Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: OTHER HEART ASSIST SYSTEM IMPLANT

Facility

$127,758.12

Service Code	MSDRG 215
Min. Negotiated Rate	$86,693.01
Max. Negotiated Rate	$127,758.12
Rate for Payer: Anthem Medicaid	$86,693.01
Rate for Payer: Anthem Medicare Advantage/PPO	$91,255.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$127,758.12
Rate for Payer: CareSource Just4Me Medicare	$123,195.33
Rate for Payer: Humana KY Medicaid	$86,693.01
Rate for Payer: Humana Medicare Advantage	$91,255.80
Rate for Payer: Kentucky WC Medicaid	$87,559.94
Rate for Payer: Molina Healthcare Benefit Exchange	$109,506.96
Rate for Payer: Molina Healthcare Medicaid	$88,426.87

MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC

Facility

$27,533.32

Service Code	MSDRG 424
Min. Negotiated Rate	$18,683.33
Max. Negotiated Rate	$27,533.32
Rate for Payer: Anthem Medicaid	$18,683.33
Rate for Payer: Anthem Medicare Advantage/PPO	$19,666.66
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$27,533.32
Rate for Payer: CareSource Just4Me Medicare	$26,549.99
Rate for Payer: Humana KY Medicaid	$18,683.33
Rate for Payer: Humana Medicare Advantage	$19,666.66
Rate for Payer: Kentucky WC Medicaid	$18,870.16
Rate for Payer: Molina Healthcare Benefit Exchange	$23,599.99
Rate for Payer: Molina Healthcare Medicaid	$19,056.99

MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC

Facility

$49,047.03

Service Code	MSDRG 423
Min. Negotiated Rate	$33,281.91
Max. Negotiated Rate	$49,047.03
Rate for Payer: Anthem Medicaid	$33,281.91
Rate for Payer: Anthem Medicare Advantage/PPO	$35,033.59
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$49,047.03
Rate for Payer: CareSource Just4Me Medicare	$47,295.35
Rate for Payer: Humana KY Medicaid	$33,281.91
Rate for Payer: Humana Medicare Advantage	$35,033.59
Rate for Payer: Kentucky WC Medicaid	$33,614.73
Rate for Payer: Molina Healthcare Benefit Exchange	$42,040.31
Rate for Payer: Molina Healthcare Medicaid	$33,947.55

MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC

Facility

$18,640.12

Service Code	MSDRG 425
Min. Negotiated Rate	$12,648.65
Max. Negotiated Rate	$18,640.12
Rate for Payer: Anthem Medicaid	$12,648.65
Rate for Payer: Anthem Medicare Advantage/PPO	$13,314.37
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,640.12
Rate for Payer: CareSource Just4Me Medicare	$17,974.40
Rate for Payer: Humana KY Medicaid	$12,648.65
Rate for Payer: Humana Medicare Advantage	$13,314.37
Rate for Payer: Kentucky WC Medicaid	$12,775.14
Rate for Payer: Molina Healthcare Benefit Exchange	$15,977.24
Rate for Payer: Molina Healthcare Medicaid	$12,901.62

MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC

Facility

$12,662.71

Service Code	MSDRG 868
Min. Negotiated Rate	$8,592.55
Max. Negotiated Rate	$12,662.71
Rate for Payer: Anthem Medicaid	$8,592.55
Rate for Payer: Anthem Medicare Advantage/PPO	$9,044.79
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,662.71
Rate for Payer: CareSource Just4Me Medicare	$12,210.47
Rate for Payer: Humana KY Medicaid	$8,592.55
Rate for Payer: Humana Medicare Advantage	$9,044.79
Rate for Payer: Kentucky WC Medicaid	$8,678.48
Rate for Payer: Molina Healthcare Benefit Exchange	$10,853.75
Rate for Payer: Molina Healthcare Medicaid	$8,764.40

MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC

Facility

$25,857.20

Service Code	MSDRG 867
Min. Negotiated Rate	$17,545.96
Max. Negotiated Rate	$25,857.20
Rate for Payer: Anthem Medicaid	$17,545.96
Rate for Payer: Anthem Medicare Advantage/PPO	$18,469.43
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,857.20
Rate for Payer: CareSource Just4Me Medicare	$24,933.73
Rate for Payer: Humana KY Medicaid	$17,545.96
Rate for Payer: Humana Medicare Advantage	$18,469.43
Rate for Payer: Kentucky WC Medicaid	$17,721.42
Rate for Payer: Molina Healthcare Benefit Exchange	$22,163.32
Rate for Payer: Molina Healthcare Medicaid	$17,896.88

MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Facility

$8,677.35

Service Code	MSDRG 869
Min. Negotiated Rate	$5,888.20
Max. Negotiated Rate	$8,677.35
Rate for Payer: Anthem Medicaid	$5,888.20
Rate for Payer: Anthem Medicare Advantage/PPO	$6,198.11
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,677.35
Rate for Payer: CareSource Just4Me Medicare	$8,367.45
Rate for Payer: Humana KY Medicaid	$5,888.20
Rate for Payer: Humana Medicare Advantage	$6,198.11
Rate for Payer: Kentucky WC Medicaid	$5,947.09
Rate for Payer: Molina Healthcare Benefit Exchange	$7,437.73
Rate for Payer: Molina Healthcare Medicaid	$6,005.97

MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility

$20,371.75

Service Code	MSDRG 922
Min. Negotiated Rate	$13,823.69
Max. Negotiated Rate	$20,371.75
Rate for Payer: Anthem Medicaid	$13,823.69
Rate for Payer: Anthem Medicare Advantage/PPO	$14,551.25
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,371.75
Rate for Payer: CareSource Just4Me Medicare	$19,644.19
Rate for Payer: Humana KY Medicaid	$13,823.69
Rate for Payer: Humana Medicare Advantage	$14,551.25
Rate for Payer: Kentucky WC Medicaid	$13,961.92
Rate for Payer: Molina Healthcare Benefit Exchange	$17,461.50
Rate for Payer: Molina Healthcare Medicaid	$14,100.16

MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility

$12,298.55

Service Code	MSDRG 923
Min. Negotiated Rate	$8,345.45
Max. Negotiated Rate	$12,298.55
Rate for Payer: Anthem Medicaid	$8,345.45
Rate for Payer: Anthem Medicare Advantage/PPO	$8,784.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,298.55
Rate for Payer: CareSource Just4Me Medicare	$11,859.32
Rate for Payer: Humana KY Medicaid	$8,345.45
Rate for Payer: Humana Medicare Advantage	$8,784.68
Rate for Payer: Kentucky WC Medicaid	$8,428.90
Rate for Payer: Molina Healthcare Benefit Exchange	$10,541.62
Rate for Payer: Molina Healthcare Medicaid	$8,512.35

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

Facility

$12,298.55

Service Code	MSDRG 699
Min. Negotiated Rate	$8,345.45
Max. Negotiated Rate	$12,298.55
Rate for Payer: Anthem Medicaid	$8,345.45
Rate for Payer: Anthem Medicare Advantage/PPO	$8,784.68
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,298.55
Rate for Payer: CareSource Just4Me Medicare	$11,859.32
Rate for Payer: Humana KY Medicaid	$8,345.45
Rate for Payer: Humana Medicare Advantage	$8,784.68
Rate for Payer: Kentucky WC Medicaid	$8,428.90
Rate for Payer: Molina Healthcare Benefit Exchange	$10,541.62
Rate for Payer: Molina Healthcare Medicaid	$8,512.35

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

Facility

$20,269.24

Service Code	MSDRG 698
Min. Negotiated Rate	$13,754.13
Max. Negotiated Rate	$20,269.24
Rate for Payer: Anthem Medicaid	$13,754.13
Rate for Payer: Anthem Medicare Advantage/PPO	$14,478.03
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,269.24
Rate for Payer: CareSource Just4Me Medicare	$19,545.34
Rate for Payer: Humana KY Medicaid	$13,754.13
Rate for Payer: Humana Medicare Advantage	$14,478.03
Rate for Payer: Kentucky WC Medicaid	$13,891.67
Rate for Payer: Molina Healthcare Benefit Exchange	$17,373.64
Rate for Payer: Molina Healthcare Medicaid	$14,029.21

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

Facility

$8,371.08

Service Code	MSDRG 700
Min. Negotiated Rate	$5,680.37
Max. Negotiated Rate	$8,371.08
Rate for Payer: Anthem Medicaid	$5,680.37
Rate for Payer: Anthem Medicare Advantage/PPO	$5,979.34
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,371.08
Rate for Payer: CareSource Just4Me Medicare	$8,072.11
Rate for Payer: Humana KY Medicaid	$5,680.37
Rate for Payer: Humana Medicare Advantage	$5,979.34
Rate for Payer: Kentucky WC Medicaid	$5,737.18
Rate for Payer: Molina Healthcare Benefit Exchange	$7,175.21
Rate for Payer: Molina Healthcare Medicaid	$5,793.98

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC

Facility

$27,835.99

Service Code	MSDRG 674
Min. Negotiated Rate	$18,888.71
Max. Negotiated Rate	$27,835.99
Rate for Payer: Anthem Medicaid	$18,888.71
Rate for Payer: Anthem Medicare Advantage/PPO	$19,882.85
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$27,835.99
Rate for Payer: CareSource Just4Me Medicare	$26,841.85
Rate for Payer: Humana KY Medicaid	$18,888.71
Rate for Payer: Humana Medicare Advantage	$19,882.85
Rate for Payer: Kentucky WC Medicaid	$19,077.59
Rate for Payer: Molina Healthcare Benefit Exchange	$23,859.42
Rate for Payer: Molina Healthcare Medicaid	$19,266.48

