Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 49: LEVEL I JOINT, TENDON, OR LIGAMENT INJECTION PROCEDURES

Facility

$152.99

Service Code	EAPG 00049
Min. Negotiated Rate	$152.99
Max. Negotiated Rate	$152.99
Rate for Payer: Aetna CHP/Medicaid	$152.99
Rate for Payer: Humana OH Medicaid	$152.99

EAPG 4: LEVEL II SKIN INCISION AND DRAINAGE, DEBRIDEMENT, DESTRUCTION, OTHER RELATED PX

Facility

$512.63

Service Code	EAPG 00004
Min. Negotiated Rate	$512.63
Max. Negotiated Rate	$512.63
Rate for Payer: Aetna CHP/Medicaid	$512.63
Rate for Payer: Humana OH Medicaid	$512.63

EAPG 50: LEVEL II JOINT, TENDON, OR LIGAMENT INJECTION PROCEDURES

Facility

$277.10

Service Code	EAPG 00050
Min. Negotiated Rate	$277.10
Max. Negotiated Rate	$277.10
Rate for Payer: Aetna CHP/Medicaid	$277.10
Rate for Payer: Humana OH Medicaid	$277.10

EAPG 518: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM

Facility

$65.74

Service Code	EAPG 00518
Min. Negotiated Rate	$65.74
Max. Negotiated Rate	$65.74
Rate for Payer: Aetna CHP/Medicaid	$65.74
Rate for Payer: Humana OH Medicaid	$65.74

EAPG 519: NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM

Facility

$58.85

Service Code	EAPG 00519
Min. Negotiated Rate	$58.85
Max. Negotiated Rate	$58.85
Rate for Payer: Aetna CHP/Medicaid	$58.85
Rate for Payer: Humana OH Medicaid	$58.85

EAPG 51: MUSCULOSKELETAL EXCISIONS, BIOPSIES, AND DRAINAGE PROCEDURES

Facility

$1,182.83

Service Code	EAPG 00051
Min. Negotiated Rate	$1,182.83
Max. Negotiated Rate	$1,182.83
Rate for Payer: Aetna CHP/Medicaid	$1,182.83
Rate for Payer: Humana OH Medicaid	$1,182.83

EAPG 520: SPINAL DIAGNOSES AND INJURIES

Facility

$61.10

Service Code	EAPG 00520
Min. Negotiated Rate	$61.10
Max. Negotiated Rate	$61.10
Rate for Payer: Aetna CHP/Medicaid	$61.10
Rate for Payer: Humana OH Medicaid	$61.10

EAPG 521: NERVOUS SYSTEM MALIGNANCY

Facility

$71.41

Service Code	EAPG 00521
Min. Negotiated Rate	$71.41
Max. Negotiated Rate	$71.41
Rate for Payer: Aetna CHP/Medicaid	$71.41
Rate for Payer: Humana OH Medicaid	$71.41

EAPG 522: DEGENERATIVE NERVOUS SYSTEM DIAGNOSES EXC MULT SCLEROSIS

Facility

$68.83

Service Code	EAPG 00522
Min. Negotiated Rate	$68.83
Max. Negotiated Rate	$68.83
Rate for Payer: Aetna CHP/Medicaid	$68.83
Rate for Payer: Humana OH Medicaid	$68.83

EAPG 523: MULTIPLE SCLEROSIS AND OTHER DEMYELINATING DISEASES

Facility

$57.49

Service Code	EAPG 00523
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Aetna CHP/Medicaid	$57.49
Rate for Payer: Humana OH Medicaid	$57.49

EAPG 524: OTHER CENTRAL NERVOUS SYSTEM DIAGNOSES

Facility

$69.91

Service Code	EAPG 00524
Min. Negotiated Rate	$69.91
Max. Negotiated Rate	$69.91
Rate for Payer: Aetna CHP/Medicaid	$69.91
Rate for Payer: Humana OH Medicaid	$69.91

EAPG 526: TRANSIENT ISCHEMIA

Facility

$62.84

Service Code	EAPG 00526
Min. Negotiated Rate	$62.84
Max. Negotiated Rate	$62.84
Rate for Payer: Aetna CHP/Medicaid	$62.84
Rate for Payer: Humana OH Medicaid	$62.84

