Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC

Facility

$15,536.29

Service Code	MSDRG 858
Min. Negotiated Rate	$10,542.48
Max. Negotiated Rate	$15,536.29
Rate for Payer: Anthem Medicaid	$10,542.48
Rate for Payer: Anthem Medicare Advantage/PPO	$11,097.35
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,536.29
Rate for Payer: CareSource Just4Me Medicare	$14,981.42
Rate for Payer: Humana KY Medicaid	$10,542.48
Rate for Payer: Humana Medicare Advantage	$11,097.35
Rate for Payer: Kentucky WC Medicaid	$10,647.91
Rate for Payer: Molina Healthcare Benefit Exchange	$13,316.82
Rate for Payer: Molina Healthcare Medicaid	$10,753.33

MS-DRG 42.00: POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES

Facility

$16,755.37

Service Code	MSDRG 769
Min. Negotiated Rate	$11,369.71
Max. Negotiated Rate	$16,755.37
Rate for Payer: Anthem Medicaid	$11,369.71
Rate for Payer: Anthem Medicare Advantage/PPO	$11,968.12
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,755.37
Rate for Payer: CareSource Just4Me Medicare	$16,156.96
Rate for Payer: Humana KY Medicaid	$11,369.71
Rate for Payer: Humana Medicare Advantage	$11,968.12
Rate for Payer: Kentucky WC Medicaid	$11,483.41
Rate for Payer: Molina Healthcare Benefit Exchange	$14,361.74
Rate for Payer: Molina Healthcare Medicaid	$11,597.11

MS-DRG 42.00: POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES

Facility

$8,603.81

Service Code	MSDRG 776
Min. Negotiated Rate	$5,838.30
Max. Negotiated Rate	$8,603.81
Rate for Payer: Anthem Medicaid	$5,838.30
Rate for Payer: Anthem Medicare Advantage/PPO	$6,145.58
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,603.81
Rate for Payer: CareSource Just4Me Medicare	$8,296.53
Rate for Payer: Humana KY Medicaid	$5,838.30
Rate for Payer: Humana Medicare Advantage	$6,145.58
Rate for Payer: Kentucky WC Medicaid	$5,896.68
Rate for Payer: Molina Healthcare Benefit Exchange	$7,374.70
Rate for Payer: Molina Healthcare Medicaid	$5,955.07

MS-DRG 42.00: PREMATURITY WITH MAJOR PROBLEMS

Facility

$48,956.59

Service Code	MSDRG 791
Min. Negotiated Rate	$33,220.54
Max. Negotiated Rate	$48,956.59
Rate for Payer: Anthem Medicaid	$33,220.54
Rate for Payer: Anthem Medicare Advantage/PPO	$34,968.99
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$48,956.59
Rate for Payer: CareSource Just4Me Medicare	$47,208.14
Rate for Payer: Humana KY Medicaid	$33,220.54
Rate for Payer: Humana Medicare Advantage	$34,968.99
Rate for Payer: Kentucky WC Medicaid	$33,552.75
Rate for Payer: Molina Healthcare Benefit Exchange	$41,962.79
Rate for Payer: Molina Healthcare Medicaid	$33,884.95

MS-DRG 42.00: PREMATURITY WITHOUT MAJOR PROBLEMS

Facility

$29,539.87

Service Code	MSDRG 792
Min. Negotiated Rate	$20,044.91
Max. Negotiated Rate	$29,539.87
Rate for Payer: Anthem Medicaid	$20,044.91
Rate for Payer: Anthem Medicare Advantage/PPO	$21,099.91
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$29,539.87
Rate for Payer: CareSource Just4Me Medicare	$28,484.88
Rate for Payer: Humana KY Medicaid	$20,044.91
Rate for Payer: Humana Medicare Advantage	$21,099.91
Rate for Payer: Kentucky WC Medicaid	$20,245.36
Rate for Payer: Molina Healthcare Benefit Exchange	$25,319.89
Rate for Payer: Molina Healthcare Medicaid	$20,445.81

