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 |
|---|---|---|---|---|
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $11,014.86 | $14,686.47 | $66.37 – $158.82 | 17 |
| Iron CPT 83540 | $309.00 | $412.00 | $6.47 – $11.65 | 17 |
| Iron binding capacity CPT 83550 | $72.75 | $97.00 | $8.74 – $15.73 | 17 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $140.34 | $187.12 | $18.11 – $43.86 | 17 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $133.11 | $177.48 | $0.54 – $1.98 | 2 |
| Irradiation of blood product each unit reference CPT 86945 | $138.75 | $185.00 | $36.22 – $65.20 | 16 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $227.25 | $303.00 | $57.21 – $102.98 | 16 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $15,760.97 | $21,014.62 | $83.58 – $201.68 | 17 |
| Ivc venogram s&i CPT 75825 | $3,076.50 | $4,102.00 | $3,062.12 – $5,511.82 | 17 |
| IV Fluids (each additional hour) CPT 96361 | $156.00 | $208.00 | $45.41 – $81.74 | 16 |
| IV Fluids (first hour) CPT 96360 | $422.25 | $563.00 | $206.28 – $371.30 | 16 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $355.50 | $474.00 | $19.43 – $34.98 | 16 |
| IV Medicine Infusion (additional drug) CPT 96367 | $383.25 | $511.00 | $69.83 – $125.69 | 16 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $114.75 | $153.00 | $45.41 – $81.74 | 16 |
| IV Medicine Infusion (first hour) CPT 96365 | $611.25 | $815.00 | $206.28 – $371.30 | 16 |
| IV Push Injection (each additional drug) CPT 96375 | $510.00 | $680.00 | $45.41 – $81.74 | 16 |
| IV Push Injection (first drug) CPT 96374 | $201.75 | $269.00 | $206.28 – $371.30 | 16 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $22,346.52 | $29,795.35 | $139.75 – $337.52 | 17 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $349.50 | $466.00 | $84.40 – $151.91 | 17 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $288.75 | $385.00 | $101.39 – $182.50 | 17 |
| Jejunstmy tube plcmt CPT 44372 | $2,244.75 | $2,993.00 | $1,860.96 – $3,349.72 | 16 |
| J-tube placement CPT 44015 | $462.00 | $616.00 | $124.95 – $224.92 | 16 |
| Ketamine and metabolite screen - quest CPT 80357 | $136.50 | $182.00 | not published | 0 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $285.75 | $381.00 | $8.17 – $14.71 | 17 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $17.11 | $22.81 | $0.32 – $0.83 | 17 |
| Kidney function study CPT 78725 | $549.75 | $733.00 | $387.70 – $697.86 | 17 |
| Kidney imaging morphology CPT 78700 | $627.00 | $836.00 | $387.70 – $697.86 | 17 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $704.25 | $939.00 | $526.57 – $947.83 | 17 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $806.25 | $1,075.00 | $101.39 – $182.50 | 17 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $674.25 | $899.00 | $101.39 – $182.50 | 17 |
| Kit case 4.2mm spinejack HCPCS C1062 | $9,652.39 | $12,869.85 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $10,575.00 | $14,100.00 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | $268.50 | $358.00 | $124.87 – $224.77 | 17 |
| Kit hfx iq ipg bundle HCPCS C1822 | $58,500.00 | $78,000.00 | not published | 0 |
| Kit ipg optimizer smart HCPCS C1824 | $51,750.00 | $69,000.00 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $73,912.50 | $98,550.00 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $801.57 | $1,068.75 | not published | 0 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | not published | not published | $63.48 – $63.48 | 1 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $2,836.08 | $3,781.44 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $2,854.50 | $3,806.00 | $338.34 – $609.01 | 16 |
| Knee MRI (with contrast) CPT 73722 | $2,682.75 | $3,577.00 | $760.25 – $1,368.44 | 16 |
| Knee MRI (without contrast) CPT 73721 | $2,854.50 | $3,806.00 | $231.40 – $416.51 | 16 |
| Knee X-ray CPT 73564 | $267.75 | $357.00 | $101.39 – $182.50 | 17 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $184.50 | $246.00 | $84.40 – $151.91 | 17 |
| Knee X-ray (3 views, both knees) CPT 73562 | $210.75 | $281.00 | $84.40 – $151.91 | 17 |
| Knee X-ray (standing, both knees) CPT 73565 | $192.00 | $256.00 | $84.40 – $151.91 | 17 |
| Kyleena, 19.5 mg HCPCS J7296 | $4,491.10 | $5,988.13 | $2,460.09 – $12,493.35 | 2 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $22.19 | $29.58 | $1.71 – $1.71 | 1 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $237.75 | $317.00 | not published | 0 |
| Lactate dehydrogenase (ldh) CPT 83615 | $52.50 | $70.00 | $6.04 – $10.87 | 17 |