EAPG 527: PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DIAGNOSES

Facility

$67.07

Service Code	EAPG 00527
Min. Negotiated Rate	$67.07
Max. Negotiated Rate	$67.07
Rate for Payer: Aetna CHP/Medicaid	$67.07
Rate for Payer: Humana OH Medicaid	$67.07

EAPG 528: ANOXIC AND OTHER SEVERE BRAIN DAMAGE OR COMA

Facility

$58.86

Service Code	EAPG 00528
Min. Negotiated Rate	$58.86
Max. Negotiated Rate	$58.86
Rate for Payer: Aetna CHP/Medicaid	$58.86
Rate for Payer: Humana OH Medicaid	$58.86

EAPG 529: SEIZURE

Facility

$101.95

Service Code	EAPG 00529
Min. Negotiated Rate	$101.95
Max. Negotiated Rate	$101.95
Rate for Payer: Aetna CHP/Medicaid	$101.95
Rate for Payer: Humana OH Medicaid	$101.95

EAPG 52: LEVEL II KNEE AND LOWER LEG PROCEDURES

Facility

$4,670.25

Service Code	EAPG 00052
Min. Negotiated Rate	$4,670.25
Max. Negotiated Rate	$4,670.25
Rate for Payer: Aetna CHP/Medicaid	$4,670.25
Rate for Payer: Humana OH Medicaid	$4,670.25

EAPG 530: HEADACHES OTHER THAN MIGRAINE

Facility

$102.66

Service Code	EAPG 00530
Min. Negotiated Rate	$102.66
Max. Negotiated Rate	$102.66
Rate for Payer: Aetna CHP/Medicaid	$102.66
Rate for Payer: Humana OH Medicaid	$102.66

EAPG 531: MIGRAINE

Facility

$87.72

Service Code	EAPG 00531
Min. Negotiated Rate	$87.72
Max. Negotiated Rate	$87.72
Rate for Payer: Aetna CHP/Medicaid	$87.72
Rate for Payer: Humana OH Medicaid	$87.72

EAPG 532: HEAD TRAUMA WITH OR WITHOUT LOC/COMA LESS THAN 1 HR

Facility

$92.69

Service Code	EAPG 00532
Min. Negotiated Rate	$92.69
Max. Negotiated Rate	$92.69
Rate for Payer: Aetna CHP/Medicaid	$92.69
Rate for Payer: Humana OH Medicaid	$92.69

EAPG 533: AFTEREFFECTS OF CEREBROVASCULAR ACCIDENT

Facility

$54.18

Service Code	EAPG 00533
Min. Negotiated Rate	$54.18
Max. Negotiated Rate	$54.18
Rate for Payer: Aetna CHP/Medicaid	$54.18
Rate for Payer: Humana OH Medicaid	$54.18

EAPG 534: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION W/O INFARC

Facility

$45.45

Service Code	EAPG 00534
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Aetna CHP/Medicaid	$45.45
Rate for Payer: Humana OH Medicaid	$45.45

EAPG 535: CVA AND PRECEREBRAL OCCLUSION W INFARCT

Facility

$45.48

Service Code	EAPG 00535
Min. Negotiated Rate	$45.48
Max. Negotiated Rate	$45.48
Rate for Payer: Aetna CHP/Medicaid	$45.48
Rate for Payer: Humana OH Medicaid	$45.48

EAPG 536: CEREBRAL PALSY

Facility

$69.57

Service Code	EAPG 00536
Min. Negotiated Rate	$69.57
Max. Negotiated Rate	$69.57
Rate for Payer: Aetna CHP/Medicaid	$69.57
Rate for Payer: Humana OH Medicaid	$69.57

EAPG 537: MALFUNCTION, REACTION, COMPLICATION OF NEUROLOGICAL DEVICE OR PROC

Facility

$101.99

Service Code	EAPG 00537
Min. Negotiated Rate	$101.99
Max. Negotiated Rate	$101.99
Rate for Payer: Aetna CHP/Medicaid	$101.99
Rate for Payer: Humana OH Medicaid	$101.99

EAPG 538: HEAD TRAUMA WITH LOC/COMA MORE THAN 1 HR

Facility

$101.95

Service Code	EAPG 00538
Min. Negotiated Rate	$101.95
Max. Negotiated Rate	$101.95
Rate for Payer: Aetna CHP/Medicaid	$101.95
Rate for Payer: Humana OH Medicaid	$101.95

Know your out-of-pocket cost for care.

All Charges