Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 3.18: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$148.67

Service Code	EAPG 00725
Min. Negotiated Rate	$148.67
Max. Negotiated Rate	$148.67
Rate for Payer: Aetna CHP/Medicaid	$148.67
Rate for Payer: Humana OH Medicaid	$148.67

EAPG 3.18: MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$112.47

Service Code	EAPG 00659
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: MALFUNCTION, REACTION, OR COMPLICATION OF CARDIOVASCULAR DEVICE OR PROC

Facility

$106.01

Service Code	EAPG 00589
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: MALFUNCTION, REACTION, OR COMPLICATION OF OCULAR DEVICE OR PROCEDURE

Facility

$108.60

Service Code	EAPG 00558
Min. Negotiated Rate	$108.60
Max. Negotiated Rate	$108.60
Rate for Payer: Aetna CHP/Medicaid	$108.60
Rate for Payer: Humana OH Medicaid	$108.60

EAPG 3.18: MALFUNCTION, REACTION, OR COMPLICATION OF OTOLARYNGOLOGIC DEVICE OR PROCEDURE

Facility

$98.25

Service Code	EAPG 00566
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: MALFUNCTION, REACTION, OR COMPLICATION OF PULMONARY DEVICE OR PROCEDURE

Facility

$107.30

Service Code	EAPG 00583
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: MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$96.96

Service Code	EAPG 00634
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: MALIGNANT BREAST DIAGNOSES

Facility

$84.03

Service Code	EAPG 00672
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: MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DIAGNOSES

Facility

$93.08

Service Code	EAPG 00690
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: MAMMOGRAPHY & OTHER RELATED PROCEDURES

Facility

$86.62

Service Code	EAPG 00286
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: MEDICATION ADMINISTRATION & OBSERVATION

Facility

$15.51

Service Code	EAPG 00322
Min. Negotiated Rate	$15.51
Max. Negotiated Rate	$15.51
Rate for Payer: Aetna CHP/Medicaid	$15.51
Rate for Payer: Humana OH Medicaid	$15.51

EAPG 3.18: MIGRAINE

Facility

$103.42

Service Code	EAPG 00531
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: MINOR AUDIOMETRIC TESTS AND SCREENING SERVICES

Facility

$56.88

Service Code	EAPG 00229
Min. Negotiated Rate	$56.88
Max. Negotiated Rate	$56.88
Rate for Payer: Aetna CHP/Medicaid	$56.88
Rate for Payer: Humana OH Medicaid	$56.88

EAPG 3.18: MINOR DERMATOLOGY SERVICES

Facility

$29.73

Service Code	EAPG 00177
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: MINOR DEVICE EVALUATION AND INTERROGATION

Facility

$58.18

Service Code	EAPG 00488
Min. Negotiated Rate	$58.18
Max. Negotiated Rate	$58.18
Rate for Payer: Aetna CHP/Medicaid	$58.18
Rate for Payer: Humana OH Medicaid	$58.18

EAPG 3.18: MINOR EAR, NOSE, MOUTH AND THROAT PROCEDURES

Facility

$94.37

Service Code	EAPG 00249
Min. Negotiated Rate	$94.37
Max. Negotiated Rate	$94.37
Rate for Payer: Aetna CHP/Medicaid	$94.37
Rate for Payer: Humana OH Medicaid	$94.37

EAPG 3.18: MINOR FEMALE REPRODUCTIVE PROCEDURES

Facility

$103.42

Service Code	EAPG 00417
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: MINOR MUSCULOSKELETAL PROCEDURES

Facility

$333.54

Service Code	EAPG 02030
Min. Negotiated Rate	$333.54
Max. Negotiated Rate	$333.54
Rate for Payer: Aetna CHP/Medicaid	$333.54
Rate for Payer: Humana OH Medicaid	$333.54

EAPG 3.18: MINOR OPHTHALMOLOGICAL INJECTION, SCRAPING AND TESTS

Facility

$64.64

Service Code	EAPG 00419
Min. Negotiated Rate	$64.64
Max. Negotiated Rate	$64.64
Rate for Payer: Aetna CHP/Medicaid	$64.64
Rate for Payer: Humana OH Medicaid	$64.64

EAPG 3.18: MINOR PULMONARY TESTS AND SERVICES

Facility

$51.71

Service Code	EAPG 00412
Min. Negotiated Rate	$51.71
Max. Negotiated Rate	$51.71
Rate for Payer: Aetna CHP/Medicaid	$51.71
Rate for Payer: Humana OH Medicaid	$51.71

EAPG 3.18: MINOR SPECIMEN COLLECTION SERVICES

Facility

$28.44

Service Code	EAPG 00304
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$28.44
Rate for Payer: Aetna CHP/Medicaid	$28.44
Rate for Payer: Humana OH Medicaid	$28.44

EAPG 3.18: MINOR SPLINT AND STRAPPING APPLICATION

Facility

$149.96

Service Code	EAPG 00040
Min. Negotiated Rate	$149.96
Max. Negotiated Rate	$149.96
Rate for Payer: Aetna CHP/Medicaid	$149.96
Rate for Payer: Humana OH Medicaid	$149.96

EAPG 3.18: MINOR UROLOGY SERVICES

Facility

$276.66

Service Code	EAPG 00159
Min. Negotiated Rate	$276.66
Max. Negotiated Rate	$276.66
Rate for Payer: Aetna CHP/Medicaid	$276.66
Rate for Payer: Humana OH Medicaid	$276.66

EAPG 3.18: MOHS MICROGRAPHIC SURGERY

Facility

$872.64

Service Code	EAPG 00019
Min. Negotiated Rate	$872.64
Max. Negotiated Rate	$872.64
Rate for Payer: Aetna CHP/Medicaid	$872.64
Rate for Payer: Humana OH Medicaid	$872.64

EAPG 3.18: MRI GUIDANCE

Facility

$184.87

Service Code	EAPG 00475
Min. Negotiated Rate	$184.87
Max. Negotiated Rate	$184.87
Rate for Payer: Aetna CHP/Medicaid	$184.87
Rate for Payer: Humana OH Medicaid	$184.87

Know your out-of-pocket cost for care.

All Charges