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 |
|---|---|---|---|---|
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $380.85 | $507.79 | $18.33 – $82.35 | 2 |
| Fmri brain by tech CPT 70554 | $1,337.25 | $1,783.00 | $231.40 – $416.51 | 16 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,270.50 | $1,694.00 | $686.75 – $1,236.14 | 16 |
| Fna bx w/ct gdn ea addl CPT 10010 | $900.00 | $1,200.00 | $220.03 – $396.05 | 16 |
| Fna bx w/mr gdn 1st les CPT 10011 | $900.00 | $1,200.00 | $686.75 – $1,236.14 | 16 |
| Fna bx w/mr gdn ea addl CPT 10012 | $846.75 | $1,129.00 | not published | 0 |
| Foam drg >16<=48 sq in w/bdr HCPCS A6213 | $40.98 | $54.64 | not published | 0 |
| Foam drg >16<=48 sq in without b HCPCS A6210 | $66.25 | $88.33 | $28.40 – $51.12 | 16 |
| Foam drg > 48 sq in w/border HCPCS A6214 | $23.01 | $30.67 | $14.68 – $26.42 | 16 |
| Foam drg > 48 sq in without brdr HCPCS A6211 | $27.27 | $36.35 | $41.86 – $75.35 | 16 |
| Folic acid CPT 82746 | $135.75 | $181.00 | $14.70 – $26.46 | 17 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $78.99 | $105.31 | not published | 0 |
| Follow-up angiography CPT 75898 | $4,329.00 | $5,772.00 | $1,384.84 – $5,511.82 | 17 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $1,261.49 | $1,681.98 | $6.54 – $27.63 | 17 |
| Fondaparinux sodium HCPCS J1652 | $121.83 | $162.44 | $1.73 – $9.81 | 2 |
| Foot arch support remov prem HCPCS L3030 | $82.50 | $110.00 | $111.71 – $201.08 | 16 |
| Foot insert plastazote or eq HCPCS L3002 | $101.25 | $135.00 | $236.41 – $425.54 | 16 |
| Foot X-ray CPT 73630 | $236.25 | $315.00 | $84.40 – $151.91 | 17 |
| Foot X-ray (2 views, both feet) CPT 73620 | $222.75 | $297.00 | $84.40 – $151.91 | 17 |
| Forearm X-ray (both sides) CPT 73090 | $259.50 | $346.00 | $84.40 – $151.91 | 17 |
| Forensic autopsy (necropsy) CPT 88040 | $162.00 | $216.00 | not published | 0 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $237.00 | $316.00 | $242.30 – $436.15 | 16 |
| Formoterol fumarate, inh HCPCS J7606 | $59.40 | $79.20 | $4.77 – $36.90 | 2 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $1,233.17 | $1,644.22 | $0.27 – $1.26 | 2 |
| Foscarnet sodium injection HCPCS J1455 | $1,101.86 | $1,469.14 | $37.92 – $534.33 | 2 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $94.85 | $126.46 | $1.33 – $1,255.94 | 17 |
| Fracture assessment via dxa CPT 77086 | $530.25 | $707.00 | $84.40 – $151.91 | 17 |
| Fragmenting of kidney stone CPT 50590 | $11,301.75 | $15,069.00 | $3,418.53 – $6,153.35 | 16 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $167.25 | $223.00 | $85.98 – $154.76 | 16 |
| Fresh frozen plasma thawing ea un CPT 86927 | $240.75 | $321.00 | $165.22 – $297.40 | 16 |
| Fructosamine glycated protein CPT 82985 | $61.50 | $82.00 | $16.76 – $30.17 | 17 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $326.25 | $435.00 | $101.39 – $182.50 | 17 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $19.53 | $26.04 | not published | 0 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $156.00 | $208.00 | $49.63 – $89.33 | 16 |
| Gabapentin non-blood CPT 80355 | $37.50 | $50.00 | not published | 0 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $177.43 | $236.57 | $0.63 – $3.06 | 2 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $3.58 – $3.58 | 1 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $119.29 | $159.05 | $0.27 – $1.17 | 2 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $486.60 | $648.79 | $35.78 – $132.66 | 2 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $85.50 | $114.00 | $21.07 – $37.93 | 17 |
| Galectin-3 CPT 82777 | $280.50 | $374.00 | $44.25 – $79.65 | 17 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $716.25 | $955.00 | $387.70 – $697.86 | 17 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,245.75 | $1,661.00 | $526.57 – $947.83 | 17 |
| Galsulfase injection HCPCS J1458 | not published | not published | $1,230.39 – $1,230.39 | 1 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $406.62 – $406.62 | 1 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $117.85 – $117.85 | 1 |
| Gammaglobulin iga CPT 82784 | $144.00 | $192.00 | $9.30 – $16.74 | 17 |
| Gammaglobulin ige CPT 82785 | $117.00 | $156.00 | $16.46 – $29.63 | 17 |
| Gamma glutamyltransferase CPT 82977 | $57.00 | $76.00 | $7.20 – $12.96 | 17 |
| Gammagraft HCPCS Q4111 | not published | not published | $17.31 – $17.31 | 1 |
| Gammaplex injection HCPCS J1557 | not published | not published | $152.03 – $152.03 | 1 |
