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 |
|---|---|---|---|---|
| Explore woundchest 20101 CPT 20101 | $1,761.00 | $2,348.00 | $2,000.97 – $3,601.74 | 16 |
| Ext ecg>48hr<7d scan a/r CPT 93243 | $238.50 | $318.00 | $129.03 – $232.25 | 16 |
| External cannula declotting CPT 36860 | $2,181.75 | $2,909.00 | $1,526.62 – $2,747.91 | 16 |
| External chromosome analysis 20-25 cells CPT 88264 | $345.75 | $461.00 | $144.61 – $260.30 | 17 |
| External recharg sys intern HCPCS L8689 | $2,475.00 | $3,300.00 | $2,530.57 – $4,555.03 | 16 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $903.75 | $1,205.00 | $143.75 – $258.75 | 17 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $234.00 | $312.00 | $17.93 – $32.27 | 17 |
| Extrnl counterpulse, per tx HCPCS G0166 | $573.75 | $765.00 | $129.03 – $232.25 | 16 |
| Eye implant band 40 HCPCS C1784 | $356.07 | $474.75 | not published | 0 |
| Eye Socket (Orbit) X-ray CPT 70200 | $387.75 | $517.00 | $101.39 – $182.50 | 17 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $1,923.00 | $2,564.00 | $170.10 – $306.19 | 16 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $1,834.50 | $2,446.00 | $170.10 – $306.19 | 16 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $1,651.50 | $2,202.00 | $101.39 – $182.50 | 16 |
| Ezh2 gene common variants CPT 81237 | $328.50 | $438.00 | $175.40 – $315.72 | 16 |
| F-18 fdg pet diag HCPCS A9552 | $2,773.11 | $3,697.47 | $3,533.40 – $3,533.40 | 1 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $5,679.38 | $7,572.50 | $1,825.64 – $3,286.15 | 16 |
| Fabrication & fitting HCPCS V2628 | $180.00 | $240.00 | $496.63 – $893.93 | 16 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $2,307.75 | $3,077.00 | $231.40 – $416.51 | 16 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $256.50 | $342.00 | $84.40 – $151.91 | 17 |
| Facial Bones X-ray (complete) CPT 70150 | $457.50 | $610.00 | $101.39 – $182.50 | 17 |
| Factor ix CPT 85250 | $186.75 | $249.00 | $19.04 – $34.27 | 17 |
| Factor ix alprolix recomb HCPCS J7201 | $38,712.83 | $51,617.10 | $3.58 – $8.81 | 17 |
| Factor ix complex HCPCS J7194 | $4,991.63 | $6,655.50 | $1.70 – $4.14 | 17 |
| Factor ix idelvion inj HCPCS J7202 | $36,235.50 | $48,314.00 | $5.32 – $13.00 | 17 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $3.24 – $3.24 | 1 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $11.12 – $11.12 | 1 |
| Factor ix recombinan rixubis HCPCS J7200 | not published | not published | $3.80 – $3.80 | 1 |
| Factor ix recombinant nos HCPCS J7195 | $7,321.05 | $9,761.40 | $1.84 – $4.55 | 17 |
| Factor viia recomb sevenfact HCPCS J7212 | not published | not published | $5.82 – $5.82 | 1 |
| Factor viii CPT 85240 | $201.75 | $269.00 | $17.90 – $32.22 | 17 |
| Factor viii HCPCS J7190 | not published | not published | $2.75 – $2.75 | 1 |
| Factor viii fc fusion recomb HCPCS J7205 | $17,969.85 | $23,959.80 | $2.46 – $5.89 | 17 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $2.85 – $2.85 | 1 |
| Factor viii pegylated recomb HCPCS J7207 | $11.10 | $14.79 | $2.14 – $5.23 | 17 |
| Factor viii recombinant nos HCPCS J7192 | $11.10 | $14.79 | $1.57 – $3.72 | 17 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $3.68 – $3.68 | 1 |
| Factor viii recomb obizur HCPCS J7188 | $5,435.33 | $7,247.10 | $3.24 – $7.84 | 17 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $26.21 – $26.21 | 1 |
| Factor xiii recomb a-subunit HCPCS J7181 | $68.26 | $91.01 | $18.33 – $44.52 | 17 |
| Fallopian tube recnl CPT 58345 | $3,020.25 | $4,027.00 | $3,139.36 – $5,650.86 | 16 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $8.88 | $11.84 | not published | 0 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $73.02 – $73.02 | 1 |
| Fatty acids nonesterified CPT 82725 | $108.75 | $145.00 | $18.77 – $33.79 | 17 |
| Fda ide #g240020 carry bag HCPCS Q0499 | $956.25 | $1,275.00 | $244.84 – $440.71 | 16 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $155.85 – $155.85 | 1 |
| Fecal microbiota prep instil HCPCS G0455 | $883.50 | $1,178.00 | $901.87 – $1,623.37 | 16 |
| #fecal-sodium CPT 84302 | $86.25 | $115.00 | $4.86 – $8.75 | 17 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $75.00 | $100.00 | $18.64 – $33.55 | 16 |
| Feno poc CPT 95012 | $220.50 | $294.00 | $36.22 – $65.20 | 16 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $35.94 | $47.92 | $2.34 – $8.73 | 2 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $3,736.68 | $4,982.24 | $1.10 – $2.77 | 17 |
