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 |
|---|---|---|---|---|
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $3,134.25 | $4,179.00 | $3,173.19 – $5,711.73 | 16 |
| I&d lacrimal sac CPT 68420 | $2,274.75 | $3,033.00 | $2,305.69 – $4,150.23 | 16 |
| Idursulfase injection HCPCS J1743 | $11,942.56 | $15,923.41 | $558.22 – $1,359.54 | 17 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $294.81 | $393.07 | $57.17 – $240.75 | 2 |
| Igh gene rearrange amp meth CPT 81261 | $305.25 | $407.00 | $197.99 – $356.38 | 17 |
| Igh@ var region somatic mutation analy CPT 81263 | $607.50 | $810.00 | $294.52 – $530.14 | 17 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $309.75 | $413.00 | $87.63 – $157.73 | 16 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $291.00 | $388.00 | $347.62 – $625.72 | 16 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $312.00 | $416.00 | $165.22 – $297.40 | 16 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $134.01 | $178.67 | $169.54 – $305.17 | 16 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $67.77 | $90.35 | $89.73 – $161.51 | 16 |
| Immobilizer shldr sling med HCPCS L3660 | $29.14 | $38.85 | $154.10 – $277.38 | 16 |
| Immune complex assay CPT 86332 | $60.00 | $80.00 | $24.37 – $43.87 | 17 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $2,613.77 | $3,485.02 | $49.08 – $116.32 | 17 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $2,778.42 | $3,704.55 | $80.40 – $198.86 | 17 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | $3,486.01 | $4,648.01 | $47.04 – $117.73 | 17 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $87.00 | $116.00 | $20.81 – $37.46 | 17 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $121.50 | $162.00 | $20.81 – $37.46 | 17 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $77.25 | $103.00 | $11.98 – $21.56 | 17 |
| Immunodiffusion nes CPT 86329 | $170.25 | $227.00 | $14.05 – $25.29 | 17 |
| Immunofixation electrophoresis serum CPT 86334 | $237.75 | $317.00 | $22.34 – $40.21 | 17 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $367.50 | $490.00 | $99.33 – $178.80 | 16 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $407.25 | $543.00 | $165.22 – $297.40 | 16 |
| Immunoglobulin assay CPT 86023 | $231.75 | $309.00 | $12.46 – $22.43 | 17 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | $1,518.75 | $2,025.00 | $1,253.04 – $2,255.47 | 16 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $101,250.00 | $135,000.00 | not published | 0 |
| Implant cochlear osia osi300 HCPCS L8690 | $20,655.00 | $27,540.00 | $6,978.96 – $12,562.13 | 16 |
| Implant hormone pellet(s) 11980 CPT 11980 | $519.00 | $692.00 | $433.23 – $779.82 | 16 |
| Implant neuroelectrodes CPT 64553 | $10,672.50 | $14,230.00 | $10,806.19 – $19,451.13 | 16 |
| Implant neuroelectrodes CPT 64555 | $7,279.50 | $9,706.00 | $6,180.53 – $11,124.95 | 16 |
| Implant neuroelectrodes CPT 64561 | $6,447.00 | $8,596.00 | $6,180.53 – $11,124.95 | 16 |
| Implant power module patient cable cable 14 volt HCPCS Q0477 | $2,812.50 | $3,750.00 | $1,138.18 – $2,048.72 | 16 |
| Implant pulse generator remede el HCPCS C1823 | $57,375.00 | $76,500.00 | not published | 0 |
| Implant ureth bulk agent HCPCS L8606 | $2,587.50 | $3,450.00 | $322.77 – $580.99 | 16 |
| Impl neurostim electr perc CPT 63650 | $6,807.00 | $9,076.00 | $6,180.53 – $11,124.95 | 16 |
| Implnt spinl canal catheter 62350 CPT 62350 | $7,722.75 | $10,297.00 | $8,510.82 – $15,319.47 | 16 |
| Imported lipodox inj HCPCS Q2049 | not published | not published | $1,237.49 – $1,237.49 | 1 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $105.37 – $105.37 | 1 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $2,808.00 | $3,744.00 | $831.46 – $1,496.63 | 16 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $2,156.25 | $2,875.00 | $745.62 – $1,342.12 | 16 |
| In-111 pentetreotide HCPCS A9572 | $47,542.46 | $63,389.94 | $2,000.94 – $3,601.69 | 16 |
| Inactivated je vacc im CPT 90738 | $2,069.33 | $2,759.10 | $2,751.39 – $2,751.39 | 1 |
| Incise/drain eyelid lining CPT 68020 | $3,291.75 | $4,389.00 | $966.77 – $1,740.19 | 16 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $2,496.00 | $3,328.00 | $1,601.72 – $2,883.09 | 16 |
| Incision of breast lesion CPT 19020 | $1,959.00 | $2,612.00 | $1,601.72 – $2,883.09 | 16 |
| Incision of hip tendons CPT 27006 | $3,126.75 | $4,169.00 | $3,173.19 – $5,711.73 | 16 |
| Incisn of toe tndn CPT 28010 | $2,176.50 | $2,902.00 | $1,559.43 – $2,806.97 | 16 |
| Incobotulinumtoxin a HCPCS J0588 | $1,889.43 | $2,519.23 | $5.29 – $12.90 | 17 |
| Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 | $586.73 | $782.30 | $9.30 – $16.74 | 16 |
