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 |
|---|---|---|---|---|
| Revasc lithotr-stent tib/per HCPCS C9773 | $16,941.00 | $22,588.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc lith-sten-ath tib/per HCPCS C9775 | $16,941.00 | $22,588.00 | $17,778.02 – $32,000.44 | 16 |
| Revefenacin inh non-com 1mcg HCPCS J7677 | not published | not published | $0.46 – $0.46 | 1 |
| Revise abdomen-venous shunt CPT 49426 | $5,251.50 | $7,002.00 | $3,472.27 – $6,250.09 | 16 |
| Revision of cervix CPT 57720 | $2,175.00 | $2,900.00 | $3,139.36 – $5,650.86 | 16 |
| Revision of cervix CPT 59320 | $2,596.50 | $3,462.00 | $3,139.36 – $5,650.86 | 16 |
| Revision of penis CPT 54420 | $3,367.50 | $4,490.00 | $3,418.53 – $6,153.35 | 16 |
| Revision tips CPT 37183 | $6,434.25 | $8,579.00 | $5,519.68 – $9,935.42 | 16 |
| Revita, per sq cm HCPCS Q4180 | not published | not published | $2,653.23 – $2,653.23 | 1 |
| Rev-rem impl neurostim gen-rec CPT 63688 | $3,288.00 | $4,384.00 | $3,390.52 – $6,102.94 | 16 |
| Rf abltj nrv nrvtg si jt CPT 64625 | $1,746.75 | $2,329.00 | $1,893.75 – $3,408.76 | 16 |
| Rheumatoid factor quantitative CPT 86431 | $100.50 | $134.00 | $5.67 – $10.21 | 17 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | not published | not published | $12.07 – $12.07 | 1 |
| Rho d immune globulin 50 mcg HCPCS J2788 | not published | not published | $67.79 – $67.79 | 1 |
| Rho(d) immune globulin h, sd HCPCS J2792 | $5,242.06 | $6,989.41 | $34.26 – $74.89 | 17 |
| Rho d immune globulin inj HCPCS J2790 | $240.75 | $321.00 | $200.61 – $730.44 | 2 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $291.00 | $388.00 | $101.39 – $182.50 | 17 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $307.50 | $410.00 | $101.39 – $182.50 | 17 |
| Rib X-ray (3 views, both sides) CPT 71110 | $295.50 | $394.00 | $101.39 – $182.50 | 17 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $300.54 | $400.72 | not published | 0 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $1,509.75 | $2,013.00 | $955.43 – $1,719.77 | 16 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $4,536.51 | $6,048.67 | $10.80 – $26.63 | 17 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | not published | not published | $184.81 – $184.81 | 1 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $27,790.74 | $37,054.31 | $36.28 – $89.96 | 17 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $9,097.89 | $12,130.52 | $31.28 – $75.89 | 17 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | not published | not published | $72.80 – $72.80 | 1 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $8,464.14 | $11,285.51 | $13.69 – $64.50 | 17 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $1,314.00 | $1,752.00 | $686.75 – $1,236.14 | 16 |
| Rmvl icd by tv extr CPT 33244 | $2,884.50 | $3,846.00 | $3,624.10 – $6,523.39 | 16 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $31,260.00 | $41,680.00 | $30,440.92 – $54,793.66 | 16 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $21,319.50 | $28,426.00 | $21,571.82 – $38,829.28 | 16 |
| Rmvl icd pulse gen only CPT 33241 | $2,562.75 | $3,417.00 | $3,624.10 – $6,523.39 | 16 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $762.00 | $1,016.00 | $608.36 – $1,095.05 | 16 |
| Rmvl perm pm pulse gen CPT 33233 | $4,150.50 | $5,534.00 | $8,025.47 – $14,445.85 | 16 |
| Rmvl phrnc nrv stim pg only CPT 33280 | $3,353.25 | $4,471.00 | $3,390.52 – $6,102.94 | 16 |
| Rmvl phrnc nrv stim sys CPT 33278 | $3,353.25 | $4,471.00 | $3,390.52 – $6,102.94 | 16 |
| Rmvl phrnc nrv stim transvns CPT 33279 | $3,287.25 | $4,383.00 | $3,390.52 – $6,102.94 | 16 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $3,118.50 | $4,158.00 | $163.30 – $293.94 | 16 |
| Rmvl sq defib electrode CPT 33272 | $3,794.25 | $5,059.00 | $3,624.10 – $6,523.39 | 16 |
| Rmvl tv pm lead dual CPT 33235 | $2,460.75 | $3,281.00 | $3,624.10 – $6,523.39 | 16 |
| Rmv&rplcmt phrnc nrv stim ld CPT 33288 | $13,161.00 | $17,548.00 | $10,806.19 – $19,451.13 | 16 |
| Rmv&rplcmt phrnc nrv stim pg CPT 33287 | $30,000.00 | $40,000.00 | $29,925.80 – $53,866.43 | 16 |
| Rolapitant, oral, 1mg HCPCS J8670 | not published | not published | $3.77 – $3.77 | 1 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $11,827.02 | $15,769.35 | $30.80 – $75.62 | 17 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $20,356.48 | $27,141.97 | $11.11 – $19.99 | 16 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $8,372.44 | $11,163.25 | $12.19 – $29.21 | 17 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $184.88 | $246.50 | $0.15 – $0.72 | 2 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $1,865.25 | $2,487.00 | $1,526.62 – $2,747.91 | 16 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $2,531.25 | $3,375.00 | $1,255.55 – $2,259.99 | 16 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $1,749.00 | $2,332.00 | $1,526.62 – $2,747.91 | 16 |
