Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 3.18: BONE OR JOINT MANIPULATION UNDER ANESTHESIA

Facility

$654.16

Service Code	EAPG 00044
Min. Negotiated Rate	$654.16
Max. Negotiated Rate	$654.16
Rate for Payer: Aetna CHP/Medicaid	$654.16
Rate for Payer: Humana OH Medicaid	$654.16

EAPG 3.18: BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$80.15

Service Code	EAPG 00572
Min. Negotiated Rate	$80.15
Max. Negotiated Rate	$80.15
Rate for Payer: Aetna CHP/Medicaid	$80.15
Rate for Payer: Humana OH Medicaid	$80.15

EAPG 3.18: BUNION PROCEDURES

Facility

$1,586.27

Service Code	EAPG 00045
Min. Negotiated Rate	$1,586.27
Max. Negotiated Rate	$1,586.27
Rate for Payer: Aetna CHP/Medicaid	$1,586.27
Rate for Payer: Humana OH Medicaid	$1,586.27

EAPG 3.18: CARDIAC ARREST OR OTHER CAUSES OF MORTALITY

Facility

$210.73

Service Code	EAPG 00595
Min. Negotiated Rate	$210.73
Max. Negotiated Rate	$210.73
Rate for Payer: Aetna CHP/Medicaid	$210.73
Rate for Payer: Humana OH Medicaid	$210.73

EAPG 3.18: CARDIAC ARRHYTHMIA AND CONDUCTION DIAGNOSES

Facility

$100.84

Service Code	EAPG 00601
Min. Negotiated Rate	$100.84
Max. Negotiated Rate	$100.84
Rate for Payer: Aetna CHP/Medicaid	$100.84
Rate for Payer: Humana OH Medicaid	$100.84

EAPG 3.18: CARDIAC ELECTROPHYSIOLOGIC TESTS AND MONITORING

Facility

$650.28

Service Code	EAPG 00082
Min. Negotiated Rate	$650.28
Max. Negotiated Rate	$650.28
Rate for Payer: Aetna CHP/Medicaid	$650.28
Rate for Payer: Humana OH Medicaid	$650.28

EAPG 3.18: CARDIAC REHABILITATION

Facility

$27.15

Service Code	EAPG 00094
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Aetna CHP/Medicaid	$27.15
Rate for Payer: Humana OH Medicaid	$27.15

EAPG 3.18: CARDIAC STRUCTURAL AND VALVULAR DIAGNOSES

Facility

$111.18

Service Code	EAPG 00600
Min. Negotiated Rate	$111.18
Max. Negotiated Rate	$111.18
Rate for Payer: Aetna CHP/Medicaid	$111.18
Rate for Payer: Humana OH Medicaid	$111.18

EAPG 3.18: CARDIOGRAM

Facility

$29.73

Service Code	EAPG 00413
Min. Negotiated Rate	$29.73
Max. Negotiated Rate	$29.73
Rate for Payer: Aetna CHP/Medicaid	$29.73
Rate for Payer: Humana OH Medicaid	$29.73

EAPG 3.18: CARDIOMYOPATHY DIAGNOSES

Facility

$93.08

Service Code	EAPG 00607
Min. Negotiated Rate	$93.08
Max. Negotiated Rate	$93.08
Rate for Payer: Aetna CHP/Medicaid	$93.08
Rate for Payer: Humana OH Medicaid	$93.08

EAPG 3.18: CARDIOVERSION

Facility

$374.91

Service Code	EAPG 00093
Min. Negotiated Rate	$374.91
Max. Negotiated Rate	$374.91
Rate for Payer: Aetna CHP/Medicaid	$374.91
Rate for Payer: Humana OH Medicaid	$374.91

EAPG 3.18: CAST APPLICATION OR REPLACEMENT

Facility

$204.26

Service Code	EAPG 00039
Min. Negotiated Rate	$204.26
Max. Negotiated Rate	$204.26
Rate for Payer: Aetna CHP/Medicaid	$204.26
Rate for Payer: Humana OH Medicaid	$204.26

