ARH Our Lady of the Way Hospital
11203 Main Street, Martin, KY · Arh · · NPI 1306339460
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Mpl gene analysis common variants CPT 81338 | $746.40 | $1,244.00 | $150.33 – $150.33 | 5 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $3,052.20 | $5,087.00 | $760.00 – $760.00 | 2 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,306.40 | $3,844.00 | $760.00 – $760.00 | 2 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $104.40 | $174.00 | $11.53 – $11.53 | 5 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $110.40 | $184.00 | $0.08 – $0.08 | 2 |
| Natriuretic peptide CPT 83880 | $230.40 | $384.00 | $39.26 – $39.26 | 5 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $2,537.40 | $4,229.00 | $542.00 – $542.00 | 2 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $3,052.20 | $5,087.00 | $760.00 – $760.00 | 2 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $103.20 | $172.00 | $0.10 – $0.10 | 2 |
| Nushield 1 square cm HCPCS Q4160 | $817.69 | $1,362.81 | $625.00 – $625.00 | 2 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $332.40 | $554.00 | $0.71 – $0.71 | 2 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $4.80 | $8.00 | $0.01 – $0.01 | 2 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $1.20 | $2.00 | $0.11 – $0.11 | 2 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $53.40 | $89.00 | $11.14 – $11.14 | 2 |
| Ot evaluation high complexity patient/family CPT 97167 | $272.40 | $454.00 | $122.74 – $122.74 | 2 |
| Ot evaluation low complexity patient/family CPT 97165 | $272.40 | $454.00 | $122.74 – $122.74 | 2 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $272.40 | $454.00 | $122.74 – $122.74 | 2 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $141.00 | $235.00 | $89.96 – $89.96 | 2 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $141.00 | $235.00 | $45.50 – $45.50 | 2 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $208.20 | $347.00 | $41.00 – $41.00 | 2 |
| Ot re-evaluation patient/family CPT 97168 | $213.00 | $355.00 | $98.18 – $98.18 | 2 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $164.40 | $274.00 | $36.74 – $36.74 | 2 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $174.60 | $291.00 | $44.00 – $44.00 | 2 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $152.40 | $254.00 | $44.00 – $44.00 | 2 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $161.40 | $269.00 | $41.76 – $41.76 | 2 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $8,341.20 | $13,902.00 | $17.79 – $17.79 | 2 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $11.40 | $19.00 | $5.36 – $5.36 | 2 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,918.40 | $4,864.00 | $542.00 – $542.00 | 2 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,357.40 | $3,929.00 | $542.00 – $542.00 | 2 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,700.40 | $2,834.00 | $542.00 – $542.00 | 2 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,205.20 | $5,342.00 | $760.00 – $760.00 | 2 |
| Peng benzathine/procaine inj HCPCS J0558 | $37.20 | $62.00 | $20.48 – $20.48 | 2 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $1,013.40 | $1,689.00 | $34.55 – $34.55 | 2 |
| Ph body fluid CPT 83986 | $158.40 | $264.00 | $3.58 – $3.58 | 5 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $6.60 | $11.00 | $0.78 – $0.78 | 2 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $16.80 | $28.00 | $3.35 – $3.35 | 2 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $31.20 | $52.00 | $1.31 – $1.31 | 2 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $15.90 | $26.50 | $0.20 – $0.20 | 2 |
| Potassium serum/plasma/whole blood CPT 84132 | $19.20 | $32.00 | $4.76 – $4.76 | 5 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | $118.80 | $198.00 | $72.89 – $103.34 | 4 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $11.40 | $19.00 | $0.33 – $0.33 | 2 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $62.40 | $104.00 | $2.98 – $2.98 | 2 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $86.40 | $144.00 | $0.10 – $0.10 | 2 |
| Prothrombin complex kcentra HCPCS J7168 | $9.00 | $15.00 | $3.21 – $3.21 | 2 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $164.40 | $274.00 | $20.14 – $20.14 | 2 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $186.60 | $311.00 | $22.50 – $22.50 | 2 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $181.20 | $302.00 | $18.00 – $18.00 | 2 |
| Pt application of modality traction mechanical CPT 97012 | $200.40 | $334.00 | $21.68 – $21.68 | 2 |
