Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$11,627.54

Service Code	APR-DRG 6252
Min. Negotiated Rate	$11,627.54
Max. Negotiated Rate	$11,627.54
Rate for Payer: Aetna CHP/Medicaid	$11,627.54
Rate for Payer: Humana OH Medicaid	$11,627.54

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$14,745.53

Service Code	APR-DRG 6222
Min. Negotiated Rate	$14,745.53
Max. Negotiated Rate	$14,745.53
Rate for Payer: Aetna CHP/Medicaid	$14,745.53
Rate for Payer: Humana OH Medicaid	$14,745.53

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$31,374.86

Service Code	APR-DRG 6224
Min. Negotiated Rate	$31,374.86
Max. Negotiated Rate	$31,374.86
Rate for Payer: Aetna CHP/Medicaid	$31,374.86
Rate for Payer: Humana OH Medicaid	$31,374.86

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$21,046.49

Service Code	APR-DRG 6223
Min. Negotiated Rate	$21,046.49
Max. Negotiated Rate	$21,046.49
Rate for Payer: Aetna CHP/Medicaid	$21,046.49
Rate for Payer: Humana OH Medicaid	$21,046.49

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$10,198.45

Service Code	APR-DRG 6221
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: NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$2,403.46

Service Code	APR-DRG 6403
Min. Negotiated Rate	$2,403.46
Max. Negotiated Rate	$2,403.46
Rate for Payer: Aetna CHP/Medicaid	$2,403.46
Rate for Payer: Humana OH Medicaid	$2,403.46

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$13,381.41

Service Code	APR-DRG 6404
Min. Negotiated Rate	$13,381.41
Max. Negotiated Rate	$13,381.41
Rate for Payer: Aetna CHP/Medicaid	$13,381.41
Rate for Payer: Humana OH Medicaid	$13,381.41

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$1,104.29

Service Code	APR-DRG 6402
Min. Negotiated Rate	$1,104.29
Max. Negotiated Rate	$1,104.29
Rate for Payer: Aetna CHP/Medicaid	$1,104.29
Rate for Payer: Humana OH Medicaid	$1,104.29

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$714.54

Service Code	APR-DRG 6401
Min. Negotiated Rate	$714.54
Max. Negotiated Rate	$714.54
Rate for Payer: Aetna CHP/Medicaid	$714.54
Rate for Payer: Humana OH Medicaid	$714.54

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$17,148.99

Service Code	APR-DRG 6363
Min. Negotiated Rate	$17,148.99
Max. Negotiated Rate	$17,148.99
Rate for Payer: Aetna CHP/Medicaid	$17,148.99
Rate for Payer: Humana OH Medicaid	$17,148.99

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$5,066.75

Service Code	APR-DRG 6361
Min. Negotiated Rate	$5,066.75
Max. Negotiated Rate	$5,066.75
Rate for Payer: Aetna CHP/Medicaid	$5,066.75
Rate for Payer: Humana OH Medicaid	$5,066.75

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$8,249.70

Service Code	APR-DRG 6362
Min. Negotiated Rate	$8,249.70
Max. Negotiated Rate	$8,249.70
Rate for Payer: Aetna CHP/Medicaid	$8,249.70
Rate for Payer: Humana OH Medicaid	$8,249.70

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$17,148.99

Service Code	APR-DRG 6364
Min. Negotiated Rate	$17,148.99
Max. Negotiated Rate	$17,148.99
Rate for Payer: Aetna CHP/Medicaid	$17,148.99
Rate for Payer: Humana OH Medicaid	$17,148.99

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$18,318.24

Service Code	APR-DRG 6333
Min. Negotiated Rate	$18,318.24
Max. Negotiated Rate	$18,318.24
Rate for Payer: Aetna CHP/Medicaid	$18,318.24
Rate for Payer: Humana OH Medicaid	$18,318.24

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$1,623.96

Service Code	APR-DRG 6331
Min. Negotiated Rate	$1,623.96
Max. Negotiated Rate	$1,623.96
Rate for Payer: Aetna CHP/Medicaid	$1,623.96
Rate for Payer: Humana OH Medicaid	$1,623.96

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$7,080.45

Service Code	APR-DRG 6332
Min. Negotiated Rate	$7,080.45
Max. Negotiated Rate	$7,080.45
Rate for Payer: Aetna CHP/Medicaid	$7,080.45
Rate for Payer: Humana OH Medicaid	$7,080.45

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$48,264.02

Service Code	APR-DRG 6334
Min. Negotiated Rate	$48,264.02
Max. Negotiated Rate	$48,264.02
Rate for Payer: Aetna CHP/Medicaid	$48,264.02
Rate for Payer: Humana OH Medicaid	$48,264.02

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$73,662.71

Service Code	APR-DRG 6303
Min. Negotiated Rate	$73,662.71
Max. Negotiated Rate	$73,662.71
Rate for Payer: Aetna CHP/Medicaid	$73,662.71
Rate for Payer: Humana OH Medicaid	$73,662.71

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$33,583.44

Service Code	APR-DRG 6302
Min. Negotiated Rate	$33,583.44
Max. Negotiated Rate	$33,583.44
Rate for Payer: Aetna CHP/Medicaid	$33,583.44
Rate for Payer: Humana OH Medicaid	$33,583.44

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$17,408.82

Service Code	APR-DRG 6301
Min. Negotiated Rate	$17,408.82
Max. Negotiated Rate	$17,408.82
Rate for Payer: Aetna CHP/Medicaid	$17,408.82
Rate for Payer: Humana OH Medicaid	$17,408.82

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$133,619.22

Service Code	APR-DRG 6304
Min. Negotiated Rate	$133,619.22
Max. Negotiated Rate	$133,619.22
Rate for Payer: Aetna CHP/Medicaid	$133,619.22
Rate for Payer: Humana OH Medicaid	$133,619.22

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$147,325.42

Service Code	APR-DRG 6314
Min. Negotiated Rate	$147,325.42
Max. Negotiated Rate	$147,325.42
Rate for Payer: Aetna CHP/Medicaid	$147,325.42
Rate for Payer: Humana OH Medicaid	$147,325.42

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$24,943.99

Service Code	APR-DRG 6312
Min. Negotiated Rate	$24,943.99
Max. Negotiated Rate	$24,943.99
Rate for Payer: Aetna CHP/Medicaid	$24,943.99
Rate for Payer: Humana OH Medicaid	$24,943.99

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$43,327.19

Service Code	APR-DRG 6313
Min. Negotiated Rate	$43,327.19
Max. Negotiated Rate	$43,327.19
Rate for Payer: Aetna CHP/Medicaid	$43,327.19
Rate for Payer: Humana OH Medicaid	$43,327.19

APR-DRG 42.00: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$5,001.79

Service Code	APR-DRG 6311
Min. Negotiated Rate	$5,001.79
Max. Negotiated Rate	$5,001.79
Rate for Payer: Aetna CHP/Medicaid	$5,001.79
Rate for Payer: Humana OH Medicaid	$5,001.79

Know your out-of-pocket cost for care.

All Charges