Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 3.18: PERIPHERAL AND OTHER VASCULAR RELATED INJURIES

Facility

$100.84

Service Code	EAPG 00548
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: PERIPHERAL, CRANIAL, AND AUTONOMIC NERVE INJURIES

Facility

$94.37

Service Code	EAPG 00545
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: PERIPHERAL VASCULAR BYPASS PROCEDURES

Facility

$1,657.37

Service Code	EAPG 00123
Min. Negotiated Rate	$1,657.37
Max. Negotiated Rate	$1,657.37
Rate for Payer: Aetna CHP/Medicaid	$1,657.37
Rate for Payer: Humana OH Medicaid	$1,657.37

EAPG 3.18: PERSONALITY AND IMPULSE CONTROL DIAGNOSES

Facility

$85.32

Service Code	EAPG 00822
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: PET SCANS

Facility

$1,073.02

Service Code	EAPG 00290
Min. Negotiated Rate	$1,073.02
Max. Negotiated Rate	$1,073.02
Rate for Payer: Aetna CHP/Medicaid	$1,073.02
Rate for Payer: Humana OH Medicaid	$1,073.02

EAPG 3.18: PHARMACOTHERAPY BY EXTENDED INFUSION

Facility

$504.19

Service Code	EAPG 00110
Min. Negotiated Rate	$504.19
Max. Negotiated Rate	$504.19
Rate for Payer: Aetna CHP/Medicaid	$504.19
Rate for Payer: Humana OH Medicaid	$504.19

EAPG 3.18: PHARMACOTHERAPY EXCEPT BY EXTENDED INFUSION

Facility

$188.75

Service Code	EAPG 00111
Min. Negotiated Rate	$188.75
Max. Negotiated Rate	$188.75
Rate for Payer: Aetna CHP/Medicaid	$188.75
Rate for Payer: Humana OH Medicaid	$188.75

EAPG 3.18: PHLEBITIS

Facility

$85.32

Service Code	EAPG 00597
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: PHYSICAL THERAPY

Facility

$87.91

Service Code	EAPG 00271
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: POISONING OF MEDICINAL AGENTS

Facility

$129.28

Service Code	EAPG 00851
Min. Negotiated Rate	$129.28
Max. Negotiated Rate	$129.28
Rate for Payer: Aetna CHP/Medicaid	$129.28
Rate for Payer: Humana OH Medicaid	$129.28

EAPG 3.18: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS AND COMPLICATIONS

Facility

$100.84

Service Code	EAPG 00806
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: POSTPARTUM AND POST ABORTION DIAGNOSES

Facility

$93.08

Service Code	EAPG 00761
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: PRESSURE ULCERS

Facility

$103.42

Service Code	EAPG 00676
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: PRETERM LABOR DIAGNOSES

Facility

$120.23

Service Code	EAPG 00762
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: PREVENTIVE DENTAL PROCEDURES

Facility

$42.66

Service Code	EAPG 00377
Min. Negotiated Rate	$42.66
Max. Negotiated Rate	$42.66
Rate for Payer: Aetna CHP/Medicaid	$42.66
Rate for Payer: Humana OH Medicaid	$42.66

EAPG 3.18: PREVENTIVE OR SCREENING ENCOUNTER

Facility

$90.50

Service Code	EAPG 00879
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: PROCEDURES FOR REVISION OR REMOVAL OF NEUROSTIMULATOR DEVICES

Facility

$1,362.61

Service Code	EAPG 00276
Min. Negotiated Rate	$1,362.61
Max. Negotiated Rate	$1,362.61
Rate for Payer: Aetna CHP/Medicaid	$1,362.61
Rate for Payer: Humana OH Medicaid	$1,362.61

EAPG 3.18: PROSTATITIS

Facility

$84.03

Service Code	EAPG 00743
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: PULMONARY EMBOLISM

Facility

$104.72

Service Code	EAPG 00586
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: PULMONARY FUNCTION TESTS

Facility

$192.63

Service Code	EAPG 00060
Min. Negotiated Rate	$192.63
Max. Negotiated Rate	$192.63
Rate for Payer: Aetna CHP/Medicaid	$192.63
Rate for Payer: Humana OH Medicaid	$192.63

EAPG 3.18: PULMONARY INFECTION DIAGNOSES INCLUDING PNEUMONIA

Facility

$112.47

Service Code	EAPG 00581
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: RADIATION THERAPY MANAGEMENT

Facility

$222.36

Service Code	EAPG 00483
Min. Negotiated Rate	$222.36
Max. Negotiated Rate	$222.36
Rate for Payer: Aetna CHP/Medicaid	$222.36
Rate for Payer: Humana OH Medicaid	$222.36

EAPG 3.18: RADIOLOGICAL GUIDANCE FOR THERAPEUTIC OR DIAGNOSTIC PROCEDURES

Facility

$249.51

Service Code	EAPG 00474
Min. Negotiated Rate	$249.51
Max. Negotiated Rate	$249.51
Rate for Payer: Aetna CHP/Medicaid	$249.51
Rate for Payer: Humana OH Medicaid	$249.51

EAPG 3.18: RADIOSURGERY

Facility

$3,372.92

Service Code	EAPG 00346
Min. Negotiated Rate	$3,372.92
Max. Negotiated Rate	$3,372.92
Rate for Payer: Aetna CHP/Medicaid	$3,372.92
Rate for Payer: Humana OH Medicaid	$3,372.92

EAPG 3.18: RADIOTHERAPY

Facility

$77.57

Service Code	EAPG 00802
Min. Negotiated Rate	$77.57
Max. Negotiated Rate	$77.57
Rate for Payer: Aetna CHP/Medicaid	$77.57
Rate for Payer: Humana OH Medicaid	$77.57

Know your out-of-pocket cost for care.

All Charges