| Induced abortion dilat&evac CPT 59841 | $7,136.25 | $9,515.00 | $3,139.36 – $5,650.86 | 16 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | $234.75 | $313.00 | $70.20 – $126.36 | 16 |
| Infect ag drug suscept pheno predict CPT 87900 | $378.00 | $504.00 | $130.35 – $234.63 | 17 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $1,863.00 | $2,484.00 | $257.45 – $463.41 | 17 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $301.50 | $402.00 | $128.73 – $231.71 | 17 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $603.75 | $805.00 | $257.45 – $463.41 | 17 |
| Infect ag ia optc obs influenza CPT 87804 | $109.50 | $146.00 | $16.55 – $29.79 | 17 |
| Infect ag if hep delta agent CPT 87380 | $136.50 | $182.00 | $18.36 – $33.05 | 17 |
| Infect ag if legionella pneumophila CPT 87278 | $60.75 | $81.00 | $15.60 – $28.08 | 17 |
| Infect ag na herpes simplex quant CPT 87530 | $225.75 | $301.00 | $42.84 – $77.11 | 17 |
| Infect ag na hpv high-risk types CPT 87624 | $247.50 | $330.00 | $35.09 – $63.16 | 17 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $228.75 | $305.00 | $95.80 – $172.44 | 17 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $180.00 | $240.00 | $51.31 – $92.36 | 16 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $812.25 | $1,083.00 | $416.78 – $750.20 | 17 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $108.00 | $144.00 | $488.66 – $879.59 | 17 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $1,288.50 | $1,718.00 | $26.07 – $46.93 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $203.25 | $271.00 | $11.98 – $21.56 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $60.75 | $81.00 | $13.42 – $24.16 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $69.00 | $92.00 | $13.82 – $24.88 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $90.00 | $120.00 | $11.98 – $21.56 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $48.00 | $64.00 | $10.33 – $18.59 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $60.75 | $81.00 | $24.08 – $43.34 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $303.00 | $404.00 | $11.98 – $21.56 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $130.50 | $174.00 | $11.98 – $21.56 | 17 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $751.50 | $1,002.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $186.00 | $248.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $202.50 | $270.00 | $37.27 – $67.09 | 17 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $836.25 | $1,115.00 | $416.78 – $750.20 | 17 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $310.50 | $414.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $147.00 | $196.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $670.50 | $894.00 | $41.68 – $75.02 | 17 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $186.00 | $248.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $141.00 | $188.00 | $51.31 – $92.36 | 16 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $299.25 | $399.00 | $142.63 – $256.73 | 16 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $299.25 | $399.00 | $142.63 – $256.73 | 16 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $78.75 | $105.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $108.75 | $145.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $357.75 | $477.00 | $76.77 – $138.19 | 16 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $984.00 | $1,312.00 | $416.78 – $750.20 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $436.50 | $582.00 | $128.29 – $230.92 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $255.00 | $340.00 | $262.99 – $473.38 | 17 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $1,008.75 | $1,345.00 | $42.84 – $77.11 | 17 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $305.25 | $407.00 | $42.84 – $77.11 | 17 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $934.50 | $1,246.00 | $42.84 – $77.11 | 17 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $680.25 | $907.00 | $85.10 – $153.18 | 17 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $358.50 | $478.00 | $142.63 – $256.73 | 17 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $1,702.78 | $2,270.37 | $31.04 – $75.87 | 17 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $50.82 – $50.82 | 1 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $1,713.99 | $2,285.31 | $26.04 – $47.88 | 17 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $203.21 – $203.21 | 1 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $70.27 – $70.27 | 1 |
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.