| Rpl tun-cvad w subq port CPT 36582 | $3,849.75 | $5,133.00 | $3,062.12 – $5,511.82 | 16 |
| Rpl tun cvc wo subq port CPT 36581 | $3,632.25 | $4,843.00 | $3,062.12 – $5,511.82 | 16 |
| Rpm tx mgmt 1st 20 min CPT 99457 | $135.00 | $180.00 | $49.17 – $88.50 | 16 |
| Rpm tx mgmt ea addl 20 min CPT 99458 | $109.50 | $146.00 | $39.71 – $71.48 | 16 |
| Rubella antibody igg CPT 86762 | $83.25 | $111.00 | $14.39 – $25.90 | 17 |
| Rubeola antibody igg CPT 86765 | $166.50 | $222.00 | $12.88 – $23.18 | 17 |
| Russell viper venom diluted CPT 85613 | $81.00 | $108.00 | $9.58 – $17.24 | 17 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $9,478.55 | $12,638.06 | $36.80 – $88.23 | 17 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $269.25 | $359.00 | $101.39 – $182.50 | 17 |
| Salivary gland imaging CPT 78230 | $262.50 | $350.00 | $387.70 – $697.86 | 17 |
| Salmonella antibody CPT 86768 | $29.25 | $39.00 | $13.19 – $23.74 | 17 |
| Sargramostim injection HCPCS J2820 | $1,092.15 | $1,456.20 | $61.89 – $136.52 | 17 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | not published | not published | $393.16 – $393.16 | 1 |
| Sarscov coronavirus ag ia CPT 87426 | $59.25 | $79.00 | $35.33 – $63.59 | 16 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $134.25 | $179.00 | $70.29 – $126.52 | 16 |
| S bowel endoscope w/stent CPT 44379 | $6,608.25 | $8,811.00 | $5,887.56 – $10,597.60 | 16 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $734.25 | $979.00 | $231.40 – $416.51 | 16 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $855.75 | $1,141.00 | $101.39 – $182.50 | 16 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $127.50 | $170.00 | $101.39 – $182.50 | 16 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $810.75 | $1,081.00 | $101.39 – $182.50 | 16 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $612.00 | $816.00 | $101.39 – $182.50 | 16 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $855.75 | $1,141.00 | $101.39 – $182.50 | 16 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,077.00 | $1,436.00 | $1,601.72 – $2,883.09 | 16 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $7,863.75 | $10,485.00 | not published | 0 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $2,478.75 | $3,305.00 | $901.87 – $1,623.37 | 16 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $1,761.75 | $2,349.00 | $901.87 – $1,623.37 | 16 |
| Screening Mammogram CPT 77067 | $444.00 | $592.00 | $117.58 – $211.64 | 16 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | $26.25 | $35.00 | $3.08 – $5.55 | 16 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $28,563.75 | $38,085.00 | not published | 0 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $736.50 | $982.00 | $101.39 – $182.50 | 17 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $8,255.25 | $11,007.00 | $1,073.96 – $1,933.14 | 16 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $667.50 | $890.00 | $61.07 – $109.93 | 16 |
| Sedimentation rate erythrocyte automated CPT 85652 | $39.00 | $52.00 | $2.70 – $4.86 | 17 |
| Select picture audiometry CPT 92583 | $56.25 | $75.00 | $57.21 – $102.98 | 16 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $106.50 | $142.00 | $30.92 – $55.66 | 16 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | $112.50 | $150.00 | $14.36 – $25.86 | 16 |
| Sertraline (zoloft) - sendout CPT 80332 | $88.50 | $118.00 | not published | 0 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $638.94 | $851.91 | not published | 0 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $206.25 | $275.00 | $194.58 – $350.24 | 16 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $7,076.25 | $9,435.00 | not published | 0 |
| Sheath laser cavaclear 14f HCPCS C1603 | $11,238.75 | $14,985.00 | not published | 0 |
| Shoe post-op mens m HCPCS L3260 | $29.76 | $39.67 | not published | 0 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $99.75 | $133.00 | $69.83 – $125.69 | 16 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $283.50 | $378.00 | $84.40 – $151.91 | 17 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $236.25 | $315.00 | $101.39 – $182.50 | 17 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,854.50 | $3,806.00 | $338.34 – $609.01 | 16 |
| Shoulder MRI (with contrast) CPT 73222 | $2,769.75 | $3,693.00 | $760.25 – $1,368.44 | 16 |
| Shoulder MRI (without contrast) CPT 73221 | $2,854.50 | $3,806.00 | $231.40 – $416.51 | 16 |
| Shoulder X-ray CPT 73030 | $276.00 | $368.00 | $84.40 – $151.91 | 17 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $216.75 | $289.00 | $84.40 – $151.91 | 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.