Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC

Facility

$51,026.40

Service Code	MSDRG 319
Min. Negotiated Rate	$34,625.06
Max. Negotiated Rate	$51,026.40
Rate for Payer: Anthem Medicaid	$34,625.06
Rate for Payer: Anthem Medicare Advantage/PPO	$36,447.43
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$51,026.40
Rate for Payer: CareSource Just4Me Medicare	$49,204.03
Rate for Payer: Humana KY Medicaid	$34,625.06
Rate for Payer: Humana Medicare Advantage	$36,447.43
Rate for Payer: Kentucky WC Medicaid	$34,971.31
Rate for Payer: Molina Healthcare Benefit Exchange	$43,736.92
Rate for Payer: Molina Healthcare Medicaid	$35,317.56

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC

Facility

$26,040.22

Service Code	MSDRG 320
Min. Negotiated Rate	$17,670.15
Max. Negotiated Rate	$26,040.22
Rate for Payer: Anthem Medicaid	$17,670.15
Rate for Payer: Anthem Medicare Advantage/PPO	$18,600.16
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$26,040.22
Rate for Payer: CareSource Just4Me Medicare	$25,110.22
Rate for Payer: Humana KY Medicaid	$17,670.15
Rate for Payer: Humana Medicare Advantage	$18,600.16
Rate for Payer: Kentucky WC Medicaid	$17,846.85
Rate for Payer: Molina Healthcare Benefit Exchange	$22,320.19
Rate for Payer: Molina Healthcare Medicaid	$18,023.56

OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$6,901.93

Service Code	MSDRG 951
Min. Negotiated Rate	$4,683.45
Max. Negotiated Rate	$6,901.93
Rate for Payer: Anthem Medicaid	$4,683.45
Rate for Payer: Anthem Medicare Advantage/PPO	$4,929.95
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$6,901.93
Rate for Payer: CareSource Just4Me Medicare	$6,655.43
Rate for Payer: Humana KY Medicaid	$4,683.45
Rate for Payer: Humana Medicare Advantage	$4,929.95
Rate for Payer: Kentucky WC Medicaid	$4,730.29
Rate for Payer: Molina Healthcare Benefit Exchange	$5,915.94
Rate for Payer: Molina Healthcare Medicaid	$4,777.12

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC

Facility

$29,446.72

Service Code	MSDRG 749
Min. Negotiated Rate	$19,981.70
Max. Negotiated Rate	$29,446.72
Rate for Payer: Anthem Medicaid	$19,981.70
Rate for Payer: Anthem Medicare Advantage/PPO	$21,033.37
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$29,446.72
Rate for Payer: CareSource Just4Me Medicare	$28,395.05
Rate for Payer: Humana KY Medicaid	$19,981.70
Rate for Payer: Humana Medicare Advantage	$21,033.37
Rate for Payer: Kentucky WC Medicaid	$20,181.52
Rate for Payer: Molina Healthcare Benefit Exchange	$25,240.04
Rate for Payer: Molina Healthcare Medicaid	$20,381.34

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$15,909.56

Service Code	MSDRG 750
Min. Negotiated Rate	$10,795.77
Max. Negotiated Rate	$15,909.56
Rate for Payer: Anthem Medicaid	$10,795.77
Rate for Payer: Anthem Medicare Advantage/PPO	$11,363.97
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$15,909.56
Rate for Payer: CareSource Just4Me Medicare	$15,341.36
Rate for Payer: Humana KY Medicaid	$10,795.77
Rate for Payer: Humana Medicare Advantage	$11,363.97
Rate for Payer: Kentucky WC Medicaid	$10,903.73
Rate for Payer: Molina Healthcare Benefit Exchange	$13,636.76
Rate for Payer: Molina Healthcare Medicaid	$11,011.69

OTHER HEART ASSIST SYSTEM IMPLANT

Facility

$119,494.83

Service Code	MSDRG 215
Min. Negotiated Rate	$81,085.78
Max. Negotiated Rate	$119,494.83
Rate for Payer: Anthem Medicaid	$81,085.78
Rate for Payer: Anthem Medicare Advantage/PPO	$85,353.45
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$119,494.83
Rate for Payer: CareSource Just4Me Medicare	$115,227.16
Rate for Payer: Humana KY Medicaid	$81,085.78
Rate for Payer: Humana Medicare Advantage	$85,353.45
Rate for Payer: Kentucky WC Medicaid	$81,896.64
Rate for Payer: Molina Healthcare Benefit Exchange	$102,424.14
Rate for Payer: Molina Healthcare Medicaid	$82,707.49

