Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 575: ASTHMA

Facility

$128.48

Service Code	EAPG 00575
Min. Negotiated Rate	$128.48
Max. Negotiated Rate	$128.48
Rate for Payer: Aetna CHP/Medicaid	$128.48
Rate for Payer: Humana OH Medicaid	$128.48

EAPG 576: OTHER RESPIRATORY SYSTEM DIAGNOSES

Facility

$110.88

Service Code	EAPG 00576
Min. Negotiated Rate	$110.88
Max. Negotiated Rate	$110.88
Rate for Payer: Aetna CHP/Medicaid	$110.88
Rate for Payer: Humana OH Medicaid	$110.88

EAPG 579: STATUS ASTHMATICUS

Facility

$447.17

Service Code	EAPG 00579
Min. Negotiated Rate	$447.17
Max. Negotiated Rate	$447.17
Rate for Payer: Aetna CHP/Medicaid	$447.17
Rate for Payer: Humana OH Medicaid	$447.17

EAPG 57: LEVEL III SPINE PROCEDURES

Facility

$12,304.96

Service Code	EAPG 00057
Min. Negotiated Rate	$12,304.96
Max. Negotiated Rate	$12,304.96
Rate for Payer: Aetna CHP/Medicaid	$12,304.96
Rate for Payer: Humana OH Medicaid	$12,304.96

EAPG 580: MAJOR CHEST AND RESPIRATORY TRAUMA

Facility

$178.77

Service Code	EAPG 00580
Min. Negotiated Rate	$178.77
Max. Negotiated Rate	$178.77
Rate for Payer: Aetna CHP/Medicaid	$178.77
Rate for Payer: Humana OH Medicaid	$178.77

EAPG 581: PULMONARY INFECTION DIAGNOSES INCLUDING PNEUMONIA

Facility

$148.90

Service Code	EAPG 00581
Min. Negotiated Rate	$148.90
Max. Negotiated Rate	$148.90
Rate for Payer: Aetna CHP/Medicaid	$148.90
Rate for Payer: Humana OH Medicaid	$148.90

EAPG 582: INTERSTITIAL AND ALVEOLAR LUNG DIAGNOSES

Facility

$76.88

Service Code	EAPG 00582
Min. Negotiated Rate	$76.88
Max. Negotiated Rate	$76.88
Rate for Payer: Aetna CHP/Medicaid	$76.88
Rate for Payer: Humana OH Medicaid	$76.88

EAPG 583: MALFUNCTION, REACTION, OR COMPLICATION OF PULMONARY DEVICE OR PROCEDURE

Facility

$216.83

Service Code	EAPG 00583
Min. Negotiated Rate	$216.83
Max. Negotiated Rate	$216.83
Rate for Payer: Aetna CHP/Medicaid	$216.83
Rate for Payer: Humana OH Medicaid	$216.83

EAPG 584: ACUTE BRONCHITIS

Facility

$126.63

Service Code	EAPG 00584
Min. Negotiated Rate	$126.63
Max. Negotiated Rate	$126.63
Rate for Payer: Aetna CHP/Medicaid	$126.63
Rate for Payer: Humana OH Medicaid	$126.63

EAPG 585: AFTERCARE, OPEN WOUNDS AND OTHER TRAUMATIC INJURIES

Facility

$48.64

Service Code	EAPG 00585
Min. Negotiated Rate	$48.64
Max. Negotiated Rate	$48.64
Rate for Payer: Aetna CHP/Medicaid	$48.64
Rate for Payer: Humana OH Medicaid	$48.64

EAPG 586: PULMONARY EMBOLISM

Facility

$43.85

Service Code	EAPG 00586
Min. Negotiated Rate	$43.85
Max. Negotiated Rate	$43.85
Rate for Payer: Aetna CHP/Medicaid	$43.85
Rate for Payer: Humana OH Medicaid	$43.85

EAPG 587: RESPIRATORY FAILURE

Facility

$238.15

Service Code	EAPG 00587
Min. Negotiated Rate	$238.15
Max. Negotiated Rate	$238.15
Rate for Payer: Aetna CHP/Medicaid	$238.15
Rate for Payer: Humana OH Medicaid	$238.15

EAPG 589: MALFUNCTION, REACTION, OR COMPLICATION OF CARDIOVASCULAR DEVICE OR PROC

Facility

$152.68

Service Code	EAPG 00589
Min. Negotiated Rate	$152.68
Max. Negotiated Rate	$152.68
Rate for Payer: Aetna CHP/Medicaid	$152.68
Rate for Payer: Humana OH Medicaid	$152.68

