$13,441.55
Max. Negotiated Rate	$19,808.60
Rate for Payer: Anthem Medicaid	$13,441.55
Rate for Payer: Anthem Medicare Advantage/PPO	$14,149.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,808.60
Rate for Payer: CareSource Just4Me Medicare	$19,101.15
Rate for Payer: Humana KY Medicaid	$13,441.55
Rate for Payer: Humana Medicare Advantage	$14,149.00
Rate for Payer: Kentucky WC Medicaid	$13,575.97
Rate for Payer: Molina Healthcare Benefit Exchange	$16,978.80
Rate for Payer: Molina Healthcare Medicaid	$13,710.38

MS-DRG 42.00: MEDICAL BACK PROBLEMS WITH MCC

Facility

$20,576.75

Service Code	MSDRG 551
Min. Negotiated Rate	$13,962.80
Max. Negotiated Rate	$20,576.75
Rate for Payer: Anthem Medicaid	$13,962.80
Rate for Payer: Anthem Medicare Advantage/PPO	$14,697.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,576.75
Rate for Payer: CareSource Just4Me Medicare	$19,841.87
Rate for Payer: Humana KY Medicaid	$13,962.80
Rate for Payer: Humana Medicare Advantage	$14,697.68
Rate for Payer: Kentucky WC Medicaid	$14,102.42
Rate for Payer: Molina Healthcare Benefit Exchange	$17,637.22
Rate for Payer: Molina Healthcare Medicaid	$14,242.05

MS-DRG 42.00: MEDICAL BACK PROBLEMS WITHOUT MCC

Facility

$11,622.06

Service Code	MSDRG 552
Min. Negotiated Rate	$7,886.40
Max. Negotiated Rate	$11,622.06
Rate for Payer: Anthem Medicaid	$7,886.40
Rate for Payer: Anthem Medicare Advantage/PPO	$8,301.47
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,622.06
Rate for Payer: CareSource Just4Me Medicare	$11,206.98
Rate for Payer: Humana KY Medicaid	$7,886.40
Rate for Payer: Humana Medicare Advantage	$8,301.47
Rate for Payer: Kentucky WC Medicaid	$7,965.26
Rate for Payer: Molina Healthcare Benefit Exchange	$9,961.76
Rate for Payer: Molina Healthcare Medicaid	$8,044.12

Know your out-of-pocket cost for care.

All Charges