Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 539: INTRACRANIAL HEMORRHAGE

Facility

$53.83

Service Code	EAPG 00539
Min. Negotiated Rate	$53.83
Max. Negotiated Rate	$53.83
Rate for Payer: Aetna CHP/Medicaid	$53.83
Rate for Payer: Humana OH Medicaid	$53.83

EAPG 53: SPINE INJECTIONS AND OTHER RELATED PROCEDURES

Facility

$495.05

Service Code	EAPG 00053
Min. Negotiated Rate	$495.05
Max. Negotiated Rate	$495.05
Rate for Payer: Aetna CHP/Medicaid	$495.05
Rate for Payer: Humana OH Medicaid	$495.05

EAPG 545: PERIPHERAL, CRANIAL, AND AUTONOMIC NERVE INJURIES

Facility

$80.17

Service Code	EAPG 00545
Min. Negotiated Rate	$80.17
Max. Negotiated Rate	$80.17
Rate for Payer: Aetna CHP/Medicaid	$80.17
Rate for Payer: Humana OH Medicaid	$80.17

EAPG 548: PERIPHERAL AND OTHER VASCULAR RELATED INJURIES

Facility

$89.54

Service Code	EAPG 00548
Min. Negotiated Rate	$89.54
Max. Negotiated Rate	$89.54
Rate for Payer: Aetna CHP/Medicaid	$89.54
Rate for Payer: Humana OH Medicaid	$89.54

EAPG 54: FIXATION DEVICE INSERTION OR REPLACEMENT PROCEDURES

Facility

$1,446.22

Service Code	EAPG 00054
Min. Negotiated Rate	$1,446.22
Max. Negotiated Rate	$1,446.22
Rate for Payer: Aetna CHP/Medicaid	$1,446.22
Rate for Payer: Humana OH Medicaid	$1,446.22

EAPG 550: ACUTE MAJOR EYE INFECTIONS

Facility

$62.04

Service Code	EAPG 00550
Min. Negotiated Rate	$62.04
Max. Negotiated Rate	$62.04
Rate for Payer: Aetna CHP/Medicaid	$62.04
Rate for Payer: Humana OH Medicaid	$62.04

EAPG 551: CATARACTS

Facility

$57.40

Service Code	EAPG 00551
Min. Negotiated Rate	$57.40
Max. Negotiated Rate	$57.40
Rate for Payer: Aetna CHP/Medicaid	$57.40
Rate for Payer: Humana OH Medicaid	$57.40

EAPG 552: GLAUCOMA

Facility

$69.95

Service Code	EAPG 00552
Min. Negotiated Rate	$69.95
Max. Negotiated Rate	$69.95
Rate for Payer: Aetna CHP/Medicaid	$69.95
Rate for Payer: Humana OH Medicaid	$69.95

EAPG 553: OTHER OPHTHALMIC SYSTEM DIAGNOSES

Facility

$59.82

Service Code	EAPG 00553
Min. Negotiated Rate	$59.82
Max. Negotiated Rate	$59.82
Rate for Payer: Aetna CHP/Medicaid	$59.82
Rate for Payer: Humana OH Medicaid	$59.82

EAPG 555: CONJUNCTIVITIS

Facility

$60.18

Service Code	EAPG 00555
Min. Negotiated Rate	$60.18
Max. Negotiated Rate	$60.18
Rate for Payer: Aetna CHP/Medicaid	$60.18
Rate for Payer: Humana OH Medicaid	$60.18

EAPG 556: OCULAR AND PERIOCULAR MALIGNANCY

Facility

$100.22

Service Code	EAPG 00556
Min. Negotiated Rate	$100.22
Max. Negotiated Rate	$100.22
Rate for Payer: Aetna CHP/Medicaid	$100.22
Rate for Payer: Humana OH Medicaid	$100.22

EAPG 557: OTHER EYE INFECTION DIAGNOSES

Facility

$60.01

Service Code	EAPG 00557
Min. Negotiated Rate	$60.01
Max. Negotiated Rate	$60.01
Rate for Payer: Aetna CHP/Medicaid	$60.01
Rate for Payer: Humana OH Medicaid	$60.01

EAPG 558: MALFUNCTION, REACTION, OR COMPLICATION OF OCULAR DEVICE OR PROCEDURE

Facility

$60.55

Service Code	EAPG 00558
Min. Negotiated Rate	$60.55
Max. Negotiated Rate	$60.55
Rate for Payer: Aetna CHP/Medicaid	$60.55
Rate for Payer: Humana OH Medicaid	$60.55

