Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$27,022.65

Service Code	APR-DRG 3003
Min. Negotiated Rate	$27,022.65
Max. Negotiated Rate	$27,022.65
Rate for Payer: Aetna CHP/Medicaid	$27,022.65
Rate for Payer: Humana OH Medicaid	$27,022.65

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

Facility

$38,650.19

Service Code	APR-DRG 3004
Min. Negotiated Rate	$38,650.19
Max. Negotiated Rate	$38,650.19
Rate for Payer: Aetna CHP/Medicaid	$38,650.19
Rate for Payer: Humana OH Medicaid	$38,650.19

APR-DRG 42.00: SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES

Facility

$10,003.58

Service Code	APR-DRG 3121
Min. Negotiated Rate	$10,003.58
Max. Negotiated Rate	$10,003.58
Rate for Payer: Aetna CHP/Medicaid	$10,003.58
Rate for Payer: Humana OH Medicaid	$10,003.58

APR-DRG 42.00: SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES

Facility

$14,355.78

Service Code	APR-DRG 3122
Min. Negotiated Rate	$14,355.78
Max. Negotiated Rate	$14,355.78
Rate for Payer: Aetna CHP/Medicaid	$14,355.78
Rate for Payer: Humana OH Medicaid	$14,355.78

APR-DRG 42.00: SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES

Facility

$35,856.98

Service Code	APR-DRG 3124
Min. Negotiated Rate	$35,856.98
Max. Negotiated Rate	$35,856.98
Rate for Payer: Aetna CHP/Medicaid	$35,856.98
Rate for Payer: Humana OH Medicaid	$35,856.98

APR-DRG 42.00: SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES

Facility

$22,020.86

Service Code	APR-DRG 3123
Min. Negotiated Rate	$22,020.86
Max. Negotiated Rate	$22,020.86
Rate for Payer: Aetna CHP/Medicaid	$22,020.86
Rate for Payer: Humana OH Medicaid	$22,020.86

APR-DRG 42.00: SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$34,882.61

Service Code	APR-DRG 3614
Min. Negotiated Rate	$34,882.61
Max. Negotiated Rate	$34,882.61
Rate for Payer: Aetna CHP/Medicaid	$34,882.61
Rate for Payer: Humana OH Medicaid	$34,882.61

APR-DRG 42.00: SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$10,718.12

Service Code	APR-DRG 3611
Min. Negotiated Rate	$10,718.12
Max. Negotiated Rate	$10,718.12
Rate for Payer: Aetna CHP/Medicaid	$10,718.12
Rate for Payer: Humana OH Medicaid	$10,718.12

APR-DRG 42.00: SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$14,225.87

Service Code	APR-DRG 3612
Min. Negotiated Rate	$14,225.87
Max. Negotiated Rate	$14,225.87
Rate for Payer: Aetna CHP/Medicaid	$14,225.87
Rate for Payer: Humana OH Medicaid	$14,225.87

APR-DRG 42.00: SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$19,617.41

Service Code	APR-DRG 3613
Min. Negotiated Rate	$19,617.41
Max. Negotiated Rate	$19,617.41
Rate for Payer: Aetna CHP/Medicaid	$19,617.41
Rate for Payer: Humana OH Medicaid	$19,617.41

APR-DRG 42.00: SKIN ULCERS

Facility

$12,991.66

Service Code	APR-DRG 3804
Min. Negotiated Rate	$12,991.66
Max. Negotiated Rate	$12,991.66
Rate for Payer: Aetna CHP/Medicaid	$12,991.66
Rate for Payer: Humana OH Medicaid	$12,991.66

APR-DRG 42.00: SKIN ULCERS

Facility

$4,871.87

Service Code	APR-DRG 3802
Min. Negotiated Rate	$4,871.87
Max. Negotiated Rate	$4,871.87
Rate for Payer: Aetna CHP/Medicaid	$4,871.87
Rate for Payer: Humana OH Medicaid	$4,871.87

