Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 764: FALSE LABOR

Facility

$87.46

Service Code	EAPG 00764
Min. Negotiated Rate	$87.46
Max. Negotiated Rate	$87.46
Rate for Payer: Aetna CHP/Medicaid	$87.46
Rate for Payer: Humana OH Medicaid	$87.46

EAPG 765: OTHER ANTEPARTUM COMPLICATION DIAGNOSES

Facility

$116.53

Service Code	EAPG 00765
Min. Negotiated Rate	$116.53
Max. Negotiated Rate	$116.53
Rate for Payer: Aetna CHP/Medicaid	$116.53
Rate for Payer: Humana OH Medicaid	$116.53

EAPG 766: ROUTINE PRENATAL CARE

Facility

$64.03

Service Code	EAPG 00766
Min. Negotiated Rate	$64.03
Max. Negotiated Rate	$64.03
Rate for Payer: Aetna CHP/Medicaid	$64.03
Rate for Payer: Humana OH Medicaid	$64.03

EAPG 767: COMPLICATIONS OF TREATMENT AFFECTING PREGNANCY

Facility

$164.91

Service Code	EAPG 00767
Min. Negotiated Rate	$164.91
Max. Negotiated Rate	$164.91
Rate for Payer: Aetna CHP/Medicaid	$164.91
Rate for Payer: Humana OH Medicaid	$164.91

EAPG 768: ANTEPARTUM ENCOUNTERS FOR NON-ROUTINE AND ABNORMAL FINDINGS

Facility

$110.79

Service Code	EAPG 00768
Min. Negotiated Rate	$110.79
Max. Negotiated Rate	$110.79
Rate for Payer: Aetna CHP/Medicaid	$110.79
Rate for Payer: Humana OH Medicaid	$110.79

EAPG 76: REVISION, REPAIR OR REMOVAL OF CENTRAL VENOUS ACCESS DEVICE

Facility

$511.08

Service Code	EAPG 00076
Min. Negotiated Rate	$511.08
Max. Negotiated Rate	$511.08
Rate for Payer: Aetna CHP/Medicaid	$511.08
Rate for Payer: Humana OH Medicaid	$511.08

EAPG 770: NORMAL NEONATE

Facility

$60.45

Service Code	EAPG 00770
Min. Negotiated Rate	$60.45
Max. Negotiated Rate	$60.45
Rate for Payer: Aetna CHP/Medicaid	$60.45
Rate for Payer: Humana OH Medicaid	$60.45

EAPG 771: NEONATAL DIAGNOSES

Facility

$80.32

Service Code	EAPG 00771
Min. Negotiated Rate	$80.32
Max. Negotiated Rate	$80.32
Rate for Payer: Aetna CHP/Medicaid	$80.32
Rate for Payer: Humana OH Medicaid	$80.32

EAPG 777: SUPERFICIAL INJURY TO SKIN AND SUBCUTANEOUS TISSUE

Facility

$87.10

Service Code	EAPG 00777
Min. Negotiated Rate	$87.10
Max. Negotiated Rate	$87.10
Rate for Payer: Aetna CHP/Medicaid	$87.10
Rate for Payer: Humana OH Medicaid	$87.10

EAPG 77: LEVEL I PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES

Facility

$2,209.03

Service Code	EAPG 00077
Min. Negotiated Rate	$2,209.03
Max. Negotiated Rate	$2,209.03
Rate for Payer: Aetna CHP/Medicaid	$2,209.03
Rate for Payer: Humana OH Medicaid	$2,209.03

EAPG 780: OTHER HEMATOLOGICAL DIAGNOSES

Facility

$115.11

Service Code	EAPG 00780
Min. Negotiated Rate	$115.11
Max. Negotiated Rate	$115.11
Rate for Payer: Aetna CHP/Medicaid	$115.11
Rate for Payer: Humana OH Medicaid	$115.11

EAPG 781: COAGULATION AND PLATELET DISORDERS AND CONGENITAL FACTOR DEFICIENCIES

Facility

$76.86

Service Code	EAPG 00781
Min. Negotiated Rate	$76.86
Max. Negotiated Rate	$76.86
Rate for Payer: Aetna CHP/Medicaid	$76.86
Rate for Payer: Humana OH Medicaid	$76.86

EAPG 783: SICKLE CELL ANEMIA CRISIS

Facility

$301.03

Service Code	EAPG 00783
Min. Negotiated Rate	$301.03
Max. Negotiated Rate	$301.03
Rate for Payer: Aetna CHP/Medicaid	$301.03
Rate for Payer: Humana OH Medicaid	$301.03

