Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 3.18: OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$86.62

Service Code	EAPG 00809
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: OTHER INJURIES AND DISORDERS OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE

Facility

$135.74

Service Code	EAPG 00652
Min. Negotiated Rate	$135.74
Max. Negotiated Rate	$135.74
Rate for Payer: Aetna CHP/Medicaid	$135.74
Rate for Payer: Humana OH Medicaid	$135.74

EAPG 3.18: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$116.35

Service Code	EAPG 00853
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: OTHER INTRA-ABDOMINAL AND INTRAPERITONEAL SURGICAL PROCEDURES

Facility

$1,467.33

Service Code	EAPG 00108
Min. Negotiated Rate	$1,467.33
Max. Negotiated Rate	$1,467.33
Rate for Payer: Aetna CHP/Medicaid	$1,467.33
Rate for Payer: Humana OH Medicaid	$1,467.33

EAPG 3.18: OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$94.37

Service Code	EAPG 00726
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 MAJOR LIVER DIAGNOSES

Facility

$90.50

Service Code	EAPG 00641
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 MALE REPRODUCTIVE SYSTEM DIAGNOSES

Facility

$93.08

Service Code	EAPG 00741
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: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$98.25

Service Code	EAPG 00660
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: OTHER OPHTHALMIC SYSTEM DIAGNOSES

Facility

$96.96

Service Code	EAPG 00553
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 PATHOLOGICAL FRACTURES W/O MUSCULOSKELETAL MALIGNANCY

Facility

$111.18

Service Code	EAPG 00649
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 RESPIRATORY SYSTEM DIAGNOSES

Facility

$99.55

Service Code	EAPG 00576
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 SKIN, SUBCUTANEOUS TISSUE AND BREAST DIAGNOSES

Facility

$84.03

Service Code	EAPG 00675
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: OTORHINOLARYNGOLOGIC FUNCTION TESTS

Facility

$95.67

Service Code	EAPG 00251
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: PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT

Facility

$4,482.14

Service Code	EAPG 00086
Min. Negotiated Rate	$4,482.14
Max. Negotiated Rate	$4,482.14
Rate for Payer: Aetna CHP/Medicaid	$4,482.14
Rate for Payer: Humana OH Medicaid	$4,482.14

EAPG 3.18: PAIN

Facility

$98.25

Service Code	EAPG 00663
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: PANCREAS DIAGNOSES EXCEPT MALIGNANCY

Facility

$87.91

Service Code	EAPG 00635
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: PAP SMEARS

Facility

$23.27

Service Code	EAPG 00392
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$23.27
Rate for Payer: Aetna CHP/Medicaid	$23.27
Rate for Payer: Humana OH Medicaid	$23.27

EAPG 3.18: PARTIAL THICKNESS BURNS W OR W/O SKIN GRAFT

Facility

$111.18

Service Code	EAPG 00861
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: PATHOLOGY CONSULTATION AND INTERPRETATION

Facility

$47.83

Service Code	EAPG 00158
Min. Negotiated Rate	$47.83
Max. Negotiated Rate	$47.83
Rate for Payer: Aetna CHP/Medicaid	$47.83
Rate for Payer: Humana OH Medicaid	$47.83

EAPG 3.18: PELVIS, FEMUR AND UPPER LEG PROCEDURES

Facility

$1,546.19

Service Code	EAPG 00027
Min. Negotiated Rate	$1,546.19
Max. Negotiated Rate	$1,546.19
Rate for Payer: Aetna CHP/Medicaid	$1,546.19
Rate for Payer: Humana OH Medicaid	$1,546.19

EAPG 3.18: PEPTIC ULCER AND GASTRITIS

Facility

$109.89

Service Code	EAPG 00621
Min. Negotiated Rate	$109.89
Max. Negotiated Rate	$109.89
Rate for Payer: Aetna CHP/Medicaid	$109.89
Rate for Payer: Humana OH Medicaid	$109.89

EAPG 3.18: PERCUTANEOUS INTRA-ABDOMINAL OR INTRATHORACIC VASCULAR PROCEDURES

Facility

$1,092.42

Service Code	EAPG 00122
Min. Negotiated Rate	$1,092.42
Max. Negotiated Rate	$1,092.42
Rate for Payer: Aetna CHP/Medicaid	$1,092.42
Rate for Payer: Humana OH Medicaid	$1,092.42

EAPG 3.18: PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$1,861.63

Service Code	EAPG 00265
Min. Negotiated Rate	$1,861.63
Max. Negotiated Rate	$1,861.63
Rate for Payer: Aetna CHP/Medicaid	$1,861.63
Rate for Payer: Humana OH Medicaid	$1,861.63

EAPG 3.18: PERIPHERAL AND CRANIAL NERVE DIAGNOSES

Facility

$89.20

Service Code	EAPG 00527
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: PERIPHERAL AND OTHER VASCULAR DIAGNOSES

Facility

$98.25

Service Code	EAPG 00596
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

Know your out-of-pocket cost for care.

All Charges