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC

Facility

$24,937.08

Service Code	MSDRG 424
Min. Negotiated Rate	$16,921.59
Max. Negotiated Rate	$24,937.08
Rate for Payer: Anthem Medicaid	$16,921.59
Rate for Payer: Anthem Medicare Advantage/PPO	$17,812.20
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$24,937.08
Rate for Payer: CareSource Just4Me Medicare	$24,046.47
Rate for Payer: Humana KY Medicaid	$16,921.59
Rate for Payer: Humana Medicare Advantage	$17,812.20
Rate for Payer: Kentucky WC Medicaid	$17,090.81
Rate for Payer: Molina Healthcare Benefit Exchange	$21,374.64
Rate for Payer: Molina Healthcare Medicaid	$17,260.02

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC

Facility

$45,750.52

Service Code	MSDRG 423
Min. Negotiated Rate	$31,044.99
Max. Negotiated Rate	$45,750.52
Rate for Payer: Anthem Medicaid	$31,044.99
Rate for Payer: Anthem Medicare Advantage/PPO	$32,678.94
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$45,750.52
Rate for Payer: CareSource Just4Me Medicare	$44,116.57
Rate for Payer: Humana KY Medicaid	$31,044.99
Rate for Payer: Humana Medicare Advantage	$32,678.94
Rate for Payer: Kentucky WC Medicaid	$31,355.44
Rate for Payer: Molina Healthcare Benefit Exchange	$39,214.73
Rate for Payer: Molina Healthcare Medicaid	$31,665.89

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC

Facility

$18,739.38

Service Code	MSDRG 425
Min. Negotiated Rate	$12,716.01
Max. Negotiated Rate	$18,739.38
Rate for Payer: Anthem Medicaid	$12,716.01
Rate for Payer: Anthem Medicare Advantage/PPO	$13,385.27
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,739.38
Rate for Payer: CareSource Just4Me Medicare	$18,070.11
Rate for Payer: Humana KY Medicaid	$12,716.01
Rate for Payer: Humana Medicare Advantage	$13,385.27
Rate for Payer: Kentucky WC Medicaid	$12,843.17
Rate for Payer: Molina Healthcare Benefit Exchange	$16,062.32
Rate for Payer: Molina Healthcare Medicaid	$12,970.33

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC

Facility

$12,698.39

Service Code	MSDRG 868
Min. Negotiated Rate	$8,616.77
Max. Negotiated Rate	$12,698.39
Rate for Payer: Anthem Medicaid	$8,616.77
Rate for Payer: Anthem Medicare Advantage/PPO	$9,070.28
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$12,698.39
Rate for Payer: CareSource Just4Me Medicare	$12,244.88
Rate for Payer: Humana KY Medicaid	$8,616.77
Rate for Payer: Humana Medicare Advantage	$9,070.28
Rate for Payer: Kentucky WC Medicaid	$8,702.93
Rate for Payer: Molina Healthcare Benefit Exchange	$10,884.34
Rate for Payer: Molina Healthcare Medicaid	$8,789.10

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC

Facility

$24,476.14

Service Code	MSDRG 867
Min. Negotiated Rate	$16,608.81
Max. Negotiated Rate	$24,476.14
Rate for Payer: Anthem Medicaid	$16,608.81
Rate for Payer: Anthem Medicare Advantage/PPO	$17,482.96
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$24,476.14
Rate for Payer: CareSource Just4Me Medicare	$23,602.00
Rate for Payer: Humana KY Medicaid	$16,608.81
Rate for Payer: Humana Medicare Advantage	$17,482.96
Rate for Payer: Kentucky WC Medicaid	$16,774.90
Rate for Payer: Molina Healthcare Benefit Exchange	$20,979.55
Rate for Payer: Molina Healthcare Medicaid	$16,940.99

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Facility

$8,079.95

Service Code	MSDRG 869
Min. Negotiated Rate	$5,482.82
Max. Negotiated Rate	$8,079.95
Rate for Payer: Anthem Medicaid	$5,482.82
Rate for Payer: Anthem Medicare Advantage/PPO	$5,771.39
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,079.95
Rate for Payer: CareSource Just4Me Medicare	$7,791.38
Rate for Payer: Humana KY Medicaid	$5,482.82
Rate for Payer: Humana Medicare Advantage	$5,771.39
Rate for Payer: Kentucky WC Medicaid	$5,537.65
Rate for Payer: Molina Healthcare Benefit Exchange	$6,925.67
Rate for Payer: Molina Healthcare Medicaid	$5,592.48

