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 |
|---|---|---|---|---|
| Lipoprotein direct measurement ldl CPT 83721 | $75.00 | $100.00 | $10.50 – $18.90 | 17 |
| Lithium therapeutic drug level CPT 80178 | $69.75 | $93.00 | $6.61 – $11.90 | 17 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $3,042.00 | $4,056.00 | $120.71 – $217.27 | 16 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $812.25 | $1,083.00 | $176.19 – $317.14 | 16 |
| Liver Function Test CPT 80076 | $55.50 | $74.00 | $8.17 – $14.71 | 17 |
| Liver imaging CPT 78201 | $558.75 | $745.00 | $526.57 – $1,694.37 | 17 |
| Liver/spleen imag static only CPT 78215 | $726.00 | $968.00 | $387.70 – $697.86 | 17 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $4.38 – $4.38 | 1 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $104,719.60 | $139,626.13 | $221.49 – $527.55 | 17 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $49.14 | $65.52 | $3.19 – $10.08 | 2 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $101.25 | $135.00 | $101.39 – $182.50 | 16 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,228.25 | $2,971.00 | $170.10 – $306.19 | 16 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,241.75 | $2,989.00 | $338.34 – $609.01 | 16 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,797.00 | $2,396.00 | $101.39 – $182.50 | 16 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,994.00 | $3,992.00 | $338.34 – $609.01 | 16 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,854.50 | $3,806.00 | $231.40 – $416.51 | 16 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $293.25 | $391.00 | $101.39 – $182.50 | 17 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $418.50 | $558.00 | $101.39 – $182.50 | 17 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $420.75 | $561.00 | $101.39 – $182.50 | 17 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $228.00 | $304.00 | $84.40 – $151.91 | 17 |
| Lso flex no ri stays pre ots HCPCS L0628 | $213.75 | $285.00 | $84.12 – $151.42 | 16 |
| Lumbar diskogram s&i CPT 72295 | $2,409.75 | $3,213.00 | $1,893.75 – $3,408.76 | 17 |
| Lumizyme injection HCPCS J0221 | $3,672.96 | $4,897.27 | $207.51 – $502.89 | 17 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $315.75 | $421.00 | $361.89 – $651.40 | 16 |
| Lung function test (mbc/mvv) CPT 94200 | $102.75 | $137.00 | $57.21 – $102.98 | 16 |
| Lung Function Test (Spirometry) CPT 94010 | $162.75 | $217.00 | $209.40 – $376.92 | 16 |
| Lung perfusion imaging CPT 78580 | $700.50 | $934.00 | $387.70 – $697.86 | 17 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $30,504.38 | $40,672.50 | $212.10 – $501.70 | 17 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $45,624.83 | $60,833.10 | $42.75 – $102.13 | 17 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $686.92 – $686.92 | 1 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,059.75 | $1,413.00 | $749.20 – $1,348.56 | 16 |
| Lymphatics/lymph node imaging CPT 78195 | $730.50 | $974.00 | $526.57 – $947.83 | 17 |
| Lymphocyte transformation mitogen CPT 86353 | $858.75 | $1,145.00 | $49.03 – $88.25 | 17 |
| Lymph vessel x-ray arm/leg CPT 75801 | $2,379.00 | $3,172.00 | $608.36 – $1,095.05 | 17 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,302.00 | $1,736.00 | $863.01 – $2,747.91 | 17 |
| Lymph vessel x-ray trunk CPT 75805 | $3,555.75 | $4,741.00 | $1,384.84 – $5,511.82 | 17 |
| Lymph vessel x-ray trunk CPT 75807 | $2,179.50 | $2,906.00 | $3,062.12 – $5,511.82 | 17 |
| Magnesium CPT 83735 | $78.00 | $104.00 | $6.70 – $12.06 | 17 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $23.30 | $31.06 | $1.19 – $6.21 | 2 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $70.44 – $70.44 | 1 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $5.43 – $5.43 | 1 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $1,536.75 | $2,049.00 | $291.63 – $524.94 | 16 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $9,885.94 | $13,181.25 | $53.27 – $122.80 | 17 |
| Marker biop eviva buckle ss HCPCS A4648 | $819.00 | $1,092.00 | not published | 0 |
| Mastoids complete CPT 70130 | $361.50 | $482.00 | $101.39 – $182.50 | 17 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $192.82 – $192.82 | 1 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $50.72 – $50.72 | 1 |
| M.avium-intra dna amp prob CPT 87561 | $489.75 | $653.00 | $35.09 – $63.16 | 17 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $66.75 | $89.00 | $14.46 – $26.03 | 17 |
