Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 42.00: MASTECTOMY PROCEDURES

Facility

$19,942.20

Service Code	APR-DRG 3624
Min. Negotiated Rate	$19,942.20
Max. Negotiated Rate	$19,942.20
Rate for Payer: Aetna CHP/Medicaid	$19,942.20
Rate for Payer: Humana OH Medicaid	$19,942.20

APR-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$3,377.83

Service Code	APR-DRG 5321
Min. Negotiated Rate	$3,377.83
Max. Negotiated Rate	$3,377.83
Rate for Payer: Aetna CHP/Medicaid	$3,377.83
Rate for Payer: Humana OH Medicaid	$3,377.83

APR-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$4,482.12

Service Code	APR-DRG 5322
Min. Negotiated Rate	$4,482.12
Max. Negotiated Rate	$4,482.12
Rate for Payer: Aetna CHP/Medicaid	$4,482.12
Rate for Payer: Humana OH Medicaid	$4,482.12

APR-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$6,300.96

Service Code	APR-DRG 5323
Min. Negotiated Rate	$6,300.96
Max. Negotiated Rate	$6,300.96
Rate for Payer: Aetna CHP/Medicaid	$6,300.96
Rate for Payer: Humana OH Medicaid	$6,300.96

APR-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$10,198.45

Service Code	APR-DRG 5324
Min. Negotiated Rate	$10,198.45
Max. Negotiated Rate	$10,198.45
Rate for Payer: Aetna CHP/Medicaid	$10,198.45
Rate for Payer: Humana OH Medicaid	$10,198.45

APR-DRG 42.00: MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$5,716.33

Service Code	APR-DRG 7401
Min. Negotiated Rate	$5,716.33
Max. Negotiated Rate	$5,716.33
Rate for Payer: Aetna CHP/Medicaid	$5,716.33
Rate for Payer: Humana OH Medicaid	$5,716.33

APR-DRG 42.00: MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$36,376.65

Service Code	APR-DRG 7404
Min. Negotiated Rate	$36,376.65
Max. Negotiated Rate	$36,376.65
Rate for Payer: Aetna CHP/Medicaid	$36,376.65
Rate for Payer: Humana OH Medicaid	$36,376.65

APR-DRG 42.00: MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$16,759.24

Service Code	APR-DRG 7403
Min. Negotiated Rate	$16,759.24
Max. Negotiated Rate	$16,759.24
Rate for Payer: Aetna CHP/Medicaid	$16,759.24
Rate for Payer: Humana OH Medicaid	$16,759.24

APR-DRG 42.00: MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$9,548.87

Service Code	APR-DRG 7402
Min. Negotiated Rate	$9,548.87
Max. Negotiated Rate	$9,548.87
Rate for Payer: Aetna CHP/Medicaid	$9,548.87
Rate for Payer: Humana OH Medicaid	$9,548.87

APR-DRG 42.00: MIGRAINE AND OTHER HEADACHES

Facility

$5,521.46

Service Code	APR-DRG 0542
Min. Negotiated Rate	$5,521.46
Max. Negotiated Rate	$5,521.46
Rate for Payer: Aetna CHP/Medicaid	$5,521.46
Rate for Payer: Humana OH Medicaid	$5,521.46

APR-DRG 42.00: MIGRAINE AND OTHER HEADACHES

Facility

$7,015.50

Service Code	APR-DRG 0543
Min. Negotiated Rate	$7,015.50
Max. Negotiated Rate	$7,015.50
Rate for Payer: Aetna CHP/Medicaid	$7,015.50
Rate for Payer: Humana OH Medicaid	$7,015.50

APR-DRG 42.00: MIGRAINE AND OTHER HEADACHES

Facility

$10,263.41

Service Code	APR-DRG 0544
Min. Negotiated Rate	$10,263.41
Max. Negotiated Rate	$10,263.41
Rate for Payer: Aetna CHP/Medicaid	$10,263.41
Rate for Payer: Humana OH Medicaid	$10,263.41

