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 |
|---|---|---|---|---|
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $1,221.00 | $1,628.00 | $526.57 – $947.83 | 17 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $675.00 | $900.00 | $387.70 – $697.86 | 17 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $546.00 | $728.00 | $226.29 – $407.32 | 17 |
| Non-card vasc flow imaging CPT 78445 | $411.75 | $549.00 | $387.70 – $697.86 | 17 |
| Noonan spectrum disorders CPT 81442 | $2,412.00 | $3,216.00 | $2,143.60 – $3,858.48 | 17 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | $283.50 | $378.00 | $84.40 – $151.91 | 17 |
| Novachor 1 sq cm HCPCS Q4194 | not published | not published | $1,747.05 – $1,747.05 | 1 |
| Npm1 gene CPT 81310 | $270.00 | $360.00 | $246.52 – $443.74 | 17 |
| Npsy fam hlth interv ea addl 15 min CPT 96168 | $115.50 | $154.00 | $27.78 – $50.01 | 16 |
| Npsy grp hlth intrv ea addl 15 min CPT 96165 | $117.00 | $156.00 | $4.89 – $8.81 | 16 |
| Npsy indiv hlth intrv ea addl 15 min CPT 96159 | $115.50 | $154.00 | $24.83 – $44.70 | 16 |
| Npsy tst eval phsy/qhp 1st hr CPT 96132 | $316.50 | $422.00 | $361.89 – $651.40 | 16 |
| Npsy tst eval phsy/qhp ea l hr CPT 96133 | $153.75 | $205.00 | $95.11 – $171.20 | 16 |
| Nuclear exam of tear flow CPT 78660 | $428.25 | $571.00 | $387.70 – $697.86 | 17 |
| Nuclear rx intra-arterial CPT 79445 | $487.50 | $650.00 | $226.29 – $407.32 | 17 |
| Nuclear rx intra-articular CPT 79440 | $240.00 | $320.00 | $226.29 – $407.32 | 17 |
| Nuclear rx intracav admin CPT 79200 | $789.00 | $1,052.00 | $226.29 – $407.32 | 17 |
| Nuclear rx IV admin CPT 79101 | $504.00 | $672.00 | $226.29 – $407.32 | 17 |
| Nuclear Stress Test (Heart) CPT 78452 | $2,765.25 | $3,687.00 | $1,255.55 – $2,259.99 | 17 |
| Nushield 1 square cm HCPCS Q4160 | $462.75 | $617.00 | $120.69 – $1,290.02 | 17 |
| Nusinersen (pf) 12 mg/5 ml intrathecal solution HCPCS J2326 | $492,978.44 | $657,304.58 | $1,285.78 – $2,741.29 | 17 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $33,278.55 | $44,371.39 | $81.81 – $190.97 | 17 |
| Obltrj a-pulm sep def w/byp CPT 33814 | $1,208.25 | $1,611.00 | $1,419.50 – $2,555.09 | 16 |
| Observation direct referral from physician office for admission HCPCS G0379 | $465.75 | $621.00 | $577.55 – $1,039.58 | 16 |
| Observation per hour HCPCS G0378 | $1,123.50 | $1,498.00 | not published | 0 |
| Obtaining screen pap smear HCPCS Q0091 | $21.75 | $29.00 | $28.05 – $50.49 | 16 |
| Occupational Therapy Evaluation (high complexity) CPT 97167 | $285.75 | $381.00 | $96.30 – $173.33 | 16 |
| Occupational Therapy Evaluation (low complexity) CPT 97165 | $272.25 | $363.00 | $96.30 – $173.33 | 16 |
| Occupational Therapy Evaluation (moderate complexity) CPT 97166 | $285.75 | $381.00 | $96.30 – $173.33 | 16 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $76,319.96 | $101,759.94 | $59.60 – $145.31 | 17 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $887.40 | $1,183.20 | $1.46 – $10.71 | 2 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $23,458.95 | $31,278.59 | $188.35 – $516.47 | 17 |
| Ofatumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9302 | $2,224.00 | $2,965.33 | $62.23 – $112.02 | 16 |
| Oil silicone ophth 8.5ml silikon 1000 HCPCS C1814 | $857.48 | $1,143.30 | not published | 0 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $172.31 | $229.74 | $8.55 – $8.55 | 1 |
| Olanzapine long-acting inj HCPCS J2358 | not published | not published | $7.08 – $7.08 | 1 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $5,445.54 | $7,260.71 | $41.82 – $98.72 | 17 |
| Oncology prostate prob score CPT 81539 | $1,623.75 | $2,165.00 | $760.00 – $1,368.00 | 17 |
| Oncoprotein dcp CPT 83951 | $537.00 | $716.00 | $64.41 – $115.94 | 17 |
| Oncoprotein her-2/neu CPT 83950 | $141.75 | $189.00 | $64.41 – $115.94 | 17 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | not published | not published | $0.02 – $0.02 | 1 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $34.32 | $45.76 | $0.22 – $0.90 | 2 |
| Ophthalmic mitomycin HCPCS J7315 | $1,327.41 | $1,769.87 | not published | 0 |
| Oph Ultrasound dx quan a-scan only CPT 76511 | $105.75 | $141.00 | $101.39 – $182.50 | 17 |
| Oral aprepitant HCPCS J8501 | $3,616.34 | $4,821.78 | $6.60 – $38.07 | 2 |
| Oral everolimus HCPCS J7527 | $2,255.34 | $3,007.11 | $4.82 – $24.75 | 2 |
| Oral netupitant, palonosetro HCPCS J8655 | not published | not published | $996.77 – $996.77 | 1 |
| Organic acids total quant ea spec CPT 83918 | $457.50 | $610.00 | $23.60 – $42.48 | 17 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | not published | not published | $100.77 – $100.77 | 1 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $11,913.61 | $15,884.81 | $28.57 – $69.42 | 17 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $31.68 | $42.24 | $22.98 – $87.39 | 2 |
