Southern Ohio Medical Center

All Charges

Charge

Type

Setting

Price

EAPG 3.18: REHABILITATION

Facility

$80.15

Service Code	EAPG 00870
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: REMOVAL OR REVISION OF PACEMAKERS AND OTHER CARDIOVASCULAR DEVICES

Facility

$1,601.78

Service Code	EAPG 00087
Min. Negotiated Rate	$1,601.78
Max. Negotiated Rate	$1,601.78
Rate for Payer: Aetna CHP/Medicaid	$1,601.78
Rate for Payer: Humana OH Medicaid	$1,601.78

EAPG 3.18: RENAL FAILURE

Facility

$86.62

Service Code	EAPG 00720
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: RESPIRATORY FAILURE

Facility

$99.55

Service Code	EAPG 00587
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: RESPIRATORY MALIGNANCY

Facility

$89.20

Service Code	EAPG 00571
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: RESUSCITATION

Facility

$404.65

Service Code	EAPG 00092
Min. Negotiated Rate	$404.65
Max. Negotiated Rate	$404.65
Rate for Payer: Aetna CHP/Medicaid	$404.65
Rate for Payer: Humana OH Medicaid	$404.65

EAPG 3.18: REVISION, REPAIR OR REMOVAL OF CENTRAL VENOUS ACCESS DEVICE

Facility

$579.17

Service Code	EAPG 00076
Min. Negotiated Rate	$579.17
Max. Negotiated Rate	$579.17
Rate for Payer: Aetna CHP/Medicaid	$579.17
Rate for Payer: Humana OH Medicaid	$579.17

EAPG 3.18: REVISION, REPLACEMENT OR REMOVAL OF CARDIAC DEVICE COMPONENT

Facility

$1,853.88

Service Code	EAPG 00074
Min. Negotiated Rate	$1,853.88
Max. Negotiated Rate	$1,853.88
Rate for Payer: Aetna CHP/Medicaid	$1,853.88
Rate for Payer: Humana OH Medicaid	$1,853.88

EAPG 3.18: ROUTINE PRENATAL CARE

Facility

$95.67

Service Code	EAPG 00766
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: SCHIZOPHRENIA

Facility

$85.32

Service Code	EAPG 00820
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: SCIATICA

Facility

$108.60

Service Code	EAPG 00658
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: SCREENING COLORECTAL SERVICES

Facility

$545.56

Service Code	EAPG 00149
Min. Negotiated Rate	$545.56
Max. Negotiated Rate	$545.56
Rate for Payer: Aetna CHP/Medicaid	$545.56
Rate for Payer: Humana OH Medicaid	$545.56

EAPG 3.18: SCREENING FOR BEHAVIORAL CHANGE OR RISK ASSESSMENT

Facility

$36.20

Service Code	EAPG 00324
Min. Negotiated Rate	$36.20
Max. Negotiated Rate	$36.20
Rate for Payer: Aetna CHP/Medicaid	$36.20
Rate for Payer: Humana OH Medicaid	$36.20

EAPG 3.18: SEALANT

Facility

$27.15

Service Code	EAPG 00372
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Aetna CHP/Medicaid	$27.15
Rate for Payer: Humana OH Medicaid	$27.15

EAPG 3.18: SEIZURE

Facility

$100.84

Service Code	EAPG 00529
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: SEPTICEMIA AND DISSEMINATED INFECTIONS

Facility

$118.94

Service Code	EAPG 00805
Min. Negotiated Rate	$118.94
Max. Negotiated Rate	$118.94
Rate for Payer: Aetna CHP/Medicaid	$118.94
Rate for Payer: Humana OH Medicaid	$118.94

EAPG 3.18: SHOULDER AND UPPER ARM PROCEDURES

Facility

$1,606.95

Service Code	EAPG 00025
Min. Negotiated Rate	$1,606.95
Max. Negotiated Rate	$1,606.95
Rate for Payer: Aetna CHP/Medicaid	$1,606.95
Rate for Payer: Humana OH Medicaid	$1,606.95

EAPG 3.18: SICKLE CELL ANEMIA CRISIS

Facility

$224.95

Service Code	EAPG 00783
Min. Negotiated Rate	$224.95
Max. Negotiated Rate	$224.95
Rate for Payer: Aetna CHP/Medicaid	$224.95
Rate for Payer: Humana OH Medicaid	$224.95

EAPG 3.18: SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$90.50

Service Code	EAPG 00871
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: SIMPLE WOUND REPAIR AND TREATMENT

Facility

$323.20

Service Code	EAPG 00016
Min. Negotiated Rate	$323.20
Max. Negotiated Rate	$323.20
Rate for Payer: Aetna CHP/Medicaid	$323.20
Rate for Payer: Humana OH Medicaid	$323.20

EAPG 3.18: SKIN AND CONNECTIVE TISSUE GRAFTING AND FLAP PROCEDURES

Facility

$1,022.60

Service Code	EAPG 00056
Min. Negotiated Rate	$1,022.60
Max. Negotiated Rate	$1,022.60
Rate for Payer: Aetna CHP/Medicaid	$1,022.60
Rate for Payer: Humana OH Medicaid	$1,022.60

EAPG 3.18: SLEEP STUDIES ATTENDED

Facility

$605.03

Service Code	EAPG 00222
Min. Negotiated Rate	$605.03
Max. Negotiated Rate	$605.03
Rate for Payer: Aetna CHP/Medicaid	$605.03
Rate for Payer: Humana OH Medicaid	$605.03

EAPG 3.18: SLEEP STUDIES UNATTENDED

Facility

$341.30

Service Code	EAPG 00226
Min. Negotiated Rate	$341.30
Max. Negotiated Rate	$341.30
Rate for Payer: Aetna CHP/Medicaid	$341.30
Rate for Payer: Humana OH Medicaid	$341.30

EAPG 3.18: SPEECH THERAPY AND EVALUATION

Facility

$85.32

Service Code	EAPG 00272
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: SPINAL DIAGNOSES AND INJURIES

Facility

$100.84

Service Code	EAPG 00520
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

Know your out-of-pocket cost for care.

All Charges