EAPG 58: LEVEL II SHOULDER AND UPPER ARM PROCEDURES

Facility

$5,777.78

Service Code	EAPG 00058
Min. Negotiated Rate	$5,777.78
Max. Negotiated Rate	$5,777.78
Rate for Payer: Aetna CHP/Medicaid	$5,777.78
Rate for Payer: Humana OH Medicaid	$5,777.78

EAPG 591: ACUTE MYOCARDIAL INFARCTION

Facility

$218.66

Service Code	EAPG 00591
Min. Negotiated Rate	$218.66
Max. Negotiated Rate	$218.66
Rate for Payer: Aetna CHP/Medicaid	$218.66
Rate for Payer: Humana OH Medicaid	$218.66

EAPG 592: OTHER CARDIOVASCULAR SYSTEM DIAGNOSES

Facility

$101.90

Service Code	EAPG 00592
Min. Negotiated Rate	$101.90
Max. Negotiated Rate	$101.90
Rate for Payer: Aetna CHP/Medicaid	$101.90
Rate for Payer: Humana OH Medicaid	$101.90

EAPG 594: HEART FAILURE

Facility

$81.33

Service Code	EAPG 00594
Min. Negotiated Rate	$81.33
Max. Negotiated Rate	$81.33
Rate for Payer: Aetna CHP/Medicaid	$81.33
Rate for Payer: Humana OH Medicaid	$81.33

EAPG 595: CARDIAC ARREST OR OTHER CAUSES OF MORTALITY

Facility

$269.99

Service Code	EAPG 00595
Min. Negotiated Rate	$269.99
Max. Negotiated Rate	$269.99
Rate for Payer: Aetna CHP/Medicaid	$269.99
Rate for Payer: Humana OH Medicaid	$269.99

EAPG 596: PERIPHERAL AND OTHER VASCULAR DIAGNOSES

Facility

$63.23

Service Code	EAPG 00596
Min. Negotiated Rate	$63.23
Max. Negotiated Rate	$63.23
Rate for Payer: Aetna CHP/Medicaid	$63.23
Rate for Payer: Humana OH Medicaid	$63.23

EAPG 597: PHLEBITIS

Facility

$152.59

Service Code	EAPG 00597
Min. Negotiated Rate	$152.59
Max. Negotiated Rate	$152.59
Rate for Payer: Aetna CHP/Medicaid	$152.59
Rate for Payer: Humana OH Medicaid	$152.59

EAPG 598: ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS

Facility

$63.30

Service Code	EAPG 00598
Min. Negotiated Rate	$63.30
Max. Negotiated Rate	$63.30
Rate for Payer: Aetna CHP/Medicaid	$63.30
Rate for Payer: Humana OH Medicaid	$63.30

EAPG 599: HYPERTENSION

Facility

$62.56

Service Code	EAPG 00599
Min. Negotiated Rate	$62.56
Max. Negotiated Rate	$62.56
Rate for Payer: Aetna CHP/Medicaid	$62.56
Rate for Payer: Humana OH Medicaid	$62.56

EAPG 59: ARTERIOVENOUS FISTULA CREATION OR REVISION FOR HEMODIALYSIS

Facility

$2,760.39

Service Code	EAPG 00059
Min. Negotiated Rate	$2,760.39
Max. Negotiated Rate	$2,760.39
Rate for Payer: Aetna CHP/Medicaid	$2,760.39
Rate for Payer: Humana OH Medicaid	$2,760.39

EAPG 5: NAIL PROCEDURES

Facility

$41.74

Service Code	EAPG 00005
Min. Negotiated Rate	$41.74
Max. Negotiated Rate	$41.74
Rate for Payer: Aetna CHP/Medicaid	$41.74
Rate for Payer: Humana OH Medicaid	$41.74

EAPG 600: CARDIAC STRUCTURAL AND VALVULAR DIAGNOSES

Facility

$76.12

Service Code	EAPG 00600
Min. Negotiated Rate	$76.12
Max. Negotiated Rate	$76.12
Rate for Payer: Aetna CHP/Medicaid	$76.12
Rate for Payer: Humana OH Medicaid	$76.12

Know your out-of-pocket cost for care.

All Charges