Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 3.18: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$93.08

Service Code	EAPG 00751
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: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$85.32

Service Code	EAPG 00750
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: FEVER

Facility

$93.08

Service Code	EAPG 00807
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: FIXATION DEVICE INSERTION OR REPLACEMENT PROCEDURES

Facility

$1,208.77

Service Code	EAPG 00054
Min. Negotiated Rate	$1,208.77
Max. Negotiated Rate	$1,208.77
Rate for Payer: Aetna CHP/Medicaid	$1,208.77
Rate for Payer: Humana OH Medicaid	$1,208.77

EAPG 3.18: FRACTURES, DISLOCATIONS AND SPRAINS OF THE SKULL, CRANIUM AND FACE

Facility

$99.55

Service Code	EAPG 00648
Min. Negotiated Rate	$99.55
Max. Negotiated Rate	$99.55
Rate for Payer: Aetna CHP/Medicaid	$99.55
Rate for Payer: Humana OH Medicaid	$99.55

EAPG 3.18: FRACTURES, DISLOCATIONS, OTHER INJURIES - LOWER EXTREMITY INCLUDING FEMUR

Facility

$147.38

Service Code	EAPG 00650
Min. Negotiated Rate	$147.38
Max. Negotiated Rate	$147.38
Rate for Payer: Aetna CHP/Medicaid	$147.38
Rate for Payer: Humana OH Medicaid	$147.38

EAPG 3.18: FRACTURES, DISLOCATIONS & OTHER INJURIES OF THE NECK, UPPER BACK AND CHEST

Facility

$104.72

Service Code	EAPG 00656
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$104.72
Rate for Payer: Aetna CHP/Medicaid	$104.72
Rate for Payer: Humana OH Medicaid	$104.72

EAPG 3.18: FRACTURES, DISLOCATIONS, SPRAINS AND OTHER INJURIES OF THE LOWER BACK

Facility

$102.13

Service Code	EAPG 00657
Min. Negotiated Rate	$102.13
Max. Negotiated Rate	$102.13
Rate for Payer: Aetna CHP/Medicaid	$102.13
Rate for Payer: Humana OH Medicaid	$102.13

EAPG 3.18: FRACTURES, DISLOCATIONS, SPRAINS AND OTHER INJURIES OF THE PELVIS AND HIP

Facility

$134.45

Service Code	EAPG 00651
Min. Negotiated Rate	$134.45
Max. Negotiated Rate	$134.45
Rate for Payer: Aetna CHP/Medicaid	$134.45
Rate for Payer: Humana OH Medicaid	$134.45

EAPG 3.18: FRACTURES, DISLOCATIONS, SPRAINS, OTHER INJURIES OF THE SHOULDER AND UPPER ARM

Facility

$120.23

Service Code	EAPG 00647
Min. Negotiated Rate	$120.23
Max. Negotiated Rate	$120.23
Rate for Payer: Aetna CHP/Medicaid	$120.23
Rate for Payer: Humana OH Medicaid	$120.23

EAPG 3.18: GALLBLADDER AND BILIARY TRACT DIAGNOSES

Facility

$82.74

Service Code	EAPG 00637
Min. Negotiated Rate	$82.74
Max. Negotiated Rate	$82.74
Rate for Payer: Aetna CHP/Medicaid	$82.74
Rate for Payer: Humana OH Medicaid	$82.74

EAPG 3.18: GASTROINTESTINAL AND PERITONEAL INFECTION DIAGNOSES

Facility

$95.67

Service Code	EAPG 00619
Min. Negotiated Rate	$95.67
Max. Negotiated Rate	$95.67
Rate for Payer: Aetna CHP/Medicaid	$95.67
Rate for Payer: Humana OH Medicaid	$95.67

EAPG 3.18: GASTROINTESTINAL HEMORRHAGE DIAGNOSES

Facility

$96.96

Service Code	EAPG 00617
Min. Negotiated Rate	$96.96
Max. Negotiated Rate	$96.96
Rate for Payer: Aetna CHP/Medicaid	$96.96
Rate for Payer: Humana OH Medicaid	$96.96

EAPG 3.18: GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$103.42

Service Code	EAPG 00642
Min. Negotiated Rate	$103.42
Max. Negotiated Rate	$103.42
Rate for Payer: Aetna CHP/Medicaid	$103.42
Rate for Payer: Humana OH Medicaid	$103.42

EAPG 3.18: GENETIC COUNSELING

Facility

$90.50

Service Code	EAPG 00882
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: GLAUCOMA

Facility

$87.91

Service Code	EAPG 00552
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: GROUP PSYCHOTHERAPY

Facility

$41.37

Service Code	EAPG 00318
Min. Negotiated Rate	$41.37
Max. Negotiated Rate	$41.37
Rate for Payer: Aetna CHP/Medicaid	$41.37
Rate for Payer: Humana OH Medicaid	$41.37

EAPG 3.18: GYNECOLOGIC PREVENTIVE MEDICINE

Facility

$90.50

Service Code	EAPG 00878
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: HAND AND FOOT TENOTOMY

Facility

$486.09

Service Code	EAPG 00048
Min. Negotiated Rate	$486.09
Max. Negotiated Rate	$486.09
Rate for Payer: Aetna CHP/Medicaid	$486.09
Rate for Payer: Humana OH Medicaid	$486.09

EAPG 3.18: HEADACHES OTHER THAN MIGRAINE

Facility

$100.84

Service Code	EAPG 00530
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: HEAD TRAUMA

Facility

$95.67

Service Code	EAPG 00532
Min. Negotiated Rate	$95.67
Max. Negotiated Rate	$95.67
Rate for Payer: Aetna CHP/Medicaid	$95.67
Rate for Payer: Humana OH Medicaid	$95.67

EAPG 3.18: HEAD TRAUMA WITH LOC/COMA MORE THEN 1 HR

Facility

$95.67

Service Code	EAPG 00538
Min. Negotiated Rate	$95.67
Max. Negotiated Rate	$95.67
Rate for Payer: Aetna CHP/Medicaid	$95.67
Rate for Payer: Humana OH Medicaid	$95.67

EAPG 3.18: HEART FAILURE

Facility

$96.96

Service Code	EAPG 00594
Min. Negotiated Rate	$96.96
Max. Negotiated Rate	$96.96
Rate for Payer: Aetna CHP/Medicaid	$96.96
Rate for Payer: Humana OH Medicaid	$96.96

EAPG 3.18: HEPATITIS WITHOUT COMA

Facility

$102.13

Service Code	EAPG 00636
Min. Negotiated Rate	$102.13
Max. Negotiated Rate	$102.13
Rate for Payer: Aetna CHP/Medicaid	$102.13
Rate for Payer: Humana OH Medicaid	$102.13

EAPG 3.18: HERNIA

Facility

$85.32

Service Code	EAPG 00631
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

Know your out-of-pocket cost for care.

All Charges