University Hospitals Samaritan Medical Center
1025 Center St, Ashland, OH · University Hospitals · · NPI 1902882939
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $141.75 | $189.00 | $29.28 – $52.70 | 17 |
| 17-hydroxypregnenolone CPT 84143 | $112.50 | $150.00 | $22.81 – $41.06 | 17 |
| 24 hr ambulatory b/p monitor CPT 93786 | $195.75 | $261.00 | $129.03 – $232.25 | 16 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $1,724.25 | $2,299.00 | $760.25 – $1,368.44 | 16 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $1,137.75 | $1,517.00 | $760.25 – $1,368.44 | 16 |
| 2nd order venous cath CPT 36012 | $2,354.25 | $3,139.00 | $749.88 – $1,349.79 | 16 |
| 3d ech img cgen car anomal CPT 93319 | $1,164.00 | $1,552.00 | $52.48 – $94.46 | 16 |
| 3d recon without postprocess indpndt CPT 76376 | $638.25 | $851.00 | $23.82 – $42.88 | 16 |
| 5' nucleotidase - sendout CPT 83915 | $252.75 | $337.00 | $11.15 – $20.07 | 17 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $108.00 | $144.00 | $51.19 – $92.15 | 16 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $106.50 | $142.00 | $108.30 – $194.93 | 16 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $111.00 | $148.00 | $113.19 – $203.75 | 16 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $111.00 | $148.00 | $118.43 – $213.17 | 16 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $102.75 | $137.00 | $97.85 – $176.14 | 16 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $100.50 | $134.00 | $104.03 – $187.25 | 16 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $111.00 | $148.00 | $103.72 – $186.70 | 16 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $121.50 | $162.00 | $114.16 – $205.48 | 16 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $75.75 | $101.00 | $133.05 – $239.49 | 16 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $5,313.35 | $7,084.46 | $44.72 – $108.29 | 17 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $132.75 | $177.00 | $12.01 – $21.62 | 17 |
| Abd aorta w/runoff s&i CPT 75630 | $3,160.50 | $4,214.00 | $3,062.12 – $5,511.82 | 17 |
| Abd/low ext cath 1st CPT 36245 | $2,412.00 | $3,216.00 | $1,110.36 – $1,998.65 | 16 |
| Abd/low ext cath 2nd CPT 36246 | $2,407.50 | $3,210.00 | $746.07 – $1,342.92 | 16 |
| Abd/low ext cath 3rd CPT 36247 | $328.50 | $438.00 | $1,258.35 – $2,265.04 | 16 |
| Abd/low ext cath addl CPT 36248 | $1,131.00 | $1,508.00 | $105.69 – $190.25 | 16 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $905.25 | $1,207.00 | $231.40 – $416.51 | 16 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $868.50 | $1,158.00 | $101.39 – $182.50 | 16 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,047.50 | $2,730.00 | $170.10 – $306.19 | 16 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,704.75 | $2,273.00 | $170.10 – $306.19 | 16 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,475.25 | $1,967.00 | $101.39 – $182.50 | 16 |
| Abdominal MRI (with and without contrast) CPT 74183 | $2,854.50 | $3,806.00 | $338.34 – $609.01 | 16 |
| Abdominal MRI (with contrast) CPT 74182 | $3,013.50 | $4,018.00 | $338.34 – $609.01 | 16 |
| Abdominal MRI (without contrast) CPT 74181 | $2,439.75 | $3,253.00 | $231.40 – $416.51 | 16 |
| Abdominal paracentesis w/image guidance CPT 49083 | $823.50 | $1,098.00 | $879.59 – $1,583.27 | 16 |
| Abdominal Ultrasound (complete) CPT 76700 | $998.25 | $1,331.00 | $101.39 – $182.50 | 17 |
| Abdominal Ultrasound (limited) CPT 76705 | $735.75 | $981.00 | $101.39 – $182.50 | 17 |
| Abdominal X-ray (2 views) CPT 74019 | $277.50 | $370.00 | $101.39 – $182.50 | 17 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $440.25 | $587.00 | $101.39 – $182.50 | 17 |
| Abdominal X-ray (single view) CPT 74018 | $183.00 | $244.00 | $84.40 – $151.91 | 17 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $747.00 | $996.00 | $879.59 – $1,583.27 | 16 |
| Abl1 gene CPT 81170 | $364.50 | $486.00 | $300.00 – $540.00 | 17 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | $5,246.25 | $6,995.00 | $7,037.08 – $12,666.74 | 16 |
| Ablate bone tumor(s) perq CPT 20982 | $5,092.50 | $6,790.00 | $17,004.30 – $30,607.73 | 16 |
| Ablate heart dysrhythm focus CPT 93650 | $16,052.25 | $21,403.00 | $7,564.11 – $13,615.41 | 16 |
| Ablate pulm tumor perq crybl CPT 32994 | $10,443.00 | $13,924.00 | $10,308.81 – $18,555.86 | 16 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $573.75 | $765.00 | $124.79 – $224.62 | 16 |
| Ablation cryo abd perit om CPT 49999 | $6,964.50 | $9,286.00 | $879.59 – $1,583.27 | 16 |
| Ablation cryo adrenal tumor CPT 60699 | $5,790.75 | $7,721.00 | $5,862.95 – $10,553.31 | 16 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | $234.00 | $312.00 | $239.22 – $430.59 | 16 |
