Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 663: PAIN RELATED DIAGNOSES

Facility

$83.62

Service Code	EAPG 00663
Min. Negotiated Rate	$83.62
Max. Negotiated Rate	$83.62
Rate for Payer: Aetna CHP/Medicaid	$83.62
Rate for Payer: Humana OH Medicaid	$83.62

EAPG 66: PULMONARY REHABILITATIVE SERVICES

Facility

$30.06

Service Code	EAPG 00066
Min. Negotiated Rate	$30.06
Max. Negotiated Rate	$30.06
Rate for Payer: Aetna CHP/Medicaid	$30.06
Rate for Payer: Humana OH Medicaid	$30.06

EAPG 670: NON-PRESSURE CHRONIC SKIN ULCERS

Facility

$52.60

Service Code	EAPG 00670
Min. Negotiated Rate	$52.60
Max. Negotiated Rate	$52.60
Rate for Payer: Aetna CHP/Medicaid	$52.60
Rate for Payer: Humana OH Medicaid	$52.60

EAPG 671: MAJOR SKIN DIAGNOSES

Facility

$61.02

Service Code	EAPG 00671
Min. Negotiated Rate	$61.02
Max. Negotiated Rate	$61.02
Rate for Payer: Aetna CHP/Medicaid	$61.02
Rate for Payer: Humana OH Medicaid	$61.02

EAPG 672: MALIGNANT BREAST DIAGNOSES

Facility

$55.76

Service Code	EAPG 00672
Min. Negotiated Rate	$55.76
Max. Negotiated Rate	$55.76
Rate for Payer: Aetna CHP/Medicaid	$55.76
Rate for Payer: Humana OH Medicaid	$55.76

EAPG 673: CELLULITIS AND OTHER BACTERIAL SKIN INFECTIONS

Facility

$78.34

Service Code	EAPG 00673
Min. Negotiated Rate	$78.34
Max. Negotiated Rate	$78.34
Rate for Payer: Aetna CHP/Medicaid	$78.34
Rate for Payer: Humana OH Medicaid	$78.34

EAPG 674: OPEN WOUNDS, PUNCTURES AND OTHER OPEN TRAUMATIC INJURIES

Facility

$116.42

Service Code	EAPG 00674
Min. Negotiated Rate	$116.42
Max. Negotiated Rate	$116.42
Rate for Payer: Aetna CHP/Medicaid	$116.42
Rate for Payer: Humana OH Medicaid	$116.42

EAPG 675: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DIAGNOSES

Facility

$58.71

Service Code	EAPG 00675
Min. Negotiated Rate	$58.71
Max. Negotiated Rate	$58.71
Rate for Payer: Aetna CHP/Medicaid	$58.71
Rate for Payer: Humana OH Medicaid	$58.71

EAPG 676: PRESSURE ULCERS

Facility

$55.87

Service Code	EAPG 00676
Min. Negotiated Rate	$55.87
Max. Negotiated Rate	$55.87
Rate for Payer: Aetna CHP/Medicaid	$55.87
Rate for Payer: Humana OH Medicaid	$55.87

EAPG 67: VENTILATION ASSISTANCE AND MANAGEMENT

Facility

$595.93

Service Code	EAPG 00067
Min. Negotiated Rate	$595.93
Max. Negotiated Rate	$595.93
Rate for Payer: Aetna CHP/Medicaid	$595.93
Rate for Payer: Humana OH Medicaid	$595.93

EAPG 68: THORACENTESIS, RELATED BIOPSY AND PLEURAL DRAINAGE PROCEDURES

Facility

$665.77

Service Code	EAPG 00068
Min. Negotiated Rate	$665.77
Max. Negotiated Rate	$665.77
Rate for Payer: Aetna CHP/Medicaid	$665.77
Rate for Payer: Humana OH Medicaid	$665.77

EAPG 690: MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DIAGNOSES

Facility

$63.74

Service Code	EAPG 00690
Min. Negotiated Rate	$63.74
Max. Negotiated Rate	$63.74
Rate for Payer: Aetna CHP/Medicaid	$63.74
Rate for Payer: Humana OH Medicaid	$63.74