EAPG 3.18: CATARACT PROCEDURES

Facility

$1,437.59

Service Code	EAPG 00233
Min. Negotiated Rate	$1,437.59
Max. Negotiated Rate	$1,437.59
Rate for Payer: Aetna CHP/Medicaid	$1,437.59
Rate for Payer: Humana OH Medicaid	$1,437.59

EAPG 3.18: CATARACTS

Facility

$87.91

Service Code	EAPG 00551
Min. Negotiated Rate	$87.91
Max. Negotiated Rate	$87.91
Rate for Payer: Aetna CHP/Medicaid	$87.91
Rate for Payer: Humana OH Medicaid	$87.91

EAPG 3.18: CELLULITIS AND OTHER BACTERIAL SKIN INFECTIONS

Facility

$86.62

Service Code	EAPG 00673
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$86.62
Rate for Payer: Aetna CHP/Medicaid	$86.62
Rate for Payer: Humana OH Medicaid	$86.62

EAPG 3.18: CEREBRAL PALSY

Facility

$106.01

Service Code	EAPG 00536
Min. Negotiated Rate	$106.01
Max. Negotiated Rate	$106.01
Rate for Payer: Aetna CHP/Medicaid	$106.01
Rate for Payer: Humana OH Medicaid	$106.01

EAPG 3.18: CHEMOTHERAPY

Facility

$112.47

Service Code	EAPG 00803
Min. Negotiated Rate	$112.47
Max. Negotiated Rate	$112.47
Rate for Payer: Aetna CHP/Medicaid	$112.47
Rate for Payer: Humana OH Medicaid	$112.47

EAPG 3.18: CHEST PAIN

Facility

$117.64

Service Code	EAPG 00604
Min. Negotiated Rate	$117.64
Max. Negotiated Rate	$117.64
Rate for Payer: Aetna CHP/Medicaid	$117.64
Rate for Payer: Humana OH Medicaid	$117.64

EAPG 3.18: CHILDHOOD BEHAVIORAL DIAGNOSES

Facility

$87.91

Service Code	EAPG 00829
Min. Negotiated Rate	$87.91
Max. Negotiated Rate	$87.91
Rate for Payer: Aetna CHP/Medicaid	$87.91
Rate for Payer: Humana OH Medicaid	$87.91

EAPG 3.18: CHILD PREVENTIVE MEDICINE

Facility

$90.50

Service Code	EAPG 00877
Min. Negotiated Rate	$90.50
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna CHP/Medicaid	$90.50
Rate for Payer: Humana OH Medicaid	$90.50

EAPG 3.18: CHOLECYSTECTOMY AND RELATED BILIARY PROCEDURES

Facility

$1,901.71

Service Code	EAPG 00107
Min. Negotiated Rate	$1,901.71
Max. Negotiated Rate	$1,901.71
Rate for Payer: Aetna CHP/Medicaid	$1,901.71
Rate for Payer: Humana OH Medicaid	$1,901.71

EAPG 3.18: CHOLECYSTITIS

Facility

$81.45

Service Code	EAPG 00638
Min. Negotiated Rate	$81.45
Max. Negotiated Rate	$81.45
Rate for Payer: Aetna CHP/Medicaid	$81.45
Rate for Payer: Humana OH Medicaid	$81.45

EAPG 3.18: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$85.32

Service Code	EAPG 00574
Min. Negotiated Rate	$85.32
Max. Negotiated Rate	$85.32
Rate for Payer: Aetna CHP/Medicaid	$85.32
Rate for Payer: Humana OH Medicaid	$85.32

EAPG 3.18: CLASS III PHARMACOTHERAPY

Facility

$130.57

Service Code	EAPG 00437
Min. Negotiated Rate	$130.57
Max. Negotiated Rate	$130.57
Rate for Payer: Aetna CHP/Medicaid	$130.57
Rate for Payer: Humana OH Medicaid	$130.57

EAPG 3.18: CLASS III THERAPEUTIC RADIOPHARMACEUTICALS

Facility

$818.34

Service Code	EAPG 00245
Min. Negotiated Rate	$818.34
Max. Negotiated Rate	$818.34
Rate for Payer: Aetna CHP/Medicaid	$818.34
Rate for Payer: Humana OH Medicaid	$818.34

Know your out-of-pocket cost for care.

All Charges