APR-DRG 42.00: MIGRAINE AND OTHER HEADACHES

Facility

$4,612.04

Service Code	APR-DRG 0541
Min. Negotiated Rate	$4,612.04
Max. Negotiated Rate	$4,612.04
Rate for Payer: Aetna CHP/Medicaid	$4,612.04
Rate for Payer: Humana OH Medicaid	$4,612.04

APR-DRG 42.00: MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$7,405.25

Service Code	APR-DRG 7931
Min. Negotiated Rate	$7,405.25
Max. Negotiated Rate	$7,405.25
Rate for Payer: Aetna CHP/Medicaid	$7,405.25
Rate for Payer: Humana OH Medicaid	$7,405.25

APR-DRG 42.00: MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$24,554.24

Service Code	APR-DRG 7934
Min. Negotiated Rate	$24,554.24
Max. Negotiated Rate	$24,554.24
Rate for Payer: Aetna CHP/Medicaid	$24,554.24
Rate for Payer: Humana OH Medicaid	$24,554.24

APR-DRG 42.00: MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$9,873.66

Service Code	APR-DRG 7932
Min. Negotiated Rate	$9,873.66
Max. Negotiated Rate	$9,873.66
Rate for Payer: Aetna CHP/Medicaid	$9,873.66
Rate for Payer: Humana OH Medicaid	$9,873.66

APR-DRG 42.00: MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$14,095.95

Service Code	APR-DRG 7933
Min. Negotiated Rate	$14,095.95
Max. Negotiated Rate	$14,095.95
Rate for Payer: Aetna CHP/Medicaid	$14,095.95
Rate for Payer: Humana OH Medicaid	$14,095.95

APR-DRG 42.00: MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$16,434.45

Service Code	APR-DRG 9513
Min. Negotiated Rate	$16,434.45
Max. Negotiated Rate	$16,434.45
Rate for Payer: Aetna CHP/Medicaid	$16,434.45
Rate for Payer: Humana OH Medicaid	$16,434.45

APR-DRG 42.00: MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$11,172.83

Service Code	APR-DRG 9512
Min. Negotiated Rate	$11,172.83
Max. Negotiated Rate	$11,172.83
Rate for Payer: Aetna CHP/Medicaid	$11,172.83
Rate for Payer: Humana OH Medicaid	$11,172.83

APR-DRG 42.00: MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$7,730.04

Service Code	APR-DRG 9511
Min. Negotiated Rate	$7,730.04
Max. Negotiated Rate	$7,730.04
Rate for Payer: Aetna CHP/Medicaid	$7,730.04
Rate for Payer: Humana OH Medicaid	$7,730.04

APR-DRG 42.00: MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$27,217.53

Service Code	APR-DRG 9514
Min. Negotiated Rate	$27,217.53
Max. Negotiated Rate	$27,217.53
Rate for Payer: Aetna CHP/Medicaid	$27,217.53
Rate for Payer: Humana OH Medicaid	$27,217.53

APR-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$50,667.47

Service Code	APR-DRG 2994
Min. Negotiated Rate	$50,667.47
Max. Negotiated Rate	$50,667.47
Rate for Payer: Aetna CHP/Medicaid	$50,667.47
Rate for Payer: Humana OH Medicaid	$50,667.47

APR-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$29,166.28

Service Code	APR-DRG 2992
Min. Negotiated Rate	$29,166.28
Max. Negotiated Rate	$29,166.28
Rate for Payer: Aetna CHP/Medicaid	$29,166.28
Rate for Payer: Humana OH Medicaid	$29,166.28

APR-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$24,229.45

Service Code	APR-DRG 2991
Min. Negotiated Rate	$24,229.45
Max. Negotiated Rate	$24,229.45
Rate for Payer: Aetna CHP/Medicaid	$24,229.45
Rate for Payer: Humana OH Medicaid	$24,229.45

APR-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$39,624.56

Service Code	APR-DRG 2993
Min. Negotiated Rate	$39,624.56
Max. Negotiated Rate	$39,624.56
Rate for Payer: Aetna CHP/Medicaid	$39,624.56
Rate for Payer: Humana OH Medicaid	$39,624.56

Know your out-of-pocket cost for care.

All Charges