MS-DRG 42.00: PROSTATECTOMY WITH CC

Facility

$19,864.08

Service Code	MSDRG 666
Min. Negotiated Rate	$13,479.20
Max. Negotiated Rate	$19,864.08
Rate for Payer: Anthem Medicaid	$13,479.20
Rate for Payer: Anthem Medicare Advantage/PPO	$14,188.63
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,864.08
Rate for Payer: CareSource Just4Me Medicare	$19,154.65
Rate for Payer: Humana KY Medicaid	$13,479.20
Rate for Payer: Humana Medicare Advantage	$14,188.63
Rate for Payer: Kentucky WC Medicaid	$13,613.99
Rate for Payer: Molina Healthcare Benefit Exchange	$17,026.36
Rate for Payer: Molina Healthcare Medicaid	$13,748.78

MS-DRG 42.00: PROSTATECTOMY WITH MCC

Facility

$41,404.30

Service Code	MSDRG 665
Min. Negotiated Rate	$28,095.78
Max. Negotiated Rate	$41,404.30
Rate for Payer: Anthem Medicaid	$28,095.78
Rate for Payer: Anthem Medicare Advantage/PPO	$29,574.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$41,404.30
Rate for Payer: CareSource Just4Me Medicare	$39,925.57
Rate for Payer: Humana KY Medicaid	$28,095.78
Rate for Payer: Humana Medicare Advantage	$29,574.50
Rate for Payer: Kentucky WC Medicaid	$28,376.73
Rate for Payer: Molina Healthcare Benefit Exchange	$35,489.40
Rate for Payer: Molina Healthcare Medicaid	$28,657.69

MS-DRG 42.00: PROSTATECTOMY WITHOUT CC/MCC

Facility

$12,393.79

Service Code	MSDRG 667
Min. Negotiated Rate	$8,410.07
Max. Negotiated Rate	$12,393.79
Rate for Payer: Anthem Medicaid	$8,410.07
Rate for Payer: Anthem Medicare Advantage/PPO	$8,852.71
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,393.79
Rate for Payer: CareSource Just4Me Medicare	$11,951.16
Rate for Payer: Humana KY Medicaid	$8,410.07
Rate for Payer: Humana Medicare Advantage	$8,852.71
Rate for Payer: Kentucky WC Medicaid	$8,494.18
Rate for Payer: Molina Healthcare Benefit Exchange	$10,623.25
Rate for Payer: Molina Healthcare Medicaid	$8,578.28

MS-DRG 42.00: PSYCHOSES

Facility

$16,997.76

Service Code	MSDRG 885
Min. Negotiated Rate	$11,534.20
Max. Negotiated Rate	$16,997.76
Rate for Payer: Anthem Medicaid	$11,534.20
Rate for Payer: Anthem Medicare Advantage/PPO	$12,141.26
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,997.76
Rate for Payer: CareSource Just4Me Medicare	$16,390.70
Rate for Payer: Humana KY Medicaid	$11,534.20
Rate for Payer: Humana Medicare Advantage	$12,141.26
Rate for Payer: Kentucky WC Medicaid	$11,649.54
Rate for Payer: Molina Healthcare Benefit Exchange	$14,569.51
Rate for Payer: Molina Healthcare Medicaid	$11,764.88

MS-DRG 42.00: PULMONARY EDEMA AND RESPIRATORY FAILURE

Facility

$14,921.27

Service Code	MSDRG 189
Min. Negotiated Rate	$10,125.15
Max. Negotiated Rate	$14,921.27
Rate for Payer: Anthem Medicaid	$10,125.15
Rate for Payer: Anthem Medicare Advantage/PPO	$10,658.05
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$14,921.27
Rate for Payer: CareSource Just4Me Medicare	$14,388.37
Rate for Payer: Humana KY Medicaid	$10,125.15
Rate for Payer: Humana Medicare Advantage	$10,658.05
Rate for Payer: Kentucky WC Medicaid	$10,226.40
Rate for Payer: Molina Healthcare Benefit Exchange	$12,789.66
Rate for Payer: Molina Healthcare Medicaid	$10,327.65

