Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 71: LEVEL II LOWER AIRWAY ENDOSCOPY

Facility

$2,293.34

Service Code	EAPG 00071
Min. Negotiated Rate	$2,293.34
Max. Negotiated Rate	$2,293.34
Rate for Payer: Aetna CHP/Medicaid	$2,293.34
Rate for Payer: Humana OH Medicaid	$2,293.34

EAPG 720: CHRONIC KIDNEY DISEASE

Facility

$74.03

Service Code	EAPG 00720
Min. Negotiated Rate	$74.03
Max. Negotiated Rate	$74.03
Rate for Payer: Aetna CHP/Medicaid	$74.03
Rate for Payer: Humana OH Medicaid	$74.03

EAPG 721: KIDNEY AND URINARY TRACT MALIGNANCY

Facility

$64.19

Service Code	EAPG 00721
Min. Negotiated Rate	$64.19
Max. Negotiated Rate	$64.19
Rate for Payer: Aetna CHP/Medicaid	$64.19
Rate for Payer: Humana OH Medicaid	$64.19

EAPG 722: NEPHRITIS AND NEPHROSIS

Facility

$99.91

Service Code	EAPG 00722
Min. Negotiated Rate	$99.91
Max. Negotiated Rate	$99.91
Rate for Payer: Aetna CHP/Medicaid	$99.91
Rate for Payer: Humana OH Medicaid	$99.91

EAPG 723: COMPLEX KIDNEY AND URINARY TRACT INFECTIONS

Facility

$147.69

Service Code	EAPG 00723
Min. Negotiated Rate	$147.69
Max. Negotiated Rate	$147.69
Rate for Payer: Aetna CHP/Medicaid	$147.69
Rate for Payer: Humana OH Medicaid	$147.69

EAPG 724: URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$95.14

Service Code	EAPG 00724
Min. Negotiated Rate	$95.14
Max. Negotiated Rate	$95.14
Rate for Payer: Aetna CHP/Medicaid	$95.14
Rate for Payer: Humana OH Medicaid	$95.14

EAPG 725: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$136.17

Service Code	EAPG 00725
Min. Negotiated Rate	$136.17
Max. Negotiated Rate	$136.17
Rate for Payer: Aetna CHP/Medicaid	$136.17
Rate for Payer: Humana OH Medicaid	$136.17

EAPG 726: OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$87.38

Service Code	EAPG 00726
Min. Negotiated Rate	$87.38
Max. Negotiated Rate	$87.38
Rate for Payer: Aetna CHP/Medicaid	$87.38
Rate for Payer: Humana OH Medicaid	$87.38

EAPG 727: ACUTE LOWER URINARY TRACT INFECTIONS

Facility

$138.17

Service Code	EAPG 00727
Min. Negotiated Rate	$138.17
Max. Negotiated Rate	$138.17
Rate for Payer: Aetna CHP/Medicaid	$138.17
Rate for Payer: Humana OH Medicaid	$138.17

EAPG 729: ACUTE KIDNEY INJURY

Facility

$151.49

Service Code	EAPG 00729
Min. Negotiated Rate	$151.49
Max. Negotiated Rate	$151.49
Rate for Payer: Aetna CHP/Medicaid	$151.49
Rate for Payer: Humana OH Medicaid	$151.49

EAPG 72: TRACHEOSTOMY AND RELATED TRACHEAL PROCEDURES

Facility

$1,683.87

Service Code	EAPG 00072
Min. Negotiated Rate	$1,683.87
Max. Negotiated Rate	$1,683.87
Rate for Payer: Aetna CHP/Medicaid	$1,683.87
Rate for Payer: Humana OH Medicaid	$1,683.87

EAPG 73: DIAPHRAGMATIC PROCEDURES AND RELATED HERNIA REPAIR

Facility

$4,883.62

Service Code	EAPG 00073
Min. Negotiated Rate	$4,883.62
Max. Negotiated Rate	$4,883.62
Rate for Payer: Aetna CHP/Medicaid	$4,883.62
Rate for Payer: Humana OH Medicaid	$4,883.62

