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 |
|---|---|---|---|---|
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $322.50 | $430.00 | $212.36 – $382.26 | 16 |
| Init pm e/m new pat 65+ yrs CPT 99387 | $148.50 | $198.00 | $161.77 – $291.19 | 16 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $9,281.66 | $12,375.54 | $7.27 – $17.60 | 17 |
| Inj, acetaminophen (b braun) HCPCS J0136 | $20.71 | $27.61 | $0.54 – $0.54 | 1 |
| Inj acetaminophen -fresenius HCPCS J0134 | $14.79 | $19.72 | $0.45 – $0.45 | 1 |
| Inj, adalimumab, 1 mg HCPCS J0139 | $24,828.50 | $33,104.66 | not published | 0 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $14.53 – $14.53 | 1 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $3.82 – $3.82 | 1 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | $5,937.23 | $7,916.30 | $3.81 – $6.86 | 16 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $20,116.77 | $26,822.36 | $18.31 – $44.06 | 17 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $7.91 – $7.91 | 1 |
| Inj, artesunate, 1mg HCPCS J0391 | $39,774.01 | $53,032.01 | $51.83 – $93.29 | 16 |
| Inj. asceniv HCPCS J1554 | not published | not published | $1,208.48 – $1,208.48 | 1 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $134.58 – $134.58 | 1 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $196.55 – $196.55 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $19,707.27 | $26,276.36 | $163.36 – $409.23 | 17 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $96.92 – $96.92 | 1 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | $7,487.44 | $9,983.25 | $214.02 – $516.88 | 17 |
| Inj., brexanolone, 1 mg HCPCS J1632 | $33,055.65 | $44,074.20 | $648.90 – $648.90 | 1 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $842.63 – $842.63 | 1 |
| Inj, bupivacaine liposome HCPCS J0666 | $1,326.75 | $1,768.99 | $1.34 – $2.41 | 16 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $151.27 – $151.27 | 1 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $22.16 | $29.54 | $1.92 – $9.63 | 2 |
| Inj cefazolin sodium, baxter HCPCS J0689 | $48.81 | $65.08 | $11.07 – $11.07 | 1 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | $54.36 | $72.48 | $50.76 – $50.76 | 1 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $846.06 | $1,128.08 | $2.42 – $5.84 | 17 |
| Inj ceftolozane tazobactam HCPCS J0695 | $597.69 | $796.91 | $8.84 – $22.20 | 17 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $39.89 – $39.89 | 1 |
| Inj, clindamycin (baxter) HCPCS J0737 | $15.35 | $20.46 | $15.75 – $15.75 | 1 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $459.75 | $613.00 | $168.33 – $302.99 | 16 |
| Inj., copanlisib, 1 mg HCPCS J9057 | $19,661.50 | $26,215.33 | $200.61 – $788.04 | 2 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $2,541.41 – $2,541.41 | 1 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $42.79 – $42.79 | 1 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $1.90 – $1.90 | 1 |
| Inj, decitabine (sun pharma) HCPCS J0893 | $369.75 | $493.00 | $7.02 – $7.02 | 1 |
| Inj disk cerv-thor ea lev CPT 62291 | $2,326.50 | $3,102.00 | $317.01 – $570.63 | 16 |
| Inj, durolane 1 mg HCPCS J7318 | $4,122.72 | $5,496.96 | $6.73 – $16.26 | 17 |
| Inj dx for sinogram CPT 20501 | $1,089.00 | $1,452.00 | $126.18 – $227.13 | 16 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $678.75 | $905.00 | $684.56 – $1,232.21 | 16 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $217.50 | $290.00 | $216.41 – $389.54 | 16 |
| Injection, belinostat, 10mg HCPCS J9032 | $9,355.72 | $12,474.29 | $53.11 – $126.67 | 17 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $1,172.12 – $1,172.12 | 1 |
| Injection, cangrelor HCPCS C9460 | $3,425.21 | $4,566.94 | $20.02 – $36.04 | 16 |
| Injection, caplacizumab-yhdp HCPCS C9047 | $31,693.80 | $42,258.39 | $801.26 – $1,442.28 | 16 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $593.25 | $791.00 | $297.68 – $535.83 | 16 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $169.97 – $169.97 | 1 |
| Injection, doxercalciferol HCPCS J1270 | $23.86 | $31.81 | $0.90 – $3.42 | 2 |
| Injection during cath supravalvular aortography CPT 93567 | $353.25 | $471.00 | $36.03 – $64.85 | 16 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $45.83 – $45.83 | 1 |
| Injection epidural blood patch or clot CPT 62273 | $1,115.25 | $1,487.00 | $684.56 – $1,232.21 | 16 |
| Injection eye drug CPT 67028 | $322.50 | $430.00 | $320.33 – $576.59 | 16 |