| Pt evaluation high complexity patient/family CPT 97163 | $223.80 | $373.00 | $120.70 – $120.70 | 2 |
| Pt evaluation low complexity patient/family CPT 97161 | $223.80 | $373.00 | $120.70 – $120.70 | 2 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $223.80 | $373.00 | $120.70 – $120.70 | 2 |
| Pt re-evaluation patient/family CPT 97164 | $148.80 | $248.00 | $60.36 – $60.36 | 2 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $141.00 | $235.00 | $43.22 – $43.22 | 2 |
| Pt wheelchair management each 15 minutes CPT 97542 | $141.00 | $235.00 | $37.22 – $37.22 | 2 |
| Rabies ig ht&sol human im/sc CPT 90377 | $13,679.40 | $22,799.00 | $279.60 – $279.60 | 2 |
| Rapid Strep Test CPT 87880 | $63.60 | $106.00 | $16.53 – $16.53 | 5 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $1,909.80 | $3,183.00 | $7.94 – $7.94 | 2 |
| Renal function panel CPT 80069 | $235.20 | $392.00 | $8.68 – $8.68 | 5 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $37.80 | $63.00 | $18.05 – $18.05 | 5 |
| Screening Mammogram CPT 77067 | $229.20 | $382.00 | $120.00 – $120.00 | 2 |
| Shoulder MRI (without contrast) CPT 73221 | $3,205.20 | $5,342.00 | $760.00 – $760.00 | 2 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $545.40 | $909.00 | $160.35 – $160.35 | 2 |
| Sinus CT scan (with contrast) CPT 70487 | $1,999.80 | $3,333.00 | $542.00 – $542.00 | 2 |
| Sinus CT scan (without contrast) CPT 70486 | $1,587.60 | $2,646.00 | $542.00 – $542.00 | 2 |
| Sodium serum/plasma/whole blood CPT 84295 | $89.40 | $149.00 | $4.81 – $4.81 | 5 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $64.80 | $108.00 | $1.60 – $1.60 | 2 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $247.20 | $412.00 | $61.19 – $61.19 | 2 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $9.60 | $16.00 | $0.19 – $0.19 | 2 |
| Tc-99m maa HCPCS A9540 | $103.20 | $172.00 | $35.38 – $35.38 | 2 |
| Tc-99m mebrofenin HCPCS A9537 | $121.80 | $203.00 | $66.63 – $66.63 | 2 |
| Tc-99m medronate HCPCS A9503 | $103.20 | $172.00 | $15.33 – $15.33 | 2 |
| Tc-99m pentetate dtpa HCPCS A9539 | $103.20 | $172.00 | $0.01 – $0.01 | 2 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $3.00 | $5.00 | $1.99 – $1.99 | 2 |
| Tc-99m sulfur colloid HCPCS A9541 | $103.20 | $172.00 | $315.30 – $315.30 | 2 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $21,126.00 | $35,210.00 | $202.76 – $202.76 | 2 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $17.40 | $29.00 | $2.11 – $2.11 | 2 |
| Thyroid (TSH) Test CPT 84443 | $64.20 | $107.00 | $16.80 – $16.80 | 5 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $12.00 | $20.00 | $2.90 – $2.90 | 2 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $40.20 | $67.00 | $120.00 – $120.00 | 2 |
| Treponema pallidum antibody CPT 86780 | $192.60 | $321.00 | $13.24 – $13.24 | 5 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $31.80 | $53.00 | $1.01 – $1.01 | 2 |
| Triglycerides CPT 84478 | $95.40 | $159.00 | $5.74 – $5.74 | 5 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $3,010.20 | $5,017.00 | $760.00 – $760.00 | 2 |
| Urea nitrogen CPT 84520 | $73.80 | $123.00 | $3.95 – $3.95 | 5 |
| Uric acid blood CPT 84550 | $67.80 | $113.00 | $4.52 – $4.52 | 5 |
| Urinalysis (without microscopy) CPT 81003 | $34.20 | $57.00 | $2.25 – $2.25 | 5 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $589.50 | $982.50 | $164.49 – $164.49 | 2 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $250.80 | $418.00 | $70.20 – $70.20 | 2 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $54.90 | $91.50 | $23.31 – $23.31 | 2 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $69.00 | $115.00 | $26.25 – $26.25 | 2 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $451.80 | $753.00 | $150.15 – $150.15 | 2 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $991.20 | $1,652.00 | $330.30 – $330.30 | 2 |
| Vaccine rabies im CPT 90675 | $1,326.00 | $2,210.00 | $497.86 – $497.86 | 2 |
| Vaccine tdap >=7 years im CPT 90715 | $173.40 | $289.00 | $58.64 – $58.64 | 2 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $105.60 | $176.00 | $48.49 – $48.49 | 2 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $94.20 | $157.00 | $0.04 – $0.04 | 2 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | $82.20 | $137.00 | $0.14 – $0.14 | 2 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $325.80 | $543.00 | $1.48 – $1.48 | 2 |
| Warde 1015200 kappa light chain free CPT 83521 | $108.00 | $180.00 | $17.27 – $17.27 | 5 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $15.00 | $25.00 | $12.05 – $12.05 | 5 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.