| Ferritin CPT 82728 | $242.25 | $323.00 | $13.63 – $24.53 | 17 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $4,030.11 | $5,373.48 | $0.23 – $0.73 | 17 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.73 – $0.73 | 1 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $656.25 | $875.00 | $101.39 – $182.50 | 17 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $102.00 | $136.00 | $196.07 – $352.92 | 16 |
| Fetal hemoglobin rosette CPT 85461 | $128.25 | $171.00 | $9.36 – $16.85 | 17 |
| Fetal monitor w/report CPT 59050 | $105.00 | $140.00 | $43.94 – $79.10 | 16 |
| Fetal non stress test CPT 59025 | $391.50 | $522.00 | $196.07 – $352.92 | 16 |
| Fetal shunt placement w/us CPT 59076 | $296.25 | $395.00 | $295.53 – $531.95 | 16 |
| #_fet/norfentcnfrmur CPT 80354 | $153.75 | $205.00 | not published | 0 |
| Fibrin degradation d dimer quantitative CPT 85379 | $77.25 | $103.00 | $10.18 – $18.32 | 17 |
| Fibrin degradation products CPT 85362 | $184.50 | $246.00 | $6.89 – $12.40 | 17 |
| Fibrinogen activity CPT 85384 | $50.25 | $67.00 | $9.72 – $17.50 | 17 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $72.00 | $96.00 | $15.48 – $27.86 | 17 |
| Fibrinolytic antiplasmin CPT 85410 | $84.00 | $112.00 | $7.71 – $13.88 | 17 |
| Fibrinolytic plasminogen CPT 85415 | $567.75 | $757.00 | $17.19 – $30.94 | 17 |
| Fibrinolytic plasminogen CPT 85421 | $335.25 | $447.00 | $10.18 – $18.32 | 17 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $416.25 | $555.00 | $6.53 – $11.75 | 17 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $492.48 | $656.64 | $0.28 – $0.68 | 17 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $1,964.97 | $2,619.96 | $1.02 – $2.39 | 17 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $1,504.82 | $2,006.42 | $0.35 – $0.88 | 17 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $8,212.50 | $10,950.00 | not published | 0 |
| Filter vena cava fem denali HCPCS C1880 | $4,659.75 | $6,213.00 | not published | 0 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $621.75 | $829.00 | $686.75 – $1,236.14 | 16 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $621.75 | $829.00 | $132.81 – $239.06 | 16 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | $168.00 | $224.00 | $51.17 – $92.10 | 16 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $702.75 | $937.00 | $58.09 – $104.56 | 16 |
| Fine needle asp without image guide 10021 CPT 10021 | $723.00 | $964.00 | $394.24 – $709.63 | 16 |
| Finger X-ray (both hands) CPT 73140 | $216.75 | $289.00 | $84.40 – $151.91 | 17 |
| Flebogamma injection HCPCS J1572 | $3,562.92 | $4,750.55 | $90.74 – $163.33 | 17 |
| Flecainide (tambocor)-sendout CPT 80181 | $54.75 | $73.00 | $18.64 – $33.55 | 16 |
| Fl exam g/colon tube w contrast CPT 49465 | $414.00 | $552.00 | $231.40 – $416.51 | 16 |
| Flexible Sigmoidoscopy CPT 45330 | $1,336.50 | $1,782.00 | $901.87 – $1,623.37 | 16 |
| Flow cytometry marker each additional CPT 88185 | $181.50 | $242.00 | $21.04 – $37.87 | 16 |
| Flow cytometry one marker technical component CPT 88184 | $270.75 | $361.00 | $347.62 – $625.72 | 16 |
| Floweramniopatch, per sq cm HCPCS Q4178 | not published | not published | $226.61 – $226.61 | 1 |
| Floxuridine injection HCPCS J9200 | $14,923.11 | $19,897.48 | $4,250.97 – $10,041.59 | 17 |
| Flt3 gene CPT 81245 | $177.00 | $236.00 | $165.51 – $297.92 | 17 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $24.41 | $32.54 | $5.48 – $25.20 | 2 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $601.96 | $802.61 | $174.37 – $1,565.73 | 2 |
| Fluidotherapy charges pt CPT 97022 | $121.50 | $162.00 | $14.86 – $26.75 | 16 |
| Fluocinol acet intravit imp HCPCS J7313 | not published | not published | $1,211.62 – $1,211.62 | 1 |
| Fluocinolone acetonide implt HCPCS J7311 | $70,344.94 | $93,793.25 | $338.79 – $826.98 | 17 |
| Fluorescent antibody titer dna CPT 86256 | $324.75 | $433.00 | $12.05 – $21.69 | 17 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $822.00 | $1,096.00 | $97.32 – $175.18 | 16 |
| Fluoroguide needle placement CPT 77002 | $354.00 | $472.00 | $112.36 – $202.26 | 16 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $492.75 | $657.00 | $231.40 – $416.51 | 17 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $203.74 | $271.65 | $4.16 – $28.98 | 2 |
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.