| Injection for arthrography wrist (both sides) CPT 25246 | $281.25 | $375.00 | $175.92 – $316.66 | 16 |
| Injection for bladder x-ray CPT 51600 | $357.75 | $477.00 | $192.16 – $345.89 | 16 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $405.00 | $540.00 | $146.46 – $263.63 | 16 |
| Injection for ureter x-ray CPT 50690 | $545.25 | $727.00 | $110.40 – $198.71 | 16 |
| Injection, fulvestrant HCPCS J9395 | $3,584.82 | $4,779.76 | $16.96 – $76.05 | 2 |
| Injection glatiramer acetate HCPCS J1595 | $1,749.29 | $2,332.38 | $1,403.82 – $1,403.82 | 1 |
| Injection, glucarpidase HCPCS C9293 | $159,854.02 | $213,138.69 | $449.10 – $808.39 | 16 |
| Injection, isavuconazonium HCPCS J1833 | $1,350.22 | $1,800.29 | $1.01 – $2.17 | 17 |
| Injection jaw joint x-ray CPT 21116 | $151.50 | $202.00 | $205.77 – $370.39 | 16 |
| Injection jugular CPT 36299 | $1,539.75 | $2,053.00 | not published | 0 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $2.73 – $2.73 | 1 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $13.95 – $13.95 | 1 |
| Injection,onabotulinumtoxina HCPCS J0585 | $4,814.15 | $6,418.86 | $6.51 – $15.82 | 17 |
| Injection, peramivir HCPCS J2547 | $1,257.68 | $1,676.90 | $1.68 – $4.06 | 17 |
| Injection px peyronie ds CPT 54200 | $239.25 | $319.00 | $242.30 – $436.15 | 16 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $269.25 | $359.00 | $387.70 – $697.86 | 16 |
| Injection, renflexis HCPCS Q5104 | $2,582.56 | $3,443.41 | $26.80 – $60.97 | 17 |
| Injection, ruconest HCPCS J0596 | not published | not published | $89.40 – $89.40 | 1 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,021.50 | $1,362.00 | $684.56 – $1,232.21 | 16 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $710.25 | $947.00 | $684.56 – $1,232.21 | 16 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,513.50 | $2,018.00 | $857.76 – $1,543.97 | 16 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,791.00 | $2,388.00 | $96.64 – $173.96 | 16 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,791.00 | $2,388.00 | $857.76 – $1,543.97 | 16 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,791.00 | $2,388.00 | $90.62 – $163.12 | 16 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,289.00 | $3,052.00 | $857.76 – $1,543.97 | 16 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $2,250.00 | $3,000.00 | $684.56 – $1,232.21 | 16 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,959.00 | $2,612.00 | $684.56 – $1,232.21 | 16 |
| Injection, siltuximab HCPCS J2860 | $23,535.37 | $31,380.49 | $174.08 – $394.19 | 17 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $216.75 | $289.00 | $297.68 – $535.83 | 16 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $699.00 | $932.00 | $297.68 – $535.83 | 16 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $856.50 | $1,142.00 | $297.68 – $535.83 | 16 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $132.00 | $176.00 | not published | 0 |
| Injection treatment of nerve CPT 64605 | $1,866.00 | $2,488.00 | $1,893.75 – $3,408.76 | 16 |
| Injection treatment of nerve CPT 64681 | $2,706.75 | $3,609.00 | $857.76 – $1,543.97 | 16 |
| Inject sacroiliac joint CPT 27096 | $250.50 | $334.00 | $165.03 – $297.06 | 16 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $928.91 – $928.91 | 1 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | $58,842.17 | $78,456.22 | $55.64 – $139.78 | 17 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $2,184.75 | $2,913.00 | $684.56 – $1,232.21 | 16 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,623.75 | $2,165.00 | $857.76 – $1,543.97 | 16 |
| Inj., eravacycline, 1 mg HCPCS J0122 | $248.03 | $330.70 | $1.29 – $3.14 | 17 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | $1,404.58 | $1,872.77 | $2.36 – $4.24 | 16 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $461.85 – $461.85 | 1 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $42.28 – $42.28 | 1 |
| Inj, factor x, (human), 1iu HCPCS J7175 | $33.28 | $44.37 | $9.95 – $24.12 | 17 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $46.12 – $46.12 | 1 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $341.78 – $341.78 | 1 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $2.92 – $2.92 | 1 |
| Inj for ext venography CPT 36005 | $1,731.75 | $2,309.00 | $226.43 – $407.58 | 16 |
| Inj for mammo ductogram CPT 19030 | $633.00 | $844.00 | $150.27 – $270.48 | 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.