MS-DRG 42.00: PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE

Facility

$16,991.73

Service Code	MSDRG 175
Min. Negotiated Rate	$11,530.10
Max. Negotiated Rate	$16,991.73
Rate for Payer: Anthem Medicaid	$11,530.10
Rate for Payer: Anthem Medicare Advantage/PPO	$12,136.95
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,991.73
Rate for Payer: CareSource Just4Me Medicare	$16,384.88
Rate for Payer: Humana KY Medicaid	$11,530.10
Rate for Payer: Humana Medicare Advantage	$12,136.95
Rate for Payer: Kentucky WC Medicaid	$11,645.40
Rate for Payer: Molina Healthcare Benefit Exchange	$14,564.34
Rate for Payer: Molina Healthcare Medicaid	$11,760.70

MS-DRG 42.00: PULMONARY EMBOLISM WITHOUT MCC

Facility

$9,821.70

Service Code	MSDRG 176
Min. Negotiated Rate	$6,664.73
Max. Negotiated Rate	$9,821.70
Rate for Payer: Anthem Medicaid	$6,664.73
Rate for Payer: Anthem Medicare Advantage/PPO	$7,015.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,821.70
Rate for Payer: CareSource Just4Me Medicare	$9,470.92
Rate for Payer: Humana KY Medicaid	$6,664.73
Rate for Payer: Humana Medicare Advantage	$7,015.50
Rate for Payer: Kentucky WC Medicaid	$6,731.37
Rate for Payer: Molina Healthcare Benefit Exchange	$8,418.60
Rate for Payer: Molina Healthcare Medicaid	$6,798.02

MS-DRG 42.00: RADIOTHERAPY

Facility

$32,209.66

Service Code	MSDRG 849
Min. Negotiated Rate	$21,856.56
Max. Negotiated Rate	$32,209.66
Rate for Payer: Anthem Medicaid	$21,856.56
Rate for Payer: Anthem Medicare Advantage/PPO	$23,006.90
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$32,209.66
Rate for Payer: CareSource Just4Me Medicare	$31,059.31
Rate for Payer: Humana KY Medicaid	$21,856.56
Rate for Payer: Humana Medicare Advantage	$23,006.90
Rate for Payer: Kentucky WC Medicaid	$22,075.12
Rate for Payer: Molina Healthcare Benefit Exchange	$27,608.28
Rate for Payer: Molina Healthcare Medicaid	$22,293.69

MS-DRG 42.00: RECTAL RESECTION WITH CC

Facility

$25,628.06

Service Code	MSDRG 333
Min. Negotiated Rate	$17,390.47
Max. Negotiated Rate	$25,628.06
Rate for Payer: Anthem Medicaid	$17,390.47
Rate for Payer: Anthem Medicare Advantage/PPO	$18,305.76
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$25,628.06
Rate for Payer: CareSource Just4Me Medicare	$24,712.78
Rate for Payer: Humana KY Medicaid	$17,390.47
Rate for Payer: Humana Medicare Advantage	$18,305.76
Rate for Payer: Kentucky WC Medicaid	$17,564.38
Rate for Payer: Molina Healthcare Benefit Exchange	$21,966.91
Rate for Payer: Molina Healthcare Medicaid	$17,738.28

MS-DRG 42.00: RECTAL RESECTION WITH MCC

Facility

$41,827.56

Service Code	MSDRG 332
Min. Negotiated Rate	$28,382.99
Max. Negotiated Rate	$41,827.56
Rate for Payer: Anthem Medicaid	$28,382.99
Rate for Payer: Anthem Medicare Advantage/PPO	$29,876.83
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$41,827.56
Rate for Payer: CareSource Just4Me Medicare	$40,333.72
Rate for Payer: Humana KY Medicaid	$28,382.99
Rate for Payer: Humana Medicare Advantage	$29,876.83
Rate for Payer: Kentucky WC Medicaid	$28,666.82
Rate for Payer: Molina Healthcare Benefit Exchange	$35,852.20
Rate for Payer: Molina Healthcare Medicaid	$28,950.65