| Ortho elbow without jnt cstm w/fit&adj HCPCS L3702 | $129.00 | $172.00 | $384.69 – $692.44 | 16 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $97.50 | $130.00 | $360.81 – $649.46 | 16 |
| Ortho hnd/fngr w/jnt cstm w/fit&adj HCPCS L3921 | $389.25 | $519.00 | $427.91 – $770.24 | 16 |
| Ortho hnd without jnt w/fit&adj HCPCS L3919 | $52.50 | $70.00 | $360.81 – $649.46 | 16 |
| Orthopantogram CPT 70355 | $163.50 | $218.00 | $84.40 – $151.91 | 17 |
| Orthovisc inj per dose HCPCS J7324 | $443.85 | $591.80 | $109.09 – $237.78 | 17 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $153.00 | $204.00 | $496.49 – $893.68 | 16 |
| Ortho wrst/hnd w/jnt cstm w/fit&adj HCPCS L3905 | $72.75 | $97.00 | $1,321.16 – $2,378.09 | 16 |
| Oscillation chest wall mechanical per session CPT 94669 | $390.75 | $521.00 | $212.36 – $382.26 | 16 |
| Osmolality blood CPT 83930 | $52.50 | $70.00 | $6.61 – $11.90 | 17 |
| Osmolality urine CPT 83935 | $59.25 | $79.00 | $6.82 – $12.28 | 17 |
| Other immunoelectrophoresis CPT 86325 | $128.25 | $171.00 | $23.13 – $41.63 | 17 |
| Oth resp proc, group HCPCS G0239 | $184.50 | $246.00 | $36.22 – $65.20 | 16 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $119.25 | $159.00 | $47.17 – $84.90 | 16 |
| Ot re-evaluation patient/family CPT 97168 | $184.50 | $246.00 | $65.34 – $117.61 | 16 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $98.25 | $131.00 | $20.61 – $37.09 | 16 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $98.25 | $131.00 | $21.92 – $39.45 | 16 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | not published | not published | $2.00 – $2.00 | 1 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $342.84 | $457.11 | $0.22 – $0.63 | 2 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $35.06 | $46.74 | $2.21 – $17.46 | 2 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $57,937.50 | $77,250.00 | not published | 0 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $34.43 | $45.90 | $0.24 – $0.99 | 2 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $5,416.36 | $7,221.81 | $6.02 – $29.50 | 17 |
| Palifermin injection HCPCS J2425 | $11,767.98 | $15,690.63 | $36.72 – $87.40 | 17 |
| Palingen or palingen xplus HCPCS Q4173 | not published | not published | $867.84 – $867.84 | 1 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $6,272.41 | $8,363.21 | $15.08 – $36.70 | 17 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $9,797.53 | $13,063.37 | $436.75 – $786.15 | 16 |
| Palonosetron hcl HCPCS J2469 | $184.88 | $246.50 | $1.07 – $7.65 | 2 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $148.35 | $197.80 | $27.16 – $79.83 | 2 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $27,287.26 | $36,383.01 | $174.39 – $419.96 | 17 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $18.49 | $24.65 | not published | 0 |
| Papaverin hcl injection HCPCS J2440 | $143.71 | $191.61 | $413.46 – $413.46 | 1 |
| Parathormone (pth) intact CPT 83970 | $500.25 | $667.00 | $41.28 – $74.30 | 17 |
| Parathyrd planar w/spect&ct CPT 78072 | $1,072.50 | $1,430.00 | $526.57 – $947.83 | 17 |
| Parathyroid planar imaging CPT 78070 | $641.25 | $855.00 | $387.70 – $697.86 | 17 |
| Parathyroid planar img w/tomo spect CPT 78071 | $948.75 | $1,265.00 | $387.70 – $697.86 | 17 |
| Paricalcitol HCPCS J2501 | $35.52 | $47.35 | $1.63 – $6.03 | 2 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $222.75 | $297.00 | $194.58 – $350.24 | 16 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $7,702.14 | $10,269.51 | $6.21 – $22.95 | 2 |
| Passy muir valve metal trach HCPCS L8501 | $1,016.73 | $1,355.64 | $197.18 – $354.92 | 16 |
| Pdgfra gene CPT 81314 | $618.00 | $824.00 | $329.51 – $593.12 | 17 |
| Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 | $7.50 | $10.00 | $33.50 – $60.30 | 16 |
| Pegademase bovine, 25 iu HCPCS J2504 | not published | not published | $895.61 – $895.61 | 1 |
| Pegaspargase injection HCPCS J9266 | $82,241.50 | $109,655.33 | $28,424.06 – $69,184.14 | 17 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $16,623.78 | $22,165.04 | $127.38 – $229.28 | 17 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $321.36 – $321.36 | 1 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $11,163.13 | $14,884.17 | $135.89 – $331.12 | 17 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $6,455.84 | $8,607.78 | $79.50 – $252.41 | 17 |
| Peg interferon alfa-2a/180 HCPCS S0145 | $3,504.65 | $4,672.86 | not published | 0 |
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.