APR-DRG 42.00: SKIN ULCERS

Facility

$3,767.58

Service Code	APR-DRG 3801
Min. Negotiated Rate	$3,767.58
Max. Negotiated Rate	$3,767.58
Rate for Payer: Aetna CHP/Medicaid	$3,767.58
Rate for Payer: Humana OH Medicaid	$3,767.58

APR-DRG 42.00: SKIN ULCERS

Facility

$7,470.20

Service Code	APR-DRG 3803
Min. Negotiated Rate	$7,470.20
Max. Negotiated Rate	$7,470.20
Rate for Payer: Aetna CHP/Medicaid	$7,470.20
Rate for Payer: Humana OH Medicaid	$7,470.20

APR-DRG 42.00: SPINAL DISORDERS AND INJURIES

Facility

$18,513.12

Service Code	APR-DRG 0404
Min. Negotiated Rate	$18,513.12
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna CHP/Medicaid	$18,513.12
Rate for Payer: Humana OH Medicaid	$18,513.12

APR-DRG 42.00: SPINAL DISORDERS AND INJURIES

Facility

$13,186.53

Service Code	APR-DRG 0403
Min. Negotiated Rate	$13,186.53
Max. Negotiated Rate	$13,186.53
Rate for Payer: Aetna CHP/Medicaid	$13,186.53
Rate for Payer: Humana OH Medicaid	$13,186.53

APR-DRG 42.00: SPINAL DISORDERS AND INJURIES

Facility

$7,015.50

Service Code	APR-DRG 0401
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: SPINAL DISORDERS AND INJURIES

Facility

$9,548.87

Service Code	APR-DRG 0402
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: SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$14,940.41

Service Code	APR-DRG 3212
Min. Negotiated Rate	$14,940.41
Max. Negotiated Rate	$14,940.41
Rate for Payer: Aetna CHP/Medicaid	$14,940.41
Rate for Payer: Humana OH Medicaid	$14,940.41

APR-DRG 42.00: SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$23,449.95

Service Code	APR-DRG 3213
Min. Negotiated Rate	$23,449.95
Max. Negotiated Rate	$23,449.95
Rate for Payer: Aetna CHP/Medicaid	$23,449.95
Rate for Payer: Humana OH Medicaid	$23,449.95

APR-DRG 42.00: SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$10,977.95

Service Code	APR-DRG 3211
Min. Negotiated Rate	$10,977.95
Max. Negotiated Rate	$10,977.95
Rate for Payer: Aetna CHP/Medicaid	$10,977.95
Rate for Payer: Humana OH Medicaid	$10,977.95

APR-DRG 42.00: SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$31,244.94

Service Code	APR-DRG 3214
Min. Negotiated Rate	$31,244.94
Max. Negotiated Rate	$31,244.94
Rate for Payer: Aetna CHP/Medicaid	$31,244.94
Rate for Payer: Humana OH Medicaid	$31,244.94

APR-DRG 42.00: SPINAL PROCEDURES

Facility

$36,441.61

Service Code	APR-DRG 0234
Min. Negotiated Rate	$36,441.61
Max. Negotiated Rate	$36,441.61
Rate for Payer: Aetna CHP/Medicaid	$36,441.61
Rate for Payer: Humana OH Medicaid	$36,441.61

APR-DRG 42.00: SPINAL PROCEDURES

Facility

$15,914.78

Service Code	APR-DRG 0232
Min. Negotiated Rate	$15,914.78
Max. Negotiated Rate	$15,914.78
Rate for Payer: Aetna CHP/Medicaid	$15,914.78
Rate for Payer: Humana OH Medicaid	$15,914.78

APR-DRG 42.00: SPINAL PROCEDURES

Facility

$11,237.79

Service Code	APR-DRG 0231
Min. Negotiated Rate	$11,237.79
Max. Negotiated Rate	$11,237.79
Rate for Payer: Aetna CHP/Medicaid	$11,237.79
Rate for Payer: Humana OH Medicaid	$11,237.79

Know your out-of-pocket cost for care.

All Charges