MS-DRG 42.00: RECTAL RESECTION WITHOUT CC/MCC

Facility

$20,000.33

Service Code	MSDRG 334
Min. Negotiated Rate	$13,571.65
Max. Negotiated Rate	$20,000.33
Rate for Payer: Anthem Medicaid	$13,571.65
Rate for Payer: Anthem Medicare Advantage/PPO	$14,285.95
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,000.33
Rate for Payer: CareSource Just4Me Medicare	$19,286.03
Rate for Payer: Humana KY Medicaid	$13,571.65
Rate for Payer: Humana Medicare Advantage	$14,285.95
Rate for Payer: Kentucky WC Medicaid	$13,707.37
Rate for Payer: Molina Healthcare Benefit Exchange	$17,143.14
Rate for Payer: Molina Healthcare Medicaid	$13,843.09

MS-DRG 42.00: RED BLOOD CELL DISORDERS WITH MCC

Facility

$16,965.20

Service Code	MSDRG 811
Min. Negotiated Rate	$11,512.10
Max. Negotiated Rate	$16,965.20
Rate for Payer: Anthem Medicaid	$11,512.10
Rate for Payer: Anthem Medicare Advantage/PPO	$12,118.00
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,965.20
Rate for Payer: CareSource Just4Me Medicare	$16,359.30
Rate for Payer: Humana KY Medicaid	$11,512.10
Rate for Payer: Humana Medicare Advantage	$12,118.00
Rate for Payer: Kentucky WC Medicaid	$11,627.22
Rate for Payer: Molina Healthcare Benefit Exchange	$14,541.60
Rate for Payer: Molina Healthcare Medicaid	$11,742.34

MS-DRG 42.00: RED BLOOD CELL DISORDERS WITHOUT MCC

Facility

$11,128.84

Service Code	MSDRG 812
Min. Negotiated Rate	$7,551.71
Max. Negotiated Rate	$11,128.84
Rate for Payer: Anthem Medicaid	$7,551.71
Rate for Payer: Anthem Medicare Advantage/PPO	$7,949.17
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,128.84
Rate for Payer: CareSource Just4Me Medicare	$10,731.38
Rate for Payer: Humana KY Medicaid	$7,551.71
Rate for Payer: Humana Medicare Advantage	$7,949.17
Rate for Payer: Kentucky WC Medicaid	$7,627.23
Rate for Payer: Molina Healthcare Benefit Exchange	$9,539.00
Rate for Payer: Molina Healthcare Medicaid	$7,702.75

MS-DRG 42.00: REHABILITATION WITH CC/MCC

Facility

$18,407.40

Service Code	MSDRG 945
Min. Negotiated Rate	$12,490.73
Max. Negotiated Rate	$18,407.40
Rate for Payer: Anthem Medicaid	$12,490.73
Rate for Payer: Anthem Medicare Advantage/PPO	$13,148.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,407.40
Rate for Payer: CareSource Just4Me Medicare	$17,749.99
Rate for Payer: Humana KY Medicaid	$12,490.73
Rate for Payer: Humana Medicare Advantage	$13,148.14
Rate for Payer: Kentucky WC Medicaid	$12,615.64
Rate for Payer: Molina Healthcare Benefit Exchange	$15,777.77
Rate for Payer: Molina Healthcare Medicaid	$12,740.55

MS-DRG 42.00: REHABILITATION WITHOUT CC/MCC

Facility

$13,463.38

Service Code	MSDRG 946
Min. Negotiated Rate	$9,135.86
Max. Negotiated Rate	$13,463.38
Rate for Payer: Anthem Medicaid	$9,135.86
Rate for Payer: Anthem Medicare Advantage/PPO	$9,616.70
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$13,463.38
Rate for Payer: CareSource Just4Me Medicare	$12,982.55
Rate for Payer: Humana KY Medicaid	$9,135.86
Rate for Payer: Humana Medicare Advantage	$9,616.70
Rate for Payer: Kentucky WC Medicaid	$9,227.22
Rate for Payer: Molina Healthcare Benefit Exchange	$11,540.04
Rate for Payer: Molina Healthcare Medicaid	$9,318.58