| Gamunex-c/gammaked HCPCS J1561 | $8,519.04 | $11,358.72 | $49.73 – $116.91 | 17 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $94.28 | $125.70 | $96.41 – $404.28 | 2 |
| Gastric motility studies CPT 91020 | $1,317.00 | $1,756.00 | $361.89 – $651.40 | 16 |
| Gastrin test CPT 82938 | $106.50 | $142.00 | $17.69 – $31.84 | 17 |
| Gastroesophageal reflux study CPT 78262 | $553.50 | $738.00 | $387.70 – $697.86 | 17 |
| Gastroesophageal reflux test CPT 91034 | $943.50 | $1,258.00 | $361.89 – $651.40 | 16 |
| Gel-one HCPCS J7326 | not published | not published | $1,275.44 – $1,275.44 | 1 |
| Gel-syn injection 0.1 mg HCPCS J7328 | $1,330.04 | $1,773.38 | $0.68 – $1.58 | 17 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $168.02 | $224.02 | $7.18 – $32.85 | 2 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $37,698.54 | $50,264.71 | $240.17 – $575.91 | 17 |
| Generator barostim neo2 2014 HCPCS C1767 | $83,687.18 | $111,582.90 | not published | 0 |
| Generator emblem MRI sicd subq HCPCS C1722 | $61,875.00 | $82,500.00 | not published | 0 |
| Genetic tstg severe inh cond CPT 81443 | $11,208.75 | $14,945.00 | $2,448.56 – $4,407.41 | 16 |
| Gen, neuro, clo loop, rechg HCPCS C1826 | $43,200.00 | $57,600.00 | not published | 0 |
| Genome sequence analysis CPT 81425 | $8,306.25 | $11,075.00 | $5,031.20 – $9,056.16 | 16 |
| Genome sequence analysis CPT 81426 | $5,081.25 | $6,775.00 | $2,709.95 – $4,877.91 | 16 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $85.57 | $114.09 | $6.35 – $24.21 | 2 |
| Gentamicin peak therapeutic drug level CPT 80170 | $120.00 | $160.00 | $16.38 – $29.48 | 17 |
| Genvisc 850, inj, 1mg HCPCS J7320 | not published | not published | $14.65 – $14.65 | 1 |
| G-esoph reflx tst w/electrod CPT 91035 | $971.25 | $1,295.00 | $832.81 – $1,499.05 | 16 |
| Ghs abscess perianal iandd CPT 46050 | $3,801.00 | $5,068.00 | $901.87 – $1,623.37 | 16 |
| Ghs abscess postoperative iandd complex CPT 10180 | $8,836.50 | $11,782.00 | $2,816.99 – $5,070.59 | 16 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $119.25 | $159.00 | $9.81 – $17.66 | 17 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $858.00 | $1,144.00 | $17.11 – $30.80 | 17 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $612.00 | $816.00 | $129.03 – $232.25 | 16 |
| Ghs antibodies (torch) igm CPT 86694 | $131.25 | $175.00 | $14.39 – $25.90 | 17 |
| Ghs bladder cath - complex-foley CPT 51703 | $277.50 | $370.00 | $124.79 – $224.62 | 16 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,470.75 | $1,961.00 | $684.56 – $1,232.21 | 16 |
| Ghs central line insert < age 5, failed CPT 36555 | $3,696.00 | $4,928.00 | $3,062.12 – $5,511.82 | 16 |
| Ghs change cysto/gastrost CPT 43762 | $591.75 | $789.00 | $242.30 – $436.15 | 16 |
| Ghs chemo >8 hrs CPT 96416 | $1,028.25 | $1,371.00 | $320.33 – $576.59 | 16 |
| Ghs chemo IV push, ea addtl CPT 96411 | $174.75 | $233.00 | $69.83 – $125.69 | 16 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $535.50 | $714.00 | $35.09 – $63.16 | 17 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $630.00 | $840.00 | $239.22 – $430.59 | 16 |
| Ghs closed reduction ankle dislocation CPT 27840 | $732.75 | $977.00 | $239.22 – $430.59 | 16 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $2,730.00 | $3,640.00 | $1,559.43 – $2,806.97 | 16 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $227.25 | $303.00 | $239.22 – $430.59 | 16 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,138.50 | $1,518.00 | $1,559.43 – $2,806.97 | 16 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $1,681.50 | $2,242.00 | $3,436.70 – $6,186.07 | 16 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $255.75 | $341.00 | $239.22 – $430.59 | 16 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $1,955.25 | $2,607.00 | $1,559.43 – $2,806.97 | 16 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $218.25 | $291.00 | $239.22 – $430.59 | 16 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $281.25 | $375.00 | $239.22 – $430.59 | 16 |
| Ghs community re-entry 15 minutes CPT 97537 | $101.25 | $135.00 | $30.70 – $55.26 | 16 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $740.25 | $987.00 | $433.23 – $779.82 | 16 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $131.25 | $175.00 | $129.03 – $232.25 | 16 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $422.25 | $563.00 | $433.23 – $779.82 | 16 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $180.75 | $241.00 | $129.03 – $232.25 | 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.