Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 3.18: OPEN INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$1,773.72

Service Code	EAPG 00266
Min. Negotiated Rate	$1,773.72
Max. Negotiated Rate	$1,773.72
Rate for Payer: Aetna CHP/Medicaid	$1,773.72
Rate for Payer: Humana OH Medicaid	$1,773.72

EAPG 3.18: OPEN OR PERCUTANEOUS TREATMENT OF FRACTURES

Facility

$2,091.75

Service Code	EAPG 00043
Min. Negotiated Rate	$2,091.75
Max. Negotiated Rate	$2,091.75
Rate for Payer: Aetna CHP/Medicaid	$2,091.75
Rate for Payer: Humana OH Medicaid	$2,091.75

EAPG 3.18: OPEN WOUNDS, PUNCTURES AND OTHER OPEN TRAUMATIC INJURIES

Facility

$125.40

Service Code	EAPG 00674
Min. Negotiated Rate	$125.40
Max. Negotiated Rate	$125.40
Rate for Payer: Aetna CHP/Medicaid	$125.40
Rate for Payer: Humana OH Medicaid	$125.40

EAPG 3.18: OPHTHALMOLOGICAL TESTS AND PROCEDURES

Facility

$138.33

Service Code	EAPG 00230
Min. Negotiated Rate	$138.33
Max. Negotiated Rate	$138.33
Rate for Payer: Aetna CHP/Medicaid	$138.33
Rate for Payer: Humana OH Medicaid	$138.33

EAPG 3.18: OPIOID ABUSE AND DEPENDENCE

Facility

$103.42

Service Code	EAPG 00840
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: ORGANIC BEHAVIORAL HEALTH DISTURBANCES

Facility

$104.72

Service Code	EAPG 00827
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: ORGAN OR DISEASE ORIENTED PANELS

Facility

$20.68

Service Code	EAPG 00403
Min. Negotiated Rate	$20.68
Max. Negotiated Rate	$20.68
Rate for Payer: Aetna CHP/Medicaid	$20.68
Rate for Payer: Humana OH Medicaid	$20.68

EAPG 3.18: OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS

Facility

$106.01

Service Code	EAPG 00654
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: OSTEOPOROSIS

Facility

$73.69

Service Code	EAPG 00662
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: OTHER AFTERCARE AND CONVALESCENCE

Facility

$87.91

Service Code	EAPG 00872
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: OTHER ANTEPARTUM DIAGNOSES

Facility

$99.55

Service Code	EAPG 00765
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: OTHER BEHAVIORAL HEALTH DIAGNOSES

Facility

$85.32

Service Code	EAPG 00831
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: OTHER CARDIOVASCULAR SYSTEM DIAGNOSES

Facility

$91.79

Service Code	EAPG 00592
Min. Negotiated Rate	$91.79
Max. Negotiated Rate	$91.79
Rate for Payer: Aetna CHP/Medicaid	$91.79
Rate for Payer: Humana OH Medicaid	$91.79

EAPG 3.18: OTHER CENTRAL NERVOUS SYSTEM DIAGNOSES

Facility

$87.91

Service Code	EAPG 00524
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: OTHER COMPLICATIONS OF TREATMENT

Facility

$111.18

Service Code	EAPG 00852
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: OTHER CRANIOTOMY PROCEDURES INCLUDING CRANIOPLASTY

Facility

$1,905.59

Service Code	EAPG 00267
Min. Negotiated Rate	$1,905.59
Max. Negotiated Rate	$1,905.59
Rate for Payer: Aetna CHP/Medicaid	$1,905.59
Rate for Payer: Humana OH Medicaid	$1,905.59

EAPG 3.18: OTHER DRUG ABUSE AND DEPENDENCE

Facility

$103.42

Service Code	EAPG 00843
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: OTHER EAR, NOSE, MOUTH, THROAT AND CRANIOFACIAL DIAGNOSES

Facility

$90.50

Service Code	EAPG 00564
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: OTHER ENDOCRINE SYSTEM DIAGNOSES

Facility

$89.20

Service Code	EAPG 00692
Min. Negotiated Rate	$89.20
Max. Negotiated Rate	$89.20
Rate for Payer: Aetna CHP/Medicaid	$89.20
Rate for Payer: Humana OH Medicaid	$89.20

EAPG 3.18: OTHER EYE INFECTION DIAGNOSES

Facility

$96.96

Service Code	EAPG 00557
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: OTHER FEMALE REPRODUCTIVE SYSTEM AND MENSTRUAL DIAGNOSES

Facility

$84.03

Service Code	EAPG 00752
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: OTHER GASTROINTESTINAL SYSTEM DIAGNOSES

Facility

$94.37

Service Code	EAPG 00624
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: OTHER GYNECOLOGICAL PROCEDURES

Facility

$398.18

Service Code	EAPG 00209
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$398.18
Rate for Payer: Aetna CHP/Medicaid	$398.18
Rate for Payer: Humana OH Medicaid	$398.18

EAPG 3.18: OTHER HEMATOLOGICAL DIAGNOSES

Facility

$102.13

Service Code	EAPG 00780
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: OTHER HEPATOBILIARY SYSTEM DIAGNOSES

Facility

$93.08

Service Code	EAPG 00639
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

Know your out-of-pocket cost for care.

All Charges