EAPG 785: ANEMIA, BLOOD AND BLOOD-FORMING ORGAN DISORDERS

Facility

$103.71

Service Code	EAPG 00785
Min. Negotiated Rate	$103.71
Max. Negotiated Rate	$103.71
Rate for Payer: Aetna CHP/Medicaid	$103.71
Rate for Payer: Humana OH Medicaid	$103.71

EAPG 787: AFTERCARE, BURNS, CORROSIONS, OTHER INJURIES RELATED TO THE SKIN AND SUB TIS

Facility

$50.12

Service Code	EAPG 00787
Min. Negotiated Rate	$50.12
Max. Negotiated Rate	$50.12
Rate for Payer: Aetna CHP/Medicaid	$50.12
Rate for Payer: Humana OH Medicaid	$50.12

EAPG 78: LEVEL I PERIPHERAL VASCULAR REPAIR, LIGATION OR RECONSTRUCTION

Facility

$1,089.44

Service Code	EAPG 00078
Min. Negotiated Rate	$1,089.44
Max. Negotiated Rate	$1,089.44
Rate for Payer: Aetna CHP/Medicaid	$1,089.44
Rate for Payer: Humana OH Medicaid	$1,089.44

EAPG 79: LEVEL II PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES

Facility

$4,089.85

Service Code	EAPG 00079
Min. Negotiated Rate	$4,089.85
Max. Negotiated Rate	$4,089.85
Rate for Payer: Aetna CHP/Medicaid	$4,089.85
Rate for Payer: Humana OH Medicaid	$4,089.85

EAPG 800: ACUTE LEUKEMIA

Facility

$165.84

Service Code	EAPG 00800
Min. Negotiated Rate	$165.84
Max. Negotiated Rate	$165.84
Rate for Payer: Aetna CHP/Medicaid	$165.84
Rate for Payer: Humana OH Medicaid	$165.84

EAPG 801: LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA

Facility

$92.27

Service Code	EAPG 00801
Min. Negotiated Rate	$92.27
Max. Negotiated Rate	$92.27
Rate for Payer: Aetna CHP/Medicaid	$92.27
Rate for Payer: Humana OH Medicaid	$92.27

EAPG 802: RADIOTHERAPY

Facility

$39.43

Service Code	EAPG 00802
Min. Negotiated Rate	$39.43
Max. Negotiated Rate	$39.43
Rate for Payer: Aetna CHP/Medicaid	$39.43
Rate for Payer: Humana OH Medicaid	$39.43

EAPG 803: CHEMOTHERAPY

Facility

$110.34

Service Code	EAPG 00803
Min. Negotiated Rate	$110.34
Max. Negotiated Rate	$110.34
Rate for Payer: Aetna CHP/Medicaid	$110.34
Rate for Payer: Humana OH Medicaid	$110.34

EAPG 804: LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$77.18

Service Code	EAPG 00804
Min. Negotiated Rate	$77.18
Max. Negotiated Rate	$77.18
Rate for Payer: Aetna CHP/Medicaid	$77.18
Rate for Payer: Humana OH Medicaid	$77.18

EAPG 805: SEPTICEMIA AND DISSEMINATED INFECTIONS

Facility

$253.65

Service Code	EAPG 00805
Min. Negotiated Rate	$253.65
Max. Negotiated Rate	$253.65
Rate for Payer: Aetna CHP/Medicaid	$253.65
Rate for Payer: Humana OH Medicaid	$253.65

EAPG 806: INTRAOPERATIVE, POST-OPERATIVE OR POST-TRAUMATIC INFECTIONS AND COMPLICATIONS

Facility

$104.29

Service Code	EAPG 00806
Min. Negotiated Rate	$104.29
Max. Negotiated Rate	$104.29
Rate for Payer: Aetna CHP/Medicaid	$104.29
Rate for Payer: Humana OH Medicaid	$104.29

EAPG 807: FEVER AND OTHER INFLAMMATORY CONDITIONS

Facility

$112.98

Service Code	EAPG 00807
Min. Negotiated Rate	$112.98
Max. Negotiated Rate	$112.98
Rate for Payer: Aetna CHP/Medicaid	$112.98
Rate for Payer: Humana OH Medicaid	$112.98

Know your out-of-pocket cost for care.

All Charges