EAPG 55: LEVEL II HIP AND FEMUR PROCEDURES

Facility

$9,800.88

Service Code	EAPG 00055
Min. Negotiated Rate	$9,800.88
Max. Negotiated Rate	$9,800.88
Rate for Payer: Aetna CHP/Medicaid	$9,800.88
Rate for Payer: Humana OH Medicaid	$9,800.88

EAPG 560: EAR, NOSE, MOUTH, THROAT, CRANIAL AND FACIAL MALIGNANCIES

Facility

$60.89

Service Code	EAPG 00560
Min. Negotiated Rate	$60.89
Max. Negotiated Rate	$60.89
Rate for Payer: Aetna CHP/Medicaid	$60.89
Rate for Payer: Humana OH Medicaid	$60.89

EAPG 561: VERTIGO AND OTHER LABYRINTH DISORDERS

Facility

$125.56

Service Code	EAPG 00561
Min. Negotiated Rate	$125.56
Max. Negotiated Rate	$125.56
Rate for Payer: Aetna CHP/Medicaid	$125.56
Rate for Payer: Humana OH Medicaid	$125.56

EAPG 562: INFECTIONS OF UPPER RESPIRATORY TRACT AND OTITIS MEDIA

Facility

$78.74

Service Code	EAPG 00562
Min. Negotiated Rate	$78.74
Max. Negotiated Rate	$78.74
Rate for Payer: Aetna CHP/Medicaid	$78.74
Rate for Payer: Humana OH Medicaid	$78.74

EAPG 563: DENTAL AND ORAL DIAGNOSES AND INJURIES

Facility

$70.39

Service Code	EAPG 00563
Min. Negotiated Rate	$70.39
Max. Negotiated Rate	$70.39
Rate for Payer: Aetna CHP/Medicaid	$70.39
Rate for Payer: Humana OH Medicaid	$70.39

EAPG 564: OTHER EAR, NOSE, MOUTH, THROAT AND CRANIOFACIAL DIAGNOSES

Facility

$70.50

Service Code	EAPG 00564
Min. Negotiated Rate	$70.50
Max. Negotiated Rate	$70.50
Rate for Payer: Aetna CHP/Medicaid	$70.50
Rate for Payer: Humana OH Medicaid	$70.50

EAPG 566: MALFUNCTION, REACTION, OR COMPLICATION OF OTOLARYNGOLOGIC DEVICE OR PROCEDURE

Facility

$66.22

Service Code	EAPG 00566
Min. Negotiated Rate	$66.22
Max. Negotiated Rate	$66.22
Rate for Payer: Aetna CHP/Medicaid	$66.22
Rate for Payer: Humana OH Medicaid	$66.22

EAPG 56: SKIN AND CONNECTIVE TISSUE GRAFTING AND FLAP PROCEDURES

Facility

$1,285.99

Service Code	EAPG 00056
Min. Negotiated Rate	$1,285.99
Max. Negotiated Rate	$1,285.99
Rate for Payer: Aetna CHP/Medicaid	$1,285.99
Rate for Payer: Humana OH Medicaid	$1,285.99

EAPG 570: CYSTIC FIBROSIS - PULMONARY DISEASE

Facility

$228.17

Service Code	EAPG 00570
Min. Negotiated Rate	$228.17
Max. Negotiated Rate	$228.17
Rate for Payer: Aetna CHP/Medicaid	$228.17
Rate for Payer: Humana OH Medicaid	$228.17

EAPG 571: RESPIRATORY MALIGNANCY

Facility

$58.86

Service Code	EAPG 00571
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 572: BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$150.08

Service Code	EAPG 00572
Min. Negotiated Rate	$150.08
Max. Negotiated Rate	$150.08
Rate for Payer: Aetna CHP/Medicaid	$150.08
Rate for Payer: Humana OH Medicaid	$150.08

EAPG 574: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$163.53

Service Code	EAPG 00574
Min. Negotiated Rate	$163.53
Max. Negotiated Rate	$163.53
Rate for Payer: Aetna CHP/Medicaid	$163.53
Rate for Payer: Humana OH Medicaid	$163.53

Know your out-of-pocket cost for care.

All Charges