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC

Facility

$50,520.57

Service Code	MSDRG 673
Min. Negotiated Rate	$34,281.81
Max. Negotiated Rate	$50,520.57
Rate for Payer: Anthem Medicaid	$34,281.81
Rate for Payer: Anthem Medicare Advantage/PPO	$36,086.12
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$50,520.57
Rate for Payer: CareSource Just4Me Medicare	$48,716.26
Rate for Payer: Humana KY Medicaid	$34,281.81
Rate for Payer: Humana Medicare Advantage	$36,086.12
Rate for Payer: Kentucky WC Medicaid	$34,624.63
Rate for Payer: Molina Healthcare Benefit Exchange	$43,303.34
Rate for Payer: Molina Healthcare Medicaid	$34,967.45

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

Facility

$18,875.26

Service Code	MSDRG 675
Min. Negotiated Rate	$12,808.21
Max. Negotiated Rate	$18,875.26
Rate for Payer: Anthem Medicaid	$12,808.21
Rate for Payer: Anthem Medicare Advantage/PPO	$13,482.33
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,875.26
Rate for Payer: CareSource Just4Me Medicare	$18,201.15
Rate for Payer: Humana KY Medicaid	$12,808.21
Rate for Payer: Humana Medicare Advantage	$13,482.33
Rate for Payer: Kentucky WC Medicaid	$12,936.30
Rate for Payer: Molina Healthcare Benefit Exchange	$16,178.80
Rate for Payer: Molina Healthcare Medicaid	$13,064.38

MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility

$41,534.51

Service Code	MSDRG 271
Min. Negotiated Rate	$28,184.13
Max. Negotiated Rate	$41,534.51
Rate for Payer: Anthem Medicaid	$28,184.13
Rate for Payer: Anthem Medicare Advantage/PPO	$29,667.51
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$41,534.51
Rate for Payer: CareSource Just4Me Medicare	$40,051.14
Rate for Payer: Humana KY Medicaid	$28,184.13
Rate for Payer: Humana Medicare Advantage	$29,667.51
Rate for Payer: Kentucky WC Medicaid	$28,465.98
Rate for Payer: Molina Healthcare Benefit Exchange	$35,601.01
Rate for Payer: Molina Healthcare Medicaid	$28,747.82

MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC

Facility

$61,896.62

Service Code	MSDRG 270
Min. Negotiated Rate	$42,001.28
Max. Negotiated Rate	$61,896.62
Rate for Payer: Anthem Medicaid	$42,001.28
Rate for Payer: Anthem Medicare Advantage/PPO	$44,211.87
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$61,896.62
Rate for Payer: CareSource Just4Me Medicare	$59,686.02
Rate for Payer: Humana KY Medicaid	$42,001.28
Rate for Payer: Humana Medicare Advantage	$44,211.87
Rate for Payer: Kentucky WC Medicaid	$42,421.29
Rate for Payer: Molina Healthcare Benefit Exchange	$53,054.24
Rate for Payer: Molina Healthcare Medicaid	$42,841.30

MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$30,172.93

Service Code	MSDRG 272
Min. Negotiated Rate	$20,474.49
Max. Negotiated Rate	$30,172.93
Rate for Payer: Anthem Medicaid	$20,474.49
Rate for Payer: Anthem Medicare Advantage/PPO	$21,552.09
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$30,172.93
Rate for Payer: CareSource Just4Me Medicare	$29,095.32
Rate for Payer: Humana KY Medicaid	$20,474.49
Rate for Payer: Humana Medicare Advantage	$21,552.09
Rate for Payer: Kentucky WC Medicaid	$20,679.23
Rate for Payer: Molina Healthcare Benefit Exchange	$25,862.51
Rate for Payer: Molina Healthcare Medicaid	$20,883.98

MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility

$13,275.28

Service Code	MSDRG 729
Min. Negotiated Rate	$9,008.22
Max. Negotiated Rate	$13,275.28
Rate for Payer: Anthem Medicaid	$9,008.22
Rate for Payer: Anthem Medicare Advantage/PPO	$9,482.34
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,275.28
Rate for Payer: CareSource Just4Me Medicare	$12,801.16
Rate for Payer: Humana KY Medicaid	$9,008.22
Rate for Payer: Humana Medicare Advantage	$9,482.34
Rate for Payer: Kentucky WC Medicaid	$9,098.31
Rate for Payer: Molina Healthcare Benefit Exchange	$11,378.81
Rate for Payer: Molina Healthcare Medicaid	$9,188.39

MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$7,318.33

Service Code	MSDRG 730
Min. Negotiated Rate	$4,966.01
Max. Negotiated Rate	$7,318.33
Rate for Payer: Anthem Medicaid	$4,966.01
Rate for Payer: Anthem Medicare Advantage/PPO	$5,227.38
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$7,318.33
Rate for Payer: CareSource Just4Me Medicare	$7,056.96
Rate for Payer: Humana KY Medicaid	$4,966.01
Rate for Payer: Humana Medicare Advantage	$5,227.38
Rate for Payer: Kentucky WC Medicaid	$5,015.67
Rate for Payer: Molina Healthcare Benefit Exchange	$6,272.86
Rate for Payer: Molina Healthcare Medicaid	$5,065.33

MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC

Facility

$22,374.67

Service Code	MSDRG 717
Min. Negotiated Rate	$15,182.81
Max. Negotiated Rate	$22,374.67
Rate for Payer: Anthem Medicaid	$15,182.81
Rate for Payer: Anthem Medicare Advantage/PPO	$15,981.91
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$22,374.67
Rate for Payer: CareSource Just4Me Medicare	$21,575.58
Rate for Payer: Humana KY Medicaid	$15,182.81
Rate for Payer: Humana Medicare Advantage	$15,981.91
Rate for Payer: Kentucky WC Medicaid	$15,334.64
Rate for Payer: Molina Healthcare Benefit Exchange	$19,178.29
Rate for Payer: Molina Healthcare Medicaid	$15,486.47

MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC

Facility

$14,854.97

Service Code	MSDRG 718
Min. Negotiated Rate	$10,080.16
Max. Negotiated Rate	$14,854.97
Rate for Payer: Anthem Medicaid	$10,080.16
Rate for Payer: Anthem Medicare Advantage/PPO	$10,610.69
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,854.97
Rate for Payer: CareSource Just4Me Medicare	$14,324.43
Rate for Payer: Humana KY Medicaid	$10,080.16
Rate for Payer: Humana Medicare Advantage	$10,610.69
Rate for Payer: Kentucky WC Medicaid	$10,180.96
Rate for Payer: Molina Healthcare Benefit Exchange	$12,732.83
Rate for Payer: Molina Healthcare Medicaid	$10,281.76

MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC

Facility

$27,231.85

Service Code	MSDRG 715
Min. Negotiated Rate	$18,478.75
Max. Negotiated Rate	$27,231.85
Rate for Payer: Anthem Medicaid	$18,478.75
Rate for Payer: Anthem Medicare Advantage/PPO	$19,451.32
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$27,231.85
Rate for Payer: CareSource Just4Me Medicare	$26,259.28
Rate for Payer: Humana KY Medicaid	$18,478.75
Rate for Payer: Humana Medicare Advantage	$19,451.32
Rate for Payer: Kentucky WC Medicaid	$18,663.54
Rate for Payer: Molina Healthcare Benefit Exchange	$23,341.58
Rate for Payer: Molina Healthcare Medicaid	$18,848.33

MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Facility

$17,114.72

Service Code	MSDRG 716
Min. Negotiated Rate	$11,613.56
Max. Negotiated Rate	$17,114.72
Rate for Payer: Anthem Medicaid	$11,613.56
Rate for Payer: Anthem Medicare Advantage/PPO	$12,224.80
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,114.72
Rate for Payer: CareSource Just4Me Medicare	$16,503.48
Rate for Payer: Humana KY Medicaid	$11,613.56
Rate for Payer: Humana Medicare Advantage	$12,224.80
Rate for Payer: Kentucky WC Medicaid	$11,729.70
Rate for Payer: Molina Healthcare Benefit Exchange	$14,669.76
Rate for Payer: Molina Healthcare Medicaid	$11,845.83

MS-DRG 42.00: OTHER MENTAL DISORDER DIAGNOSES

Facility

$14,342.45

Service Code	MSDRG 887
Min. Negotiated Rate	$9,732.38
Max. Negotiated Rate	$14,342.45
Rate for Payer: Anthem Medicaid	$9,732.38
Rate for Payer: Anthem Medicare Advantage/PPO	$10,244.61
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,342.45
Rate for Payer: CareSource Just4Me Medicare	$13,830.22
Rate for Payer: Humana KY Medicaid	$9,732.38
Rate for Payer: Humana Medicare Advantage	$10,244.61
Rate for Payer: Kentucky WC Medicaid	$9,829.70
Rate for Payer: Molina Healthcare Benefit Exchange	$12,293.53
Rate for Payer: Molina Healthcare Medicaid	$9,927.03

Know your out-of-pocket cost for care.

All Charges