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility

$20,412.20

Service Code	MSDRG 922
Min. Negotiated Rate	$13,851.13
Max. Negotiated Rate	$20,412.20
Rate for Payer: Anthem Medicaid	$13,851.13
Rate for Payer: Anthem Medicare Advantage/PPO	$14,580.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$20,412.20
Rate for Payer: CareSource Just4Me Medicare	$19,683.19
Rate for Payer: Humana KY Medicaid	$13,851.13
Rate for Payer: Humana Medicare Advantage	$14,580.14
Rate for Payer: Kentucky WC Medicaid	$13,989.64
Rate for Payer: Molina Healthcare Benefit Exchange	$17,496.17
Rate for Payer: Molina Healthcare Medicaid	$14,128.16

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility

$11,831.55

Service Code	MSDRG 923
Min. Negotiated Rate	$8,028.55
Max. Negotiated Rate	$11,831.55
Rate for Payer: Anthem Medicaid	$8,028.55
Rate for Payer: Anthem Medicare Advantage/PPO	$8,451.11
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,831.55
Rate for Payer: CareSource Just4Me Medicare	$11,409.00
Rate for Payer: Humana KY Medicaid	$8,028.55
Rate for Payer: Humana Medicare Advantage	$8,451.11
Rate for Payer: Kentucky WC Medicaid	$8,108.84
Rate for Payer: Molina Healthcare Benefit Exchange	$10,141.33
Rate for Payer: Molina Healthcare Medicaid	$8,189.13

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

Facility

$11,941.52

Service Code	MSDRG 699
Min. Negotiated Rate	$8,103.18
Max. Negotiated Rate	$11,941.52
Rate for Payer: Anthem Medicaid	$8,103.18
Rate for Payer: Anthem Medicare Advantage/PPO	$8,529.66
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,941.52
Rate for Payer: CareSource Just4Me Medicare	$11,515.04
Rate for Payer: Humana KY Medicaid	$8,103.18
Rate for Payer: Humana Medicare Advantage	$8,529.66
Rate for Payer: Kentucky WC Medicaid	$8,184.21
Rate for Payer: Molina Healthcare Benefit Exchange	$10,235.59
Rate for Payer: Molina Healthcare Medicaid	$8,265.24

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

Facility

$19,353.53

Service Code	MSDRG 698
Min. Negotiated Rate	$13,132.75
Max. Negotiated Rate	$19,353.53
Rate for Payer: Anthem Medicaid	$13,132.75
Rate for Payer: Anthem Medicare Advantage/PPO	$13,823.95
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$19,353.53
Rate for Payer: CareSource Just4Me Medicare	$18,662.33
Rate for Payer: Humana KY Medicaid	$13,132.75
Rate for Payer: Humana Medicare Advantage	$13,823.95
Rate for Payer: Kentucky WC Medicaid	$13,264.08
Rate for Payer: Molina Healthcare Benefit Exchange	$16,588.74
Rate for Payer: Molina Healthcare Medicaid	$13,395.41

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC

Facility

$8,285.86

Service Code	MSDRG 700
Min. Negotiated Rate	$5,622.55
Max. Negotiated Rate	$8,285.86
Rate for Payer: Anthem Medicaid	$5,622.55
Rate for Payer: Anthem Medicare Advantage/PPO	$5,918.47
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$8,285.86
Rate for Payer: CareSource Just4Me Medicare	$7,989.93
Rate for Payer: Humana KY Medicaid	$5,622.55
Rate for Payer: Humana Medicare Advantage	$5,918.47
Rate for Payer: Kentucky WC Medicaid	$5,678.77
Rate for Payer: Molina Healthcare Benefit Exchange	$7,102.16
Rate for Payer: Molina Healthcare Medicaid	$5,735.00

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC

Facility

$27,867.45

Service Code	MSDRG 674
Min. Negotiated Rate	$18,910.05
Max. Negotiated Rate	$27,867.45
Rate for Payer: Anthem Medicaid	$18,910.05
Rate for Payer: Anthem Medicare Advantage/PPO	$19,905.32
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$27,867.45
Rate for Payer: CareSource Just4Me Medicare	$26,872.18
Rate for Payer: Humana KY Medicaid	$18,910.05
Rate for Payer: Humana Medicare Advantage	$19,905.32
Rate for Payer: Kentucky WC Medicaid	$19,099.15
Rate for Payer: Molina Healthcare Benefit Exchange	$23,886.38
Rate for Payer: Molina Healthcare Medicaid	$19,288.26

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC

Facility

$43,259.96

Service Code	MSDRG 673
Min. Negotiated Rate	$29,354.97
Max. Negotiated Rate	$43,259.96
Rate for Payer: Anthem Medicaid	$29,354.97
Rate for Payer: Anthem Medicare Advantage/PPO	$30,899.97
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$43,259.96
Rate for Payer: CareSource Just4Me Medicare	$41,714.96
Rate for Payer: Humana KY Medicaid	$29,354.97
Rate for Payer: Humana Medicare Advantage	$30,899.97
Rate for Payer: Kentucky WC Medicaid	$29,648.52
Rate for Payer: Molina Healthcare Benefit Exchange	$37,079.96
Rate for Payer: Molina Healthcare Medicaid	$29,942.07