| Ablation cryo pq liver tumor(s) CPT 47383 | $8,080.50 | $10,774.00 | $10,308.81 – $18,555.86 | 16 |
| Ablation cryo retro lymph node CPT 38999 | $418.50 | $558.00 | $427.85 – $770.13 | 16 |
| Ablation cryo thigh/knee CPT 27599 | $228.00 | $304.00 | $239.22 – $430.59 | 16 |
| Ablation of upper extremity nerves rf CPT 64999 | $2,425.50 | $3,234.00 | $297.68 – $535.83 | 16 |
| Abobotulinumtoxina HCPCS J0586 | $3,255.66 | $4,340.87 | $8.90 – $22.32 | 17 |
| Abscess drain retroperitoneal surg code CPT 49406 | $4,681.50 | $6,242.00 | $1,601.72 – $2,883.09 | 16 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $5,877.00 | $7,836.00 | $109.63 – $197.33 | 16 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $147.54 | $196.71 | $0.12 – $0.45 | 2 |
| Acetaminophen level CPT 80143 | $180.00 | $240.00 | $18.64 – $33.55 | 16 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $137.07 | $182.76 | $41.91 – $253.08 | 2 |
| Acetylcholine receptor modulating antibody CPT 86043 | $489.00 | $652.00 | $12.05 – $21.69 | 16 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $406.77 | $542.35 | $0.88 – $6.30 | 2 |
| Acetylcysteine non-comp unit HCPCS J7608 | $87.97 | $117.29 | $21.64 – $61.47 | 2 |
| Acne surgery 10040 CPT 10040 | $295.50 | $394.00 | $194.58 – $350.24 | 16 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $243.00 | $324.00 | $167.28 – $301.10 | 16 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $160.50 | $214.00 | $131.63 – $236.94 | 16 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $65.25 | $87.00 | $16.31 – $29.36 | 16 |
| Acth stimulation panel CPT 80402 | $414.75 | $553.00 | $86.96 – $156.53 | 17 |
| Acth stimulation panel CPT 80406 | $404.25 | $539.00 | $78.26 – $140.87 | 17 |
| Actinotherapy uv light CPT 96900 | $138.75 | $185.00 | $36.22 – $65.20 | 16 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | $45.75 | $61.00 | $28.05 – $50.49 | 16 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | $36.00 | $48.00 | $27.69 – $49.84 | 16 |
| Acup 1/> without estim ea add 15 CPT 97811 | $36.00 | $48.00 | $27.35 – $49.23 | 16 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | $45.75 | $61.00 | $28.05 – $50.49 | 16 |
| Acute hepatitis panel CPT 80074 | $409.50 | $546.00 | $47.63 – $85.73 | 17 |
| Acute venous thrombus image CPT 78456 | $308.25 | $411.00 | $1,255.55 – $2,259.99 | 17 |
| Acyclovir 400 mg tablet HCPCS J8499 | $100,424.10 | $133,898.80 | not published | 0 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $77.65 | $103.53 | $0.05 – $0.54 | 2 |
| #acylcarnitineprfl CPT 82017 | $98.25 | $131.00 | $16.87 – $30.37 | 17 |
| Adapter b 8 channel 10cm HCPCS C1883 | $29,250.00 | $39,000.00 | not published | 0 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $528.78 | $705.04 | $1.10 – $5.40 | 2 |
| Adenovirus antibody,serum - quest CPT 86603 | $49.50 | $66.00 | $12.87 – $23.17 | 17 |
| Adh-sendout CPT 84588 | $663.75 | $885.00 | $33.94 – $61.09 | 17 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $5,046.43 | $6,728.57 | $2.17 – $5.04 | 2 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $420.75 | $561.00 | $69.83 – $125.69 | 16 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $863.25 | $1,151.00 | $69.83 – $125.69 | 16 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $762.00 | $1,016.00 | $320.33 – $576.59 | 16 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $1,003.50 | $1,338.00 | $320.33 – $576.59 | 16 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $559.50 | $746.00 | $69.83 – $125.69 | 16 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $573.75 | $765.00 | $69.83 – $125.69 | 16 |
| Administration immunization each additional component CPT 90461 | $67.50 | $90.00 | $8.48 – $15.27 | 16 |
| Administration immunization each additional vaccine CPT 90472 | $36.75 | $49.00 | $15.11 – $27.19 | 16 |
| Administration immunization first component each vaccine CPT 90460 | $67.50 | $90.00 | $22.08 – $39.74 | 16 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $47.25 | $63.00 | $69.83 – $125.69 | 16 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $44.25 | $59.00 | $11.75 – $21.15 | 16 |
| Administration vaccine hepatitis b HCPCS G0010 | $41.25 | $55.00 | $45.41 – $81.74 | 16 |
| Administration vaccine influenza virus HCPCS G0008 | $41.25 | $55.00 | $45.41 – $81.74 | 16 |
| Administration vaccine pneumococcal HCPCS G0009 | $41.25 | $55.00 | $45.41 – $81.74 | 16 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $23,602.63 | $31,470.17 | $42.20 – $101.86 | 17 |
| Adrenalin epinephrine inject HCPCS J0171 | $28.46 | $37.94 | $6.75 – $6.75 | 1 |
| Aep neurodiagnostic i&r CPT 92653 | $1,471.50 | $1,962.00 | $209.40 – $376.92 | 16 |
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.