Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 42.00: URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$5,131.71

Service Code	APR-DRG 4652
Min. Negotiated Rate	$5,131.71
Max. Negotiated Rate	$5,131.71
Rate for Payer: Aetna CHP/Medicaid	$5,131.71
Rate for Payer: Humana OH Medicaid	$5,131.71

APR-DRG 42.00: URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$4,157.33

Service Code	APR-DRG 4651
Min. Negotiated Rate	$4,157.33
Max. Negotiated Rate	$4,157.33
Rate for Payer: Aetna CHP/Medicaid	$4,157.33
Rate for Payer: Humana OH Medicaid	$4,157.33

APR-DRG 42.00: URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$7,470.20

Service Code	APR-DRG 4653
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: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$25,528.61

Service Code	APR-DRG 5194
Min. Negotiated Rate	$25,528.61
Max. Negotiated Rate	$25,528.61
Rate for Payer: Aetna CHP/Medicaid	$25,528.61
Rate for Payer: Humana OH Medicaid	$25,528.61

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$15,395.12

Service Code	APR-DRG 5193
Min. Negotiated Rate	$15,395.12
Max. Negotiated Rate	$15,395.12
Rate for Payer: Aetna CHP/Medicaid	$15,395.12
Rate for Payer: Humana OH Medicaid	$15,395.12

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$8,509.54

Service Code	APR-DRG 5192
Min. Negotiated Rate	$8,509.54
Max. Negotiated Rate	$8,509.54
Rate for Payer: Aetna CHP/Medicaid	$8,509.54
Rate for Payer: Humana OH Medicaid	$8,509.54

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$6,430.87

Service Code	APR-DRG 5191
Min. Negotiated Rate	$6,430.87
Max. Negotiated Rate	$6,430.87
Rate for Payer: Aetna CHP/Medicaid	$6,430.87
Rate for Payer: Humana OH Medicaid	$6,430.87

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$6,950.54

Service Code	APR-DRG 5131
Min. Negotiated Rate	$6,950.54
Max. Negotiated Rate	$6,950.54
Rate for Payer: Aetna CHP/Medicaid	$6,950.54
Rate for Payer: Humana OH Medicaid	$6,950.54

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$14,095.95

Service Code	APR-DRG 5133
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: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$8,574.50

Service Code	APR-DRG 5132
Min. Negotiated Rate	$8,574.50
Max. Negotiated Rate	$8,574.50
Rate for Payer: Aetna CHP/Medicaid	$8,574.50
Rate for Payer: Humana OH Medicaid	$8,574.50

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$25,398.70

Service Code	APR-DRG 5134
Min. Negotiated Rate	$25,398.70
Max. Negotiated Rate	$25,398.70
Rate for Payer: Aetna CHP/Medicaid	$25,398.70
Rate for Payer: Humana OH Medicaid	$25,398.70

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$9,289.04

Service Code	APR-DRG 5121
Min. Negotiated Rate	$9,289.04
Max. Negotiated Rate	$9,289.04
Rate for Payer: Aetna CHP/Medicaid	$9,289.04
Rate for Payer: Humana OH Medicaid	$9,289.04

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$17,603.70

Service Code	APR-DRG 5123
Min. Negotiated Rate	$17,603.70
Max. Negotiated Rate	$17,603.70
Rate for Payer: Aetna CHP/Medicaid	$17,603.70
Rate for Payer: Humana OH Medicaid	$17,603.70

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$10,653.16

Service Code	APR-DRG 5122
Min. Negotiated Rate	$10,653.16
Max. Negotiated Rate	$10,653.16
Rate for Payer: Aetna CHP/Medicaid	$10,653.16
Rate for Payer: Humana OH Medicaid	$10,653.16

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$30,140.65

Service Code	APR-DRG 5124
Min. Negotiated Rate	$30,140.65
Max. Negotiated Rate	$30,140.65
Rate for Payer: Aetna CHP/Medicaid	$30,140.65
Rate for Payer: Humana OH Medicaid	$30,140.65

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$31,504.78

Service Code	APR-DRG 5114
Min. Negotiated Rate	$31,504.78
Max. Negotiated Rate	$31,504.78
Rate for Payer: Aetna CHP/Medicaid	$31,504.78
Rate for Payer: Humana OH Medicaid	$31,504.78

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$9,289.04

Service Code	APR-DRG 5111
Min. Negotiated Rate	$9,289.04
Max. Negotiated Rate	$9,289.04
Rate for Payer: Aetna CHP/Medicaid	$9,289.04
Rate for Payer: Humana OH Medicaid	$9,289.04

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$17,213.95

Service Code	APR-DRG 5113
Min. Negotiated Rate	$17,213.95
Max. Negotiated Rate	$17,213.95
Rate for Payer: Aetna CHP/Medicaid	$17,213.95
Rate for Payer: Humana OH Medicaid	$17,213.95

APR-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$11,237.79

Service Code	APR-DRG 5112
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

APR-DRG 42.00: VAGINAL DELIVERY

Facility

$7,795.00

Service Code	APR-DRG 5604
Min. Negotiated Rate	$7,795.00
Max. Negotiated Rate	$7,795.00
Rate for Payer: Aetna CHP/Medicaid	$7,795.00
Rate for Payer: Humana OH Medicaid	$7,795.00

APR-DRG 42.00: VAGINAL DELIVERY

Facility

$3,897.50

Service Code	APR-DRG 5603
Min. Negotiated Rate	$3,897.50
Max. Negotiated Rate	$3,897.50
Rate for Payer: Aetna CHP/Medicaid	$3,897.50
Rate for Payer: Humana OH Medicaid	$3,897.50

APR-DRG 42.00: VAGINAL DELIVERY

Facility

$2,208.58

Service Code	APR-DRG 5601
Min. Negotiated Rate	$2,208.58
Max. Negotiated Rate	$2,208.58
Rate for Payer: Aetna CHP/Medicaid	$2,208.58
Rate for Payer: Humana OH Medicaid	$2,208.58

APR-DRG 42.00: VAGINAL DELIVERY

Facility

$2,598.33

Service Code	APR-DRG 5602
Min. Negotiated Rate	$2,598.33
Max. Negotiated Rate	$2,598.33
Rate for Payer: Aetna CHP/Medicaid	$2,598.33
Rate for Payer: Humana OH Medicaid	$2,598.33

APR-DRG 42.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$16,044.70

Service Code	APR-DRG 5424
Min. Negotiated Rate	$16,044.70
Max. Negotiated Rate	$16,044.70
Rate for Payer: Aetna CHP/Medicaid	$16,044.70
Rate for Payer: Humana OH Medicaid	$16,044.70

APR-DRG 42.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$5,846.25

Service Code	APR-DRG 5423
Min. Negotiated Rate	$5,846.25
Max. Negotiated Rate	$5,846.25
Rate for Payer: Aetna CHP/Medicaid	$5,846.25
Rate for Payer: Humana OH Medicaid	$5,846.25

Know your out-of-pocket cost for care.

All Charges