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Charges for Select Hospital Services

Charges effective January 1, 2019

Room and Board - Per Day Charges

Med/Surg Semi Private $1,791
Med/Surg Private $1,825
ICU $3,959
Chemical Dependency ONCOL $2,750
Chemical Dependency DETOX $1,791

Emergency Department Charges

Emergency Department charges are based on the level of emergency care provided to our patients. The levels, with level 1 representing basic emergency care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. They also do not include Emergency Department physician fees, which are billed separately.

Level 1 $334
Level 2 $530
Level 3 $875
Level 4 $1,433
Level 5 $2,315

Operating Room Charges

Operating Room Charges are based on the complexity level, with Type 1 being the most basic. The following list does not include charges for anesthesia, drugs, or supplies required for a particular operating room procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.

Level 1 - 30 mins $2,391 Level 1 - each additional 15 mins $1,009
Level 2 - 30 mins $2,918 Level 2 - each additional 15 mins $1,163
Level 3 - 30 mins $3,369 Level 3 - each additional 15 mins $1,319
Level 4 - 30 mins $3,673 Level 4 - each additional 15 mins $1,474
Recovery Phase I - 30 mins $622 Phase I - each additional 15 mins $236
Recovery Phase II - 30 mins $389 Phase II - each additional 15 mins $158

Observation Status

Initial Hour $704
Each Additional Hour $44
R+B Oncology $2,696
R+B Detox $1,756
R+B Step Down $2,835

Physical, Occupational and Pulmonary Therapies

The following charges reflect the most common services offered by our Physical Therapy, Occupational Therapy, and Pulmonary Therapy Departments. Patients may have additional charges, depending upon the services performed.

Inhalation Treatment $332
Occupational Therapy - 15 mins $188
Occupational Therapy Evaluation $470
Physical Therapy Evaluation $369
Physical Therapy - 15 mins $201
Gait Training - 15 mins $137

X-Ray and Radiological Charges

The following charges reflect the hospital’s 30 most common x-ray and radiological procedures.

CT Head/Brain without contrast $1,896 Chest X-Ray 1 view $290
CT Head/Brain w & without contrast $2,885 Chest X-Ray 2 views $359
CT Sinuses/Facial $1,918 Lumbar Spine 1 view $317
CT Pelvis with contrast $2,431 Lumbar Spine 3 views $404
CT Thorax with contrast $2,597 Lumbar Spine-obliques $791
CT Abdomen with /contrast $2,635 Modified Barium Swallow $800
MRI Brain w & without contrast $6,440 Abdomen X-Ray-3 views $393
Thoracic Spine X-Ray 3 views $468 Abdomen X-Ray-Compl $653
Cervical Spine X-Ray 2-3 views $367 Bone Density Study $587
Cervical Spine X-Ray 4 view min. $485 Shoulder X-Ray $388
Screening Mammogram-bilateral $534 Elbow X-Ray-3 views $326
Diagnostic Mammogram-bilateral $651 Wrist X-RAY-3 views $415
Hand X-Ray $381 Hip X-Ray compl.-1 view $330
Finger X-Ray-2 views-one hand $244 Knee X-Ray compl-4 view $473
Ankle X-Ray-compl.-3 views $408 Foot X-Ray compl-3 view $379

Laboratory Charges

The following charges reflect the hospital’s most common laboratory procedures.

Basic Metabolic Panel $126 BUN $39
CBC $90 Creatine Kinase MB frac $99
CBC Platelet Auto Diff $99
Comp Metabolic Panel $240 Creatine Kinase (CK) $77
Creatine Bld $47 Culture Blood $201
Culture Urine $77 Cyto PAP Smear $105
Hematocrit $32 Hemoglobin $32
Hemoglobin A1C $126 CBC Auto $90
Hepatic Panel $111 Lipid Panel $176
Lytes Panel $72 Magnesium $80
Myoglobin $208 Protime $51
PTT (Partial Prothrombin Time) $91 PSA $122
SED Rate Manual $47 Sensitivity Micro $87
Surgical Pathology Level 4 $416 Troponin Quant $174
TSH (Thyroid Stimulating Hormone) $192 Urinanalysis- with Micro $47
Urinalysis w/out Micro $30 Venipuncture $16

* In accordance with Ohio Revised Code, Section 3727.42

Professional fees are not billed by the hospital and are not included in these charges. Prices/charges may be updated at any time without notice. The patient/guarantor may be responsible for any amount different than those prices listed here.

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