EAPG 691: INBORN ERRORS OF METABOLISM

Facility

$61.15

Service Code	EAPG 00691
Min. Negotiated Rate	$61.15
Max. Negotiated Rate	$61.15
Rate for Payer: Aetna CHP/Medicaid	$61.15
Rate for Payer: Humana OH Medicaid	$61.15

EAPG 692: OTHER ENDOCRINE SYSTEM DIAGNOSES

Facility

$72.91

Service Code	EAPG 00692
Min. Negotiated Rate	$72.91
Max. Negotiated Rate	$72.91
Rate for Payer: Aetna CHP/Medicaid	$72.91
Rate for Payer: Humana OH Medicaid	$72.91

EAPG 694: ELECTROLYTE DISORDERS

Facility

$192.89

Service Code	EAPG 00694
Min. Negotiated Rate	$192.89
Max. Negotiated Rate	$192.89
Rate for Payer: Aetna CHP/Medicaid	$192.89
Rate for Payer: Humana OH Medicaid	$192.89

EAPG 695: OBESITY

Facility

$63.55

Service Code	EAPG 00695
Min. Negotiated Rate	$63.55
Max. Negotiated Rate	$63.55
Rate for Payer: Aetna CHP/Medicaid	$63.55
Rate for Payer: Humana OH Medicaid	$63.55

EAPG 696: THYROID AND PARATHYROID DIAGNOSES

Facility

$66.45

Service Code	EAPG 00696
Min. Negotiated Rate	$66.45
Max. Negotiated Rate	$66.45
Rate for Payer: Aetna CHP/Medicaid	$66.45
Rate for Payer: Humana OH Medicaid	$66.45

EAPG 69: LEVEL I THORACIC AND CHEST PROCEDURES

Facility

$1,507.60

Service Code	EAPG 00069
Min. Negotiated Rate	$1,507.60
Max. Negotiated Rate	$1,507.60
Rate for Payer: Aetna CHP/Medicaid	$1,507.60
Rate for Payer: Humana OH Medicaid	$1,507.60

EAPG 70: LEVEL II THORACIC AND CHEST PROCEDURES

Facility

$2,778.94

Service Code	EAPG 00070
Min. Negotiated Rate	$2,778.94
Max. Negotiated Rate	$2,778.94
Rate for Payer: Aetna CHP/Medicaid	$2,778.94
Rate for Payer: Humana OH Medicaid	$2,778.94

EAPG 710: DIABETES WITH OPHTHALMIC MANIFESTATIONS

Facility

$80.53

Service Code	EAPG 00710
Min. Negotiated Rate	$80.53
Max. Negotiated Rate	$80.53
Rate for Payer: Aetna CHP/Medicaid	$80.53
Rate for Payer: Humana OH Medicaid	$80.53

EAPG 711: DIABETES WITH OTHER MANIFESTATIONS AND COMPLICATIONS

Facility

$81.06

Service Code	EAPG 00711
Min. Negotiated Rate	$81.06
Max. Negotiated Rate	$81.06
Rate for Payer: Aetna CHP/Medicaid	$81.06
Rate for Payer: Humana OH Medicaid	$81.06

EAPG 712: DIABETES WITH NEUROLOGIC MANIFESTATIONS

Facility

$57.41

Service Code	EAPG 00712
Min. Negotiated Rate	$57.41
Max. Negotiated Rate	$57.41
Rate for Payer: Aetna CHP/Medicaid	$57.41
Rate for Payer: Humana OH Medicaid	$57.41

EAPG 713: DIABETES WITHOUT COMPLICATIONS

Facility

$57.00

Service Code	EAPG 00713
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$57.00
Rate for Payer: Aetna CHP/Medicaid	$57.00
Rate for Payer: Humana OH Medicaid	$57.00

EAPG 714: DIABETES WITH RENAL MANIFESTATIONS

Facility

$58.50

Service Code	EAPG 00714
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna CHP/Medicaid	$58.50
Rate for Payer: Humana OH Medicaid	$58.50

EAPG 715: DIABETES WITH VASCULAR COMPLICATIONS INCLUDING FOOT AND OTHER SKIN ULCERS

Facility

$58.65

Service Code	EAPG 00715
Min. Negotiated Rate	$58.65
Max. Negotiated Rate	$58.65
Rate for Payer: Aetna CHP/Medicaid	$58.65
Rate for Payer: Humana OH Medicaid	$58.65

Know your out-of-pocket cost for care.

All Charges