MS-DRG 42.00: RENAL FAILURE WITH CC

Facility

$10,718.86

Service Code	MSDRG 683
Min. Negotiated Rate	$7,273.51
Max. Negotiated Rate	$10,718.86
Rate for Payer: Anthem Medicaid	$7,273.51
Rate for Payer: Anthem Medicare Advantage/PPO	$7,656.33
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,718.86
Rate for Payer: CareSource Just4Me Medicare	$10,336.05
Rate for Payer: Humana KY Medicaid	$7,273.51
Rate for Payer: Humana Medicare Advantage	$7,656.33
Rate for Payer: Kentucky WC Medicaid	$7,346.25
Rate for Payer: Molina Healthcare Benefit Exchange	$9,187.60
Rate for Payer: Molina Healthcare Medicaid	$7,418.98

MS-DRG 42.00: RENAL FAILURE WITH MCC

Facility

$18,110.75

Service Code	MSDRG 682
Min. Negotiated Rate	$12,289.44
Max. Negotiated Rate	$18,110.75
Rate for Payer: Anthem Medicaid	$12,289.44
Rate for Payer: Anthem Medicare Advantage/PPO	$12,936.25
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,110.75
Rate for Payer: CareSource Just4Me Medicare	$17,463.94
Rate for Payer: Humana KY Medicaid	$12,289.44
Rate for Payer: Humana Medicare Advantage	$12,936.25
Rate for Payer: Kentucky WC Medicaid	$12,412.33
Rate for Payer: Molina Healthcare Benefit Exchange	$15,523.50
Rate for Payer: Molina Healthcare Medicaid	$12,535.23

MS-DRG 42.00: RENAL FAILURE WITHOUT CC/MCC

Facility

$7,324.38

Service Code	MSDRG 684
Min. Negotiated Rate	$4,970.11
Max. Negotiated Rate	$7,324.38
Rate for Payer: Anthem Medicaid	$4,970.11
Rate for Payer: Anthem Medicare Advantage/PPO	$5,231.70
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$7,324.38
Rate for Payer: CareSource Just4Me Medicare	$7,062.80
Rate for Payer: Humana KY Medicaid	$4,970.11
Rate for Payer: Humana Medicare Advantage	$5,231.70
Rate for Payer: Kentucky WC Medicaid	$5,019.82
Rate for Payer: Molina Healthcare Benefit Exchange	$6,278.04
Rate for Payer: Molina Healthcare Medicaid	$5,069.52

MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC

Facility

$11,963.31

Service Code	MSDRG 178
Min. Negotiated Rate	$8,117.96
Max. Negotiated Rate	$11,963.31
Rate for Payer: Anthem Medicaid	$8,117.96
Rate for Payer: Anthem Medicare Advantage/PPO	$8,545.22
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,963.31
Rate for Payer: CareSource Just4Me Medicare	$11,536.05
Rate for Payer: Humana KY Medicaid	$8,117.96
Rate for Payer: Humana Medicare Advantage	$8,545.22
Rate for Payer: Kentucky WC Medicaid	$8,199.14
Rate for Payer: Molina Healthcare Benefit Exchange	$10,254.26
Rate for Payer: Molina Healthcare Medicaid	$8,280.32

MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC

Facility

$19,492.66

Service Code	MSDRG 177
Min. Negotiated Rate	$13,227.16
Max. Negotiated Rate	$19,492.66
Rate for Payer: Anthem Medicaid	$13,227.16
Rate for Payer: Anthem Medicare Advantage/PPO	$13,923.33
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,492.66
Rate for Payer: CareSource Just4Me Medicare	$18,796.50
Rate for Payer: Humana KY Medicaid	$13,227.16
Rate for Payer: Humana Medicare Advantage	$13,923.33
Rate for Payer: Kentucky WC Medicaid	$13,359.44
Rate for Payer: Molina Healthcare Benefit Exchange	$16,708.00
Rate for Payer: Molina Healthcare Medicaid	$13,491.71

Know your out-of-pocket cost for care.

All Charges