| Mayo aathr protein s free CPT 85306 | $167.25 | $223.00 | $15.32 – $27.58 | 17 |
| Mayo activated protein c resistance assay CPT 85307 | $125.25 | $167.00 | $15.32 – $27.58 | 17 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $2,744.25 | $3,659.00 | $38.57 – $69.43 | 16 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $63.00 | $84.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $564.75 | $753.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $153.75 | $205.00 | $14.78 – $26.60 | 17 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $270.75 | $361.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $276.00 | $368.00 | $13.44 – $24.19 | 17 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $186.00 | $248.00 | $15.08 – $27.14 | 17 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $72.00 | $96.00 | not published | 0 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $89.25 | $119.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $215.25 | $287.00 | $91.66 – $164.99 | 17 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $241.50 | $322.00 | $137.00 – $246.60 | 16 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,242.00 | $1,656.00 | $1,160.00 – $2,088.00 | 17 |
| Mayo androstenedione CPT 82157 | $195.75 | $261.00 | $29.28 – $52.70 | 17 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $56.25 | $75.00 | $14.60 – $26.28 | 17 |
| Mayo antithrombin iii antigen CPT 85301 | $73.50 | $98.00 | $10.81 – $19.46 | 17 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $77.25 | $103.00 | $15.05 – $27.09 | 17 |
| Mayo avwpr vw factor activity CPT 85397 | $911.25 | $1,215.00 | $30.86 – $55.55 | 17 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $105.00 | $140.00 | $35.09 – $63.16 | 16 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $450.00 | $600.00 | not published | 0 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $66.75 | $89.00 | $10.18 – $18.32 | 17 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $239.25 | $319.00 | $144.84 – $260.71 | 17 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $189.75 | $253.00 | $12.90 – $23.22 | 17 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $92.25 | $123.00 | not published | 0 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $122.25 | $163.00 | $13.19 – $23.74 | 17 |
| Mayo brcmg brucella antibody igm CPT 86622 | $210.75 | $281.00 | $8.93 – $16.07 | 17 |
| Mayo c1 esterase inhibitor CPT 83883 | $149.25 | $199.00 | $13.60 – $24.48 | 17 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $300.00 | $400.00 | not published | 0 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $78.75 | $105.00 | $16.87 – $30.37 | 17 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $773.25 | $1,031.00 | $26.78 – $48.20 | 17 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $333.00 | $444.00 | $122.22 – $220.00 | 17 |
| Mayo ceruloplasmin CPT 82390 | $93.00 | $124.00 | $10.74 – $19.33 | 17 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $377.25 | $503.00 | $14.12 – $25.42 | 17 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $423.00 | $564.00 | $12.88 – $23.18 | 17 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $114.75 | $153.00 | $11.82 – $21.28 | 17 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $82.50 | $110.00 | $12.68 – $22.82 | 17 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $519.00 | $692.00 | $116.49 – $209.68 | 17 |
| Mayo chromium CPT 82495 | $89.25 | $119.00 | $20.28 – $36.50 | 17 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $267.00 | $356.00 | not published | 0 |
| Mayo coccidioides antibody CPT 86635 | $128.25 | $171.00 | $11.47 – $20.65 | 17 |
| Mayo cocou cortisone urine CPT 82542 | $1,213.50 | $1,618.00 | $24.09 – $43.36 | 17 |
| Mayo cortisol free CPT 82530 | $131.25 | $175.00 | $16.71 – $30.08 | 17 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $122.25 | $163.00 | $42.13 – $75.83 | 16 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $90.75 | $121.00 | $12.12 – $21.82 | 17 |
| Mayo csmpu benzodiazepines definitive assay >=13 urine CPT 80347 | $140.25 | $187.00 | not published | 0 |
| Mayo csmpu opiod/analogs definitive assay >=5 urine CPT 80364 | $123.00 | $164.00 | not published | 0 |
| Mayo cyanide CPT 82600 | $170.25 | $227.00 | $19.40 – $34.92 | 17 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $82.50 | $110.00 | $13.25 – $23.85 | 17 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $191.25 | $255.00 | $25.27 – $45.49 | 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.