EAPG 740: MALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$59.40

Service Code	EAPG 00740
Min. Negotiated Rate	$59.40
Max. Negotiated Rate	$59.40
Rate for Payer: Aetna CHP/Medicaid	$59.40
Rate for Payer: Humana OH Medicaid	$59.40

EAPG 741: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES

Facility

$108.25

Service Code	EAPG 00741
Min. Negotiated Rate	$108.25
Max. Negotiated Rate	$108.25
Rate for Payer: Aetna CHP/Medicaid	$108.25
Rate for Payer: Humana OH Medicaid	$108.25

EAPG 743: PROSTATITIS

Facility

$62.66

Service Code	EAPG 00743
Min. Negotiated Rate	$62.66
Max. Negotiated Rate	$62.66
Rate for Payer: Aetna CHP/Medicaid	$62.66
Rate for Payer: Humana OH Medicaid	$62.66

EAPG 744: MALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$81.54

Service Code	EAPG 00744
Min. Negotiated Rate	$81.54
Max. Negotiated Rate	$81.54
Rate for Payer: Aetna CHP/Medicaid	$81.54
Rate for Payer: Humana OH Medicaid	$81.54

EAPG 74: REVISION, REPLACEMENT OR REMOVAL OF CARDIAC DEVICE COMPONENT

Facility

$705.71

Service Code	EAPG 00074
Min. Negotiated Rate	$705.71
Max. Negotiated Rate	$705.71
Rate for Payer: Aetna CHP/Medicaid	$705.71
Rate for Payer: Humana OH Medicaid	$705.71

EAPG 750: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$57.46

Service Code	EAPG 00750
Min. Negotiated Rate	$57.46
Max. Negotiated Rate	$57.46
Rate for Payer: Aetna CHP/Medicaid	$57.46
Rate for Payer: Humana OH Medicaid	$57.46

EAPG 751: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$145.23

Service Code	EAPG 00751
Min. Negotiated Rate	$145.23
Max. Negotiated Rate	$145.23
Rate for Payer: Aetna CHP/Medicaid	$145.23
Rate for Payer: Humana OH Medicaid	$145.23

EAPG 752: OTHER FEMALE REPRODUCTIVE SYSTEM AND MENSTRUAL DIAGNOSES

Facility

$119.91

Service Code	EAPG 00752
Min. Negotiated Rate	$119.91
Max. Negotiated Rate	$119.91
Rate for Payer: Aetna CHP/Medicaid	$119.91
Rate for Payer: Humana OH Medicaid	$119.91

EAPG 75: LEVEL I CENTRAL VENOUS ACCESS PROCEDURES

Facility

$673.59

Service Code	EAPG 00075
Min. Negotiated Rate	$673.59
Max. Negotiated Rate	$673.59
Rate for Payer: Aetna CHP/Medicaid	$673.59
Rate for Payer: Humana OH Medicaid	$673.59

EAPG 760: LABOR AND DELIVERY RELATED DIAGNOSES

Facility

$93.29

Service Code	EAPG 00760
Min. Negotiated Rate	$93.29
Max. Negotiated Rate	$93.29
Rate for Payer: Aetna CHP/Medicaid	$93.29
Rate for Payer: Humana OH Medicaid	$93.29

EAPG 761: POSTPARTUM AND POST ABORTION DIAGNOSES

Facility

$98.46

Service Code	EAPG 00761
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Aetna CHP/Medicaid	$98.46
Rate for Payer: Humana OH Medicaid	$98.46

EAPG 762: PRETERM LABOR DIAGNOSES

Facility

$256.79

Service Code	EAPG 00762
Min. Negotiated Rate	$256.79
Max. Negotiated Rate	$256.79
Rate for Payer: Aetna CHP/Medicaid	$256.79
Rate for Payer: Humana OH Medicaid	$256.79

EAPG 763: ABORTION RELATED DIAGNOSES

Facility

$220.55

Service Code	EAPG 00763
Min. Negotiated Rate	$220.55
Max. Negotiated Rate	$220.55
Rate for Payer: Aetna CHP/Medicaid	$220.55
Rate for Payer: Humana OH Medicaid	$220.55

Know your out-of-pocket cost for care.

All Charges