| Lactated ringers intravenous solution HCPCS J7120 | $22.19 | $29.58 | $5.99 – $23.31 | 2 |
| Lactic acid CPT 83605 | $164.25 | $219.00 | $11.57 – $20.83 | 17 |
| Lactoferrin fecal qualitative CPT 83630 | $33.75 | $45.00 | $19.70 – $35.46 | 17 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $35,355.50 | $47,140.66 | $35.72 – $89.21 | 17 |
| Lanthanum carbonate oral 5mg HCPCS J0607 | $2,066.54 | $2,755.38 | not published | 0 |
| Laparoscopye procstom 43659 CPT 43659 | $5,688.75 | $7,585.00 | $5,862.95 – $10,553.31 | 16 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $794.25 | $1,059.00 | $297.68 – $535.83 | 16 |
| Laronidase injection HCPCS J1931 | $4,116.73 | $5,488.97 | $39.95 – $97.07 | 17 |
| Laryngeal function studies CPT 92520 | $359.25 | $479.00 | $129.03 – $232.25 | 16 |
| Laryngoscope w/vc inj CPT 31570 | $3,737.25 | $4,983.00 | $3,615.75 – $6,508.35 | 16 |
| Laryngoscopy telescopic CPT 31579 | $725.25 | $967.00 | $379.31 – $682.75 | 16 |
| Laryngoscopy w/exc of tumor CPT 31540 | $7,290.00 | $9,720.00 | $3,615.75 – $6,508.35 | 16 |
| Laryngoscopy w/fb removal CPT 31530 | $1,681.50 | $2,242.00 | $1,726.15 – $3,107.06 | 16 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | $473.25 | $631.00 | $379.31 – $682.75 | 16 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $4,863.24 | $6,484.32 | not published | 0 |
| Lead capillary CPT 83655 | $79.50 | $106.00 | $12.11 – $21.80 | 17 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $7,616.25 | $10,155.00 | not published | 0 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $13,488.75 | $17,985.00 | not published | 0 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $908.25 | $1,211.00 | $231.40 – $416.51 | 16 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,555.50 | $2,074.00 | $170.10 – $306.19 | 16 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $1,169.25 | $1,559.00 | $101.39 – $182.50 | 16 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $832.50 | $1,110.00 | $231.40 – $416.51 | 16 |
| Leishmania antibody CPT 86717 | $182.25 | $243.00 | $12.25 – $22.05 | 17 |
| Lens, intraocular (new tech) HCPCS C1780 | $2,238.75 | $2,985.00 | not published | 0 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $2,238.75 | $2,985.00 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $1,136.25 | $1,515.00 | $145.73 – $262.31 | 16 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $191.25 | $255.00 | $145.73 – $262.31 | 16 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $83.13 | $110.83 | $9.59 – $40.23 | 2 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $30,791.46 | $41,055.27 | $176.20 – $378.27 | 17 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $42,325.47 | $56,433.96 | $1,765.57 – $4,228.08 | 17 |
| Leuprolide acetate injeciton HCPCS J9218 | $1,901.89 | $2,535.85 | $21.69 – $123.75 | 2 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $125.11 – $125.11 | 1 |
| Levalbuterol non-comp con HCPCS J7612 | $9.80 | $13.06 | $0.73 – $2.79 | 2 |
| Levalbuterol non-comp unit HCPCS J7614 | $5.40 | $7.19 | $0.19 – $0.45 | 2 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $97.62 | $130.16 | $0.10 – $0.54 | 2 |
| Levetiracetam therapeutic drug level CPT 80177 | $155.25 | $207.00 | $13.25 – $23.85 | 17 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $47.70 | $63.60 | $4.75 – $8.19 | 2 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $652.50 | $870.00 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $63,376.43 | $84,501.90 | not published | 0 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $74.62 | $99.49 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $25.89 | $34.51 | not published | 0 |
| Lidocaine therapeutic drug level CPT 80176 | $63.75 | $85.00 | $14.69 – $26.44 | 17 |
| Lifileucel til/dose 7.5b-72b snij HCPCS J9999 | $38,415.18 | $51,220.24 | not published | 0 |
| Lig/band angioaccess av fistula CPT 37607 | $2,678.25 | $3,571.00 | $3,062.12 – $5,511.82 | 16 |
| Liletta, 52 mg HCPCS J7297 | $3,445.08 | $4,593.43 | $9,583.47 – $9,583.47 | 1 |
| Lincomycin injection HCPCS J2010 | not published | not published | $13.65 – $13.65 | 1 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $119.81 | $159.74 | $8.45 – $29.70 | 2 |
| Lipase CPT 83690 | $127.50 | $170.00 | $6.89 – $12.40 | 17 |
| Lipoprotein blood quant CPT 83704 | $175.50 | $234.00 | $34.19 – $61.54 | 17 |
| Lipoprotein direct measurement hdl CPT 83718 | $63.75 | $85.00 | $8.19 – $14.74 | 17 |
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.