Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$20,396.91

Service Code	APR-DRG 6394
Min. Negotiated Rate	$20,396.91
Max. Negotiated Rate	$20,396.91
Rate for Payer: Aetna CHP/Medicaid	$20,396.91
Rate for Payer: Humana OH Medicaid	$20,396.91

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

Facility

$13,576.28

Service Code	APR-DRG 6393
Min. Negotiated Rate	$13,576.28
Max. Negotiated Rate	$13,576.28
Rate for Payer: Aetna CHP/Medicaid	$13,576.28
Rate for Payer: Humana OH Medicaid	$13,576.28

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

Facility

$4,612.04

Service Code	APR-DRG 6392
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: NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$2,403.46

Service Code	APR-DRG 6391
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 WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$7,665.08

Service Code	APR-DRG 6342
Min. Negotiated Rate	$7,665.08
Max. Negotiated Rate	$7,665.08
Rate for Payer: Aetna CHP/Medicaid	$7,665.08
Rate for Payer: Humana OH Medicaid	$7,665.08

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

Facility

$15,265.20

Service Code	APR-DRG 6343
Min. Negotiated Rate	$15,265.20
Max. Negotiated Rate	$15,265.20
Rate for Payer: Aetna CHP/Medicaid	$15,265.20
Rate for Payer: Humana OH Medicaid	$15,265.20

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

Facility

$4,677.00

Service Code	APR-DRG 6341
Min. Negotiated Rate	$4,677.00
Max. Negotiated Rate	$4,677.00
Rate for Payer: Aetna CHP/Medicaid	$4,677.00
Rate for Payer: Humana OH Medicaid	$4,677.00

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

Facility

$29,231.24

Service Code	APR-DRG 6344
Min. Negotiated Rate	$29,231.24
Max. Negotiated Rate	$29,231.24
Rate for Payer: Aetna CHP/Medicaid	$29,231.24
Rate for Payer: Humana OH Medicaid	$29,231.24

APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$108,740.19

Service Code	APR-DRG 5913
Min. Negotiated Rate	$108,740.19
Max. Negotiated Rate	$108,740.19
Rate for Payer: Aetna CHP/Medicaid	$108,740.19
Rate for Payer: Humana OH Medicaid	$108,740.19

APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$144,142.47

Service Code	APR-DRG 5914
Min. Negotiated Rate	$144,142.47
Max. Negotiated Rate	$144,142.47
Rate for Payer: Aetna CHP/Medicaid	$144,142.47
Rate for Payer: Humana OH Medicaid	$144,142.47

APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$93,280.12

Service Code	APR-DRG 5912
Min. Negotiated Rate	$93,280.12
Max. Negotiated Rate	$93,280.12
Rate for Payer: Aetna CHP/Medicaid	$93,280.12
Rate for Payer: Humana OH Medicaid	$93,280.12

APR-DRG 42.00: NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$19,812.28

Service Code	APR-DRG 5911
Min. Negotiated Rate	$19,812.28
Max. Negotiated Rate	$19,812.28
Rate for Payer: Aetna CHP/Medicaid	$19,812.28
Rate for Payer: Humana OH Medicaid	$19,812.28

APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility

$2,143.62

Service Code	APR-DRG 5894
Min. Negotiated Rate	$2,143.62
Max. Negotiated Rate	$2,143.62
Rate for Payer: Aetna CHP/Medicaid	$2,143.62
Rate for Payer: Humana OH Medicaid	$2,143.62

APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility

$102,504.20

Service Code	APR-DRG 5892
Min. Negotiated Rate	$102,504.20
Max. Negotiated Rate	$102,504.20
Rate for Payer: Aetna CHP/Medicaid	$102,504.20
Rate for Payer: Humana OH Medicaid	$102,504.20

APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility

$102,504.20

Service Code	APR-DRG 5891
Min. Negotiated Rate	$102,504.20
Max. Negotiated Rate	$102,504.20
Rate for Payer: Aetna CHP/Medicaid	$102,504.20
Rate for Payer: Humana OH Medicaid	$102,504.20

APR-DRG 42.00: NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility

$102,504.20

Service Code	APR-DRG 5893
Min. Negotiated Rate	$102,504.20
Max. Negotiated Rate	$102,504.20
Rate for Payer: Aetna CHP/Medicaid	$102,504.20
Rate for Payer: Humana OH Medicaid	$102,504.20

APR-DRG 42.00: NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$56,773.55

Service Code	APR-DRG 5931
Min. Negotiated Rate	$56,773.55
Max. Negotiated Rate	$56,773.55
Rate for Payer: Aetna CHP/Medicaid	$56,773.55
Rate for Payer: Humana OH Medicaid	$56,773.55

APR-DRG 42.00: NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$92,695.49

Service Code	APR-DRG 5933
Min. Negotiated Rate	$92,695.49
Max. Negotiated Rate	$92,695.49
Rate for Payer: Aetna CHP/Medicaid	$92,695.49
Rate for Payer: Humana OH Medicaid	$92,695.49

APR-DRG 42.00: NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$74,572.13

Service Code	APR-DRG 5932
Min. Negotiated Rate	$74,572.13
Max. Negotiated Rate	$74,572.13
Rate for Payer: Aetna CHP/Medicaid	$74,572.13
Rate for Payer: Humana OH Medicaid	$74,572.13

APR-DRG 42.00: NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$126,733.64

Service Code	APR-DRG 5934
Min. Negotiated Rate	$126,733.64
Max. Negotiated Rate	$126,733.64
Rate for Payer: Aetna CHP/Medicaid	$126,733.64
Rate for Payer: Humana OH Medicaid	$126,733.64

APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$2,013.71

Service Code	APR-DRG 5813
Min. Negotiated Rate	$2,013.71
Max. Negotiated Rate	$2,013.71
Rate for Payer: Aetna CHP/Medicaid	$2,013.71
Rate for Payer: Humana OH Medicaid	$2,013.71

APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$3,637.66

Service Code	APR-DRG 5814
Min. Negotiated Rate	$3,637.66
Max. Negotiated Rate	$3,637.66
Rate for Payer: Aetna CHP/Medicaid	$3,637.66
Rate for Payer: Humana OH Medicaid	$3,637.66

APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$1,039.33

Service Code	APR-DRG 5812
Min. Negotiated Rate	$1,039.33
Max. Negotiated Rate	$1,039.33
Rate for Payer: Aetna CHP/Medicaid	$1,039.33
Rate for Payer: Humana OH Medicaid	$1,039.33

APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$649.58

Service Code	APR-DRG 5811
Min. Negotiated Rate	$649.58
Max. Negotiated Rate	$649.58
Rate for Payer: Aetna CHP/Medicaid	$649.58
Rate for Payer: Humana OH Medicaid	$649.58

APR-DRG 42.00: NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$5,976.16

Service Code	APR-DRG 5803
Min. Negotiated Rate	$5,976.16
Max. Negotiated Rate	$5,976.16
Rate for Payer: Aetna CHP/Medicaid	$5,976.16
Rate for Payer: Humana OH Medicaid	$5,976.16

Know your out-of-pocket cost for care.

All Charges