Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: SYNCOPE AND COLLAPSE

Facility

$10,506.62

Service Code	MSDRG 312
Min. Negotiated Rate	$7,129.49
Max. Negotiated Rate	$10,506.62
Rate for Payer: Anthem Medicaid	$7,129.49
Rate for Payer: Anthem Medicare Advantage/PPO	$7,504.73
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,506.62
Rate for Payer: CareSource Just4Me Medicare	$10,131.39
Rate for Payer: Humana KY Medicaid	$7,129.49
Rate for Payer: Humana Medicare Advantage	$7,504.73
Rate for Payer: Kentucky WC Medicaid	$7,200.79
Rate for Payer: Molina Healthcare Benefit Exchange	$9,005.68
Rate for Payer: Molina Healthcare Medicaid	$7,272.08

MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITH MCC

Facility

$18,687.14

Service Code	MSDRG 557
Min. Negotiated Rate	$12,680.56
Max. Negotiated Rate	$18,687.14
Rate for Payer: Anthem Medicaid	$12,680.56
Rate for Payer: Anthem Medicare Advantage/PPO	$13,347.96
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,687.14
Rate for Payer: CareSource Just4Me Medicare	$18,019.75
Rate for Payer: Humana KY Medicaid	$12,680.56
Rate for Payer: Humana Medicare Advantage	$13,347.96
Rate for Payer: Kentucky WC Medicaid	$12,807.37
Rate for Payer: Molina Healthcare Benefit Exchange	$16,017.55
Rate for Payer: Molina Healthcare Medicaid	$12,934.17

MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC

Facility

$10,416.20

Service Code	MSDRG 558
Min. Negotiated Rate	$7,068.13
Max. Negotiated Rate	$10,416.20
Rate for Payer: Anthem Medicaid	$7,068.13
Rate for Payer: Anthem Medicare Advantage/PPO	$7,440.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,416.20
Rate for Payer: CareSource Just4Me Medicare	$10,044.19
Rate for Payer: Humana KY Medicaid	$7,068.13
Rate for Payer: Humana Medicare Advantage	$7,440.14
Rate for Payer: Kentucky WC Medicaid	$7,138.81
Rate for Payer: Molina Healthcare Benefit Exchange	$8,928.17
Rate for Payer: Molina Healthcare Medicaid	$7,209.50

MS-DRG 42.00: TESTES PROCEDURES WITH CC/MCC

Facility

$23,039.10

Service Code	MSDRG 711
Min. Negotiated Rate	$15,633.67
Max. Negotiated Rate	$23,039.10
Rate for Payer: Anthem Medicaid	$15,633.67
Rate for Payer: Anthem Medicare Advantage/PPO	$16,456.50
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$23,039.10
Rate for Payer: CareSource Just4Me Medicare	$22,216.28
Rate for Payer: Humana KY Medicaid	$15,633.67
Rate for Payer: Humana Medicare Advantage	$16,456.50
Rate for Payer: Kentucky WC Medicaid	$15,790.01
Rate for Payer: Molina Healthcare Benefit Exchange	$19,747.80
Rate for Payer: Molina Healthcare Medicaid	$15,946.35

MS-DRG 42.00: TESTES PROCEDURES WITHOUT CC/MCC

Facility

$12,897.84

Service Code	MSDRG 712
Min. Negotiated Rate	$8,752.10
Max. Negotiated Rate	$12,897.84
Rate for Payer: Anthem Medicaid	$8,752.10
Rate for Payer: Anthem Medicare Advantage/PPO	$9,212.74
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,897.84
Rate for Payer: CareSource Just4Me Medicare	$12,437.20
Rate for Payer: Humana KY Medicaid	$8,752.10
Rate for Payer: Humana Medicare Advantage	$9,212.74
Rate for Payer: Kentucky WC Medicaid	$8,839.62
Rate for Payer: Molina Healthcare Benefit Exchange	$11,055.29
Rate for Payer: Molina Healthcare Medicaid	$8,927.15

MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC

Facility

$18,200.01

Service Code	MSDRG 626
Min. Negotiated Rate	$12,350.01
Max. Negotiated Rate	$18,200.01
Rate for Payer: Anthem Medicaid	$12,350.01
Rate for Payer: Anthem Medicare Advantage/PPO	$13,000.01
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,200.01
Rate for Payer: CareSource Just4Me Medicare	$17,550.01
Rate for Payer: Humana KY Medicaid	$12,350.01
Rate for Payer: Humana Medicare Advantage	$13,000.01
Rate for Payer: Kentucky WC Medicaid	$12,473.51
Rate for Payer: Molina Healthcare Benefit Exchange	$15,600.01
Rate for Payer: Molina Healthcare Medicaid	$12,597.01

MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC

Facility

$34,573.13

Service Code	MSDRG 625
Min. Negotiated Rate	$23,460.34
Max. Negotiated Rate	$34,573.13
Rate for Payer: Anthem Medicaid	$23,460.34
Rate for Payer: Anthem Medicare Advantage/PPO	$24,695.09
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$34,573.13
Rate for Payer: CareSource Just4Me Medicare	$33,338.37
Rate for Payer: Humana KY Medicaid	$23,460.34
Rate for Payer: Humana Medicare Advantage	$24,695.09
Rate for Payer: Kentucky WC Medicaid	$23,694.94
Rate for Payer: Molina Healthcare Benefit Exchange	$29,634.11
Rate for Payer: Molina Healthcare Medicaid	$23,929.54

MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC

Facility

$15,277.00

Service Code	MSDRG 627
Min. Negotiated Rate	$10,366.53
Max. Negotiated Rate	$15,277.00
Rate for Payer: Anthem Medicaid	$10,366.53
Rate for Payer: Anthem Medicare Advantage/PPO	$10,912.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,277.00
Rate for Payer: CareSource Just4Me Medicare	$14,731.39
Rate for Payer: Humana KY Medicaid	$10,366.53
Rate for Payer: Humana Medicare Advantage	$10,912.14
Rate for Payer: Kentucky WC Medicaid	$10,470.20
Rate for Payer: Molina Healthcare Benefit Exchange	$13,094.57
Rate for Payer: Molina Healthcare Medicaid	$10,573.86

MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC

Facility

$49,484.74

Service Code	MSDRG 012
Min. Negotiated Rate	$33,578.93
Max. Negotiated Rate	$49,484.74
Rate for Payer: Anthem Medicaid	$33,578.93
Rate for Payer: Anthem Medicare Advantage/PPO	$35,346.24
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$49,484.74
Rate for Payer: CareSource Just4Me Medicare	$47,717.42
Rate for Payer: Humana KY Medicaid	$33,578.93
Rate for Payer: Humana Medicare Advantage	$35,346.24
Rate for Payer: Kentucky WC Medicaid	$33,914.72
Rate for Payer: Molina Healthcare Benefit Exchange	$42,415.49
Rate for Payer: Molina Healthcare Medicaid	$34,250.51

MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC

Facility

$65,066.82

Service Code	MSDRG 011
Min. Negotiated Rate	$44,152.49
Max. Negotiated Rate	$65,066.82
Rate for Payer: Anthem Medicaid	$44,152.49
Rate for Payer: Anthem Medicare Advantage/PPO	$46,476.30
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$65,066.82
Rate for Payer: CareSource Just4Me Medicare	$62,743.00
Rate for Payer: Humana KY Medicaid	$44,152.49
Rate for Payer: Humana Medicare Advantage	$46,476.30
Rate for Payer: Kentucky WC Medicaid	$44,594.01
Rate for Payer: Molina Healthcare Benefit Exchange	$55,771.56
Rate for Payer: Molina Healthcare Medicaid	$45,035.53

MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC

Facility

$31,955.17

Service Code	MSDRG 013
Min. Negotiated Rate	$21,683.86
Max. Negotiated Rate	$31,955.17
Rate for Payer: Anthem Medicaid	$21,683.86
Rate for Payer: Anthem Medicare Advantage/PPO	$22,825.12
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$31,955.17
Rate for Payer: CareSource Just4Me Medicare	$30,813.91
Rate for Payer: Humana KY Medicaid	$21,683.86
Rate for Payer: Humana Medicare Advantage	$22,825.12
Rate for Payer: Kentucky WC Medicaid	$21,900.70
Rate for Payer: Molina Healthcare Benefit Exchange	$27,390.14
Rate for Payer: Molina Healthcare Medicaid	$22,117.54

MS-DRG 42.00: TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES

Facility

$170,387.56

Service Code	MSDRG 004
Min. Negotiated Rate	$115,620.13
Max. Negotiated Rate	$170,387.56
Rate for Payer: Anthem Medicaid	$115,620.13
Rate for Payer: Anthem Medicare Advantage/PPO	$121,705.40
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$170,387.56
Rate for Payer: CareSource Just4Me Medicare	$164,302.29
Rate for Payer: Humana KY Medicaid	$115,620.13
Rate for Payer: Humana Medicare Advantage	$121,705.40
Rate for Payer: Kentucky WC Medicaid	$116,776.33
Rate for Payer: Molina Healthcare Benefit Exchange	$146,046.48
Rate for Payer: Molina Healthcare Medicaid	$117,932.53

MS-DRG 42.00: TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC

Facility

$9,648.07

Service Code	MSDRG 069
Min. Negotiated Rate	$6,546.91
Max. Negotiated Rate	$9,648.07
Rate for Payer: Anthem Medicaid	$6,546.91
Rate for Payer: Anthem Medicare Advantage/PPO	$6,891.48
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$9,648.07
Rate for Payer: CareSource Just4Me Medicare	$9,303.50
Rate for Payer: Humana KY Medicaid	$6,546.91
Rate for Payer: Humana Medicare Advantage	$6,891.48
Rate for Payer: Kentucky WC Medicaid	$6,612.38
Rate for Payer: Molina Healthcare Benefit Exchange	$8,269.78
Rate for Payer: Molina Healthcare Medicaid	$6,677.84

MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH CC

Facility

$18,660.64

Service Code	MSDRG 669
Min. Negotiated Rate	$12,662.58
Max. Negotiated Rate	$18,660.64
Rate for Payer: Anthem Medicaid	$12,662.58
Rate for Payer: Anthem Medicare Advantage/PPO	$13,329.03
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,660.64
Rate for Payer: CareSource Just4Me Medicare	$17,994.19
Rate for Payer: Humana KY Medicaid	$12,662.58
Rate for Payer: Humana Medicare Advantage	$13,329.03
Rate for Payer: Kentucky WC Medicaid	$12,789.20
Rate for Payer: Molina Healthcare Benefit Exchange	$15,994.84
Rate for Payer: Molina Healthcare Medicaid	$12,915.83

MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH MCC

Facility

$35,166.42

Service Code	MSDRG 668
Min. Negotiated Rate	$23,862.93
Max. Negotiated Rate	$35,166.42
Rate for Payer: Anthem Medicaid	$23,862.93
Rate for Payer: Anthem Medicare Advantage/PPO	$25,118.87
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$35,166.42
Rate for Payer: CareSource Just4Me Medicare	$33,910.47
Rate for Payer: Humana KY Medicaid	$23,862.93
Rate for Payer: Humana Medicare Advantage	$25,118.87
Rate for Payer: Kentucky WC Medicaid	$24,101.56
Rate for Payer: Molina Healthcare Benefit Exchange	$30,142.64
Rate for Payer: Molina Healthcare Medicaid	$24,340.19

MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITHOUT CC/MCC

Facility

$11,524.37

Service Code	MSDRG 670
Min. Negotiated Rate	$7,820.11
Max. Negotiated Rate	$11,524.37
Rate for Payer: Anthem Medicaid	$7,820.11
Rate for Payer: Anthem Medicare Advantage/PPO	$8,231.69
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,524.37
Rate for Payer: CareSource Just4Me Medicare	$11,112.78
Rate for Payer: Humana KY Medicaid	$7,820.11
Rate for Payer: Humana Medicare Advantage	$8,231.69
Rate for Payer: Kentucky WC Medicaid	$7,898.31
Rate for Payer: Molina Healthcare Benefit Exchange	$9,878.03
Rate for Payer: Molina Healthcare Medicaid	$7,976.51

MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITH CC/MCC

Facility

$17,436.69

Service Code	MSDRG 713
Min. Negotiated Rate	$11,832.04
Max. Negotiated Rate	$17,436.69
Rate for Payer: Anthem Medicaid	$11,832.04
Rate for Payer: Anthem Medicare Advantage/PPO	$12,454.78
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$17,436.69
Rate for Payer: CareSource Just4Me Medicare	$16,813.95
Rate for Payer: Humana KY Medicaid	$11,832.04
Rate for Payer: Humana Medicare Advantage	$12,454.78
Rate for Payer: Kentucky WC Medicaid	$11,950.36
Rate for Payer: Molina Healthcare Benefit Exchange	$14,945.74
Rate for Payer: Molina Healthcare Medicaid	$12,068.68

MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC

Facility

$11,331.43

Service Code	MSDRG 714
Min. Negotiated Rate	$7,689.19
Max. Negotiated Rate	$11,331.43
Rate for Payer: Anthem Medicaid	$7,689.19
Rate for Payer: Anthem Medicare Advantage/PPO	$8,093.88
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,331.43
Rate for Payer: CareSource Just4Me Medicare	$10,926.74
Rate for Payer: Humana KY Medicaid	$7,689.19
Rate for Payer: Humana Medicare Advantage	$8,093.88
Rate for Payer: Kentucky WC Medicaid	$7,766.08
Rate for Payer: Molina Healthcare Benefit Exchange	$9,712.66
Rate for Payer: Molina Healthcare Medicaid	$7,842.97

MS-DRG 42.00: TRAUMATIC INJURY WITH MCC

Facility

$19,514.39

Service Code	MSDRG 913
Min. Negotiated Rate	$13,241.91
Max. Negotiated Rate	$19,514.39
Rate for Payer: Anthem Medicaid	$13,241.91
Rate for Payer: Anthem Medicare Advantage/PPO	$13,938.85
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,514.39
Rate for Payer: CareSource Just4Me Medicare	$18,817.45
Rate for Payer: Humana KY Medicaid	$13,241.91
Rate for Payer: Humana Medicare Advantage	$13,938.85
Rate for Payer: Kentucky WC Medicaid	$13,374.33
Rate for Payer: Molina Healthcare Benefit Exchange	$16,726.62
Rate for Payer: Molina Healthcare Medicaid	$13,506.75

MS-DRG 42.00: TRAUMATIC INJURY WITHOUT MCC

Facility

$11,050.48

Service Code	MSDRG 914
Min. Negotiated Rate	$7,498.54
Max. Negotiated Rate	$11,050.48
Rate for Payer: Anthem Medicaid	$7,498.54
Rate for Payer: Anthem Medicare Advantage/PPO	$7,893.20
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,050.48
Rate for Payer: CareSource Just4Me Medicare	$10,655.82
Rate for Payer: Humana KY Medicaid	$7,498.54
Rate for Payer: Humana Medicare Advantage	$7,893.20
Rate for Payer: Kentucky WC Medicaid	$7,573.53
Rate for Payer: Molina Healthcare Benefit Exchange	$9,471.84
Rate for Payer: Molina Healthcare Medicaid	$7,648.51

MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC

Facility

$15,816.01

Service Code	MSDRG 086
Min. Negotiated Rate	$10,732.29
Max. Negotiated Rate	$15,816.01
Rate for Payer: Anthem Medicaid	$10,732.29
Rate for Payer: Anthem Medicare Advantage/PPO	$11,297.15
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,816.01
Rate for Payer: CareSource Just4Me Medicare	$15,251.15
Rate for Payer: Humana KY Medicaid	$10,732.29
Rate for Payer: Humana Medicare Advantage	$11,297.15
Rate for Payer: Kentucky WC Medicaid	$10,839.62
Rate for Payer: Molina Healthcare Benefit Exchange	$13,556.58
Rate for Payer: Molina Healthcare Medicaid	$10,946.94

MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC

Facility

$16,766.22

Service Code	MSDRG 083
Min. Negotiated Rate	$11,377.08
Max. Negotiated Rate	$16,766.22
Rate for Payer: Anthem Medicaid	$11,377.08
Rate for Payer: Anthem Medicare Advantage/PPO	$11,975.87
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$16,766.22
Rate for Payer: CareSource Just4Me Medicare	$16,167.42
Rate for Payer: Humana KY Medicaid	$11,377.08
Rate for Payer: Humana Medicare Advantage	$11,975.87
Rate for Payer: Kentucky WC Medicaid	$11,490.85
Rate for Payer: Molina Healthcare Benefit Exchange	$14,371.04
Rate for Payer: Molina Healthcare Medicaid	$11,604.62

MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC

Facility

$27,324.72

Service Code	MSDRG 085
Min. Negotiated Rate	$18,541.78
Max. Negotiated Rate	$27,324.72
Rate for Payer: Anthem Medicaid	$18,541.78
Rate for Payer: Anthem Medicare Advantage/PPO	$19,517.66
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$27,324.72
Rate for Payer: CareSource Just4Me Medicare	$26,348.84
Rate for Payer: Humana KY Medicaid	$18,541.78
Rate for Payer: Humana Medicare Advantage	$19,517.66
Rate for Payer: Kentucky WC Medicaid	$18,727.19
Rate for Payer: Molina Healthcare Benefit Exchange	$23,421.19
Rate for Payer: Molina Healthcare Medicaid	$18,912.61

MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC

Facility

$27,978.29

Service Code	MSDRG 082
Min. Negotiated Rate	$18,985.27
Max. Negotiated Rate	$27,978.29
Rate for Payer: Anthem Medicaid	$18,985.27
Rate for Payer: Anthem Medicare Advantage/PPO	$19,984.49
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$27,978.29
Rate for Payer: CareSource Just4Me Medicare	$26,979.06
Rate for Payer: Humana KY Medicaid	$18,985.27
Rate for Payer: Humana Medicare Advantage	$19,984.49
Rate for Payer: Kentucky WC Medicaid	$19,175.12
Rate for Payer: Molina Healthcare Benefit Exchange	$23,981.39
Rate for Payer: Molina Healthcare Medicaid	$19,364.97

MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC

Facility

$10,659.77

Service Code	MSDRG 087
Min. Negotiated Rate	$7,233.41
Max. Negotiated Rate	$10,659.77
Rate for Payer: Anthem Medicaid	$7,233.41
Rate for Payer: Anthem Medicare Advantage/PPO	$7,614.12
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$10,659.77
Rate for Payer: CareSource Just4Me Medicare	$10,279.06
Rate for Payer: Humana KY Medicaid	$7,233.41
Rate for Payer: Humana Medicare Advantage	$7,614.12
Rate for Payer: Kentucky WC Medicaid	$7,305.75
Rate for Payer: Molina Healthcare Benefit Exchange	$9,136.94
Rate for Payer: Molina Healthcare Medicaid	$7,378.08

Know your out-of-pocket cost for care.

All Charges