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC

Facility

$18,559.24

Service Code	MSDRG 675
Min. Negotiated Rate	$12,593.77
Max. Negotiated Rate	$18,559.24
Rate for Payer: Anthem Medicaid	$12,593.77
Rate for Payer: Anthem Medicare Advantage/PPO	$13,256.60
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$18,559.24
Rate for Payer: CareSource Just4Me Medicare	$17,896.41
Rate for Payer: Humana KY Medicaid	$12,593.77
Rate for Payer: Humana Medicare Advantage	$13,256.60
Rate for Payer: Kentucky WC Medicaid	$12,719.71
Rate for Payer: Molina Healthcare Benefit Exchange	$15,907.92
Rate for Payer: Molina Healthcare Medicaid	$12,845.65

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility

$40,431.33

Service Code	MSDRG 271
Min. Negotiated Rate	$27,435.54
Max. Negotiated Rate	$40,431.33
Rate for Payer: Anthem Medicaid	$27,435.54
Rate for Payer: Anthem Medicare Advantage/PPO	$28,879.52
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$40,431.33
Rate for Payer: CareSource Just4Me Medicare	$38,987.35
Rate for Payer: Humana KY Medicaid	$27,435.54
Rate for Payer: Humana Medicare Advantage	$28,879.52
Rate for Payer: Kentucky WC Medicaid	$27,709.90
Rate for Payer: Molina Healthcare Benefit Exchange	$34,655.42
Rate for Payer: Molina Healthcare Medicaid	$27,984.25

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC

Facility

$59,156.65

Service Code	MSDRG 270
Min. Negotiated Rate	$40,142.01
Max. Negotiated Rate	$59,156.65
Rate for Payer: Anthem Medicaid	$40,142.01
Rate for Payer: Anthem Medicare Advantage/PPO	$42,254.75
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$59,156.65
Rate for Payer: CareSource Just4Me Medicare	$57,043.91
Rate for Payer: Humana KY Medicaid	$40,142.01
Rate for Payer: Humana Medicare Advantage	$42,254.75
Rate for Payer: Kentucky WC Medicaid	$40,543.43
Rate for Payer: Molina Healthcare Benefit Exchange	$50,705.70
Rate for Payer: Molina Healthcare Medicaid	$40,944.85

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$28,537.80

Service Code	MSDRG 272
Min. Negotiated Rate	$19,364.93
Max. Negotiated Rate	$28,537.80
Rate for Payer: Anthem Medicaid	$19,364.93
Rate for Payer: Anthem Medicare Advantage/PPO	$20,384.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$28,537.80
Rate for Payer: CareSource Just4Me Medicare	$27,518.59
Rate for Payer: Humana KY Medicaid	$19,364.93
Rate for Payer: Humana Medicare Advantage	$20,384.14
Rate for Payer: Kentucky WC Medicaid	$19,558.58
Rate for Payer: Molina Healthcare Benefit Exchange	$24,460.97
Rate for Payer: Molina Healthcare Medicaid	$19,752.23

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility

$11,743.82

Service Code	MSDRG 729
Min. Negotiated Rate	$7,969.02
Max. Negotiated Rate	$11,743.82
Rate for Payer: Anthem Medicaid	$7,969.02
Rate for Payer: Anthem Medicare Advantage/PPO	$8,388.44
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$11,743.82
Rate for Payer: CareSource Just4Me Medicare	$11,324.39
Rate for Payer: Humana KY Medicaid	$7,969.02
Rate for Payer: Humana Medicare Advantage	$8,388.44
Rate for Payer: Kentucky WC Medicaid	$8,048.71
Rate for Payer: Molina Healthcare Benefit Exchange	$10,066.13
Rate for Payer: Molina Healthcare Medicaid	$8,128.40

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$7,271.61

Service Code	MSDRG 730
Min. Negotiated Rate	$4,934.31
Max. Negotiated Rate	$7,271.61
Rate for Payer: Anthem Medicaid	$4,934.31
Rate for Payer: Anthem Medicare Advantage/PPO	$5,194.01
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage	$7,271.61
Rate for Payer: CareSource Just4Me Medicare	$7,011.91
Rate for Payer: Humana KY Medicaid	$4,934.31
Rate for Payer: Humana Medicare Advantage	$5,194.01
Rate for Payer: Kentucky WC Medicaid	$4,983.65
Rate for Payer: Molina Healthcare Benefit Exchange	$6,232.81
Rate for Payer: Molina Healthcare Medicaid	$5,033.00

Know your out-of-pocket cost for care.

All Charges