Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 3.18: HERNIA REPAIRS

Facility

$1,440.18

Service Code	EAPG 00139
Min. Negotiated Rate	$1,440.18
Max. Negotiated Rate	$1,440.18
Rate for Payer: Aetna CHP/Medicaid	$1,440.18
Rate for Payer: Humana OH Medicaid	$1,440.18

EAPG 3.18: HIV INFECTION

Facility

$103.42

Service Code	EAPG 00880
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: H. PYLORI INFECTION

Facility

$69.81

Service Code	EAPG 00810
Min. Negotiated Rate	$69.81
Max. Negotiated Rate	$69.81
Rate for Payer: Aetna CHP/Medicaid	$69.81
Rate for Payer: Humana OH Medicaid	$69.81

EAPG 3.18: HYPERTENSION

Facility

$84.03

Service Code	EAPG 00599
Min. Negotiated Rate	$84.03
Max. Negotiated Rate	$84.03
Rate for Payer: Aetna CHP/Medicaid	$84.03
Rate for Payer: Humana OH Medicaid	$84.03

EAPG 3.18: IMPLANTED TISSUE OF ANY TYPE

Facility

$835.15

Service Code	EAPG 00455
Min. Negotiated Rate	$835.15
Max. Negotiated Rate	$835.15
Rate for Payer: Aetna CHP/Medicaid	$835.15
Rate for Payer: Humana OH Medicaid	$835.15

EAPG 3.18: INBORN ERRORS OF METABOLISM

Facility

$78.86

Service Code	EAPG 00691
Min. Negotiated Rate	$78.86
Max. Negotiated Rate	$78.86
Rate for Payer: Aetna CHP/Medicaid	$78.86
Rate for Payer: Humana OH Medicaid	$78.86

EAPG 3.18: INCIDENTAL INTRAOPERATIVE PROCEDURES

Facility

$1,197.13

Service Code	EAPG 02008
Min. Negotiated Rate	$1,197.13
Max. Negotiated Rate	$1,197.13
Rate for Payer: Aetna CHP/Medicaid	$1,197.13
Rate for Payer: Humana OH Medicaid	$1,197.13

EAPG 3.18: INCIDENTAL SKIN SUBSTITUTES

Facility

$835.15

Service Code	EAPG 02010
Min. Negotiated Rate	$835.15
Max. Negotiated Rate	$835.15
Rate for Payer: Aetna CHP/Medicaid	$835.15
Rate for Payer: Humana OH Medicaid	$835.15

EAPG 3.18: INDIVIDUAL COMPREHENSIVE PSYCHOTHERAPY

Facility

$107.30

Service Code	EAPG 00316
Min. Negotiated Rate	$107.30
Max. Negotiated Rate	$107.30
Rate for Payer: Aetna CHP/Medicaid	$107.30
Rate for Payer: Humana OH Medicaid	$107.30

EAPG 3.18: INFECTIONS OF UPPER RESPIRATORY TRACT & OTITIS MEDIA

Facility

$82.74

Service Code	EAPG 00562
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: INFLAMMATORY BOWEL DISEASE

Facility

$80.15

Service Code	EAPG 00626
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: INGUINAL, FEMORAL AND UMBILICAL HERNIA REPAIR

Facility

$1,469.91

Service Code	EAPG 03033
Min. Negotiated Rate	$1,469.91
Max. Negotiated Rate	$1,469.91
Rate for Payer: Aetna CHP/Medicaid	$1,469.91
Rate for Payer: Humana OH Medicaid	$1,469.91

EAPG 3.18: INJECTION(S) FOR RADIOLOGICAL IMAGING

Facility

$327.08

Service Code	EAPG 00278
Min. Negotiated Rate	$327.08
Max. Negotiated Rate	$327.08
Rate for Payer: Aetna CHP/Medicaid	$327.08
Rate for Payer: Humana OH Medicaid	$327.08

EAPG 3.18: INSERTION OF PENILE PROSTHESIS

Facility

$3,731.02

Service Code	EAPG 00182
Min. Negotiated Rate	$3,731.02
Max. Negotiated Rate	$3,731.02
Rate for Payer: Aetna CHP/Medicaid	$3,731.02
Rate for Payer: Humana OH Medicaid	$3,731.02

EAPG 3.18: INSERTION OR REMOVAL OF DRUG DELIVERY DEVICE

Facility

$227.53

Service Code	EAPG 00307
Min. Negotiated Rate	$227.53
Max. Negotiated Rate	$227.53
Rate for Payer: Aetna CHP/Medicaid	$227.53
Rate for Payer: Humana OH Medicaid	$227.53

EAPG 3.18: INTELLECTUAL DISABILITY

Facility

$87.91

Service Code	EAPG 00828
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: INTENSIVE OUTPATIENT PSYCHIATRIC TREATMENT

Facility

$99.55

Service Code	EAPG 00327
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: INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE

Facility

$116.35

Service Code	EAPG 00832
Min. Negotiated Rate	$116.35
Max. Negotiated Rate	$116.35
Rate for Payer: Aetna CHP/Medicaid	$116.35
Rate for Payer: Humana OH Medicaid	$116.35

EAPG 3.18: INTERMEDIATE WOUND REPAIR AND TREATMENT

Facility

$492.56

Service Code	EAPG 00017
Min. Negotiated Rate	$492.56
Max. Negotiated Rate	$492.56
Rate for Payer: Aetna CHP/Medicaid	$492.56
Rate for Payer: Humana OH Medicaid	$492.56

EAPG 3.18: INTERSTITIAL AND ALVEOLAR LUNG DIAGNOSES

Facility

$120.23

Service Code	EAPG 00582
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: INTESTINAL OBSTRUCTION DIAGNOSES

Facility

$96.96

Service Code	EAPG 00618
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: INTRACRANIAL HEMORRHAGE

Facility

$98.25

Service Code	EAPG 00539
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$98.25
Rate for Payer: Aetna CHP/Medicaid	$98.25
Rate for Payer: Humana OH Medicaid	$98.25

EAPG 3.18: IRRITABLE BOWEL SYNDROME

Facility

$73.69

Service Code	EAPG 00632
Min. Negotiated Rate	$73.69
Max. Negotiated Rate	$73.69
Rate for Payer: Aetna CHP/Medicaid	$73.69
Rate for Payer: Humana OH Medicaid	$73.69

EAPG 3.18: KIDNEY AND URINARY TRACT MALIGNANCY

Facility

$96.96

Service Code	EAPG 00721
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: LABOR AND DELIVERY RELATED DIAGNOSES

Facility

$81.45

Service Code	EAPG 00760
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

Know your out-of-pocket cost for care.

All Charges