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 |
|---|---|---|---|---|
| Troponin quantitative CPT 84484 | $147.00 | $196.00 | $12.47 – $22.45 | 17 |
| Tte w or without fol w/con,stres HCPCS C8928 | $1,369.50 | $1,826.00 | $760.25 – $1,368.44 | 16 |
| Tte w or without fol w/cont, com HCPCS C8921 | $1,142.25 | $1,523.00 | $760.25 – $1,368.44 | 16 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $693.75 | $925.00 | $760.25 – $1,368.44 | 16 |
| Tx closed hip disl traumatic without anes CPT 27250 | $218.25 | $291.00 | $239.22 – $430.59 | 16 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $3,767.25 | $5,023.00 | $3,173.19 – $5,711.73 | 16 |
| Tx closed tib shaft fx without manip CPT 27750 | $288.00 | $384.00 | $239.22 – $430.59 | 16 |
| Typhoid vaccine oral CPT 90690 | $365.66 | $487.54 | $812.25 – $812.25 | 1 |
| Ugt1a1 gene analy common variants CPT 81350 | $438.75 | $585.00 | $234.00 – $421.20 | 17 |
| Ultrasound breast complete CPT 76641 | $439.50 | $586.00 | $101.39 – $182.50 | 17 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $216.75 | $289.00 | $84.40 – $151.91 | 17 |
| Ultrasound dx ophth b-scan CPT 76512 | $336.00 | $448.00 | $101.39 – $182.50 | 17 |
| Ultrasound elastography ea l target les CPT 76983 | $177.00 | $236.00 | $56.96 – $102.54 | 16 |
| Ultrasound encephalogram CPT 76506 | $397.50 | $530.00 | $101.39 – $182.50 | 17 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $885.75 | $1,181.00 | $101.39 – $182.50 | 17 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $728.25 | $971.00 | $101.39 – $182.50 | 17 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $993.75 | $1,325.00 | $60.57 – $109.02 | 16 |
| Ultrasound guidance for vascular access CPT 76937 | $668.25 | $891.00 | $37.87 – $68.16 | 16 |
| Ultrasound guide intraoperative CPT 76998 | $371.25 | $495.00 | not published | 0 |
| Ultrasound guide tissue ablation CPT 76940 | $1,032.75 | $1,377.00 | not published | 0 |
| Ultrasound hips infant dynamic CPT 76885 | $317.25 | $423.00 | $84.40 – $151.91 | 17 |
| Ultrasound infant hips ltd without stress CPT 76886 | $258.00 | $344.00 | $84.40 – $151.91 | 17 |
| Ultrasound joint complete left CPT 76881 | $763.50 | $1,018.00 | $101.39 – $182.50 | 17 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $687.00 | $916.00 | $83.79 – $150.83 | 16 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $455.25 | $607.00 | $57.68 – $103.82 | 16 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $970.50 | $1,294.00 | $161.25 – $416.51 | 17 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $597.75 | $797.00 | $101.39 – $182.50 | 17 |
| Ultrasound prostate/transrectal CPT 76872 | $745.50 | $994.00 | $101.39 – $182.50 | 17 |
| Ultrasound spinal canal and contents CPT 76800 | $292.50 | $390.00 | $101.39 – $182.50 | 17 |
| Ultrasound transabd ea addl gest CPT 76812 | $631.50 | $842.00 | $182.85 – $329.14 | 16 |
| Unit mobile power mpu HCPCS Q0479 | $18,857.25 | $25,143.00 | $17,581.09 – $31,645.96 | 16 |
| Unlisted chemotherapy px CPT 96549 | $44.25 | $59.00 | $45.41 – $81.74 | 16 |
| Unlisted CT procedure CPT 76497 | $1,578.75 | $2,105.00 | $84.40 – $151.91 | 16 |
| Unlisted dx gi procedure CPT 91299 | $2,463.00 | $3,284.00 | $124.79 – $224.62 | 16 |
| Unlisted maaa CPT 81599 | $1,618.50 | $2,158.00 | not published | 0 |
| Unlisted misc path test CPT 89240 | $1,014.00 | $1,352.00 | $50.54 – $90.97 | 16 |
| Unlisted mr procedure CPT 76498 | $1,596.75 | $2,129.00 | $84.40 – $151.91 | 16 |
| Unlisted orl service/px CPT 92700 | $121.50 | $162.00 | $28.05 – $50.49 | 16 |
| Unlisted procedure colon CPT 45399 | $4,911.75 | $6,549.00 | $901.87 – $1,623.37 | 16 |
| Unlisted procedure larynx CPT 31599 | $4,133.25 | $5,511.00 | $229.70 – $413.45 | 16 |
| Unlisted procedure liver CPT 47399 | $2,802.00 | $3,736.00 | $686.75 – $1,236.14 | 16 |
| Unlisted procedure microbiology CPT 87999 | $277.50 | $370.00 | not published | 0 |
| Unlisted procedure rectum CPT 45999 | $882.75 | $1,177.00 | $901.87 – $1,623.37 | 16 |
| Unlisted px abdomen muscskel CPT 22999 | $1,520.25 | $2,027.00 | $239.22 – $430.59 | 16 |
| Unlisted px casting/strpg CPT 29799 | $316.50 | $422.00 | $157.59 – $283.67 | 16 |
| Unlisted px tongue flr mouth CPT 41599 | $1,627.50 | $2,170.00 | $229.70 – $413.45 | 16 |
| Unlisted ultrasound procedure CPT 76999 | $460.50 | $614.00 | $84.40 – $151.91 | 17 |
| Upgrade pm system CPT 33214 | $7,818.75 | $10,425.00 | $10,136.35 – $18,245.42 | 16 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $236.25 | $315.00 | $84.40 – $151.91 | 17 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $1,293.00 | $1,724.00 | $170.10 – $306.19 | 16 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $944.25 | $1,259.00 | $101.39 – $182.50 | 16 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,994.00 | $3,992.00 | $338.34 – $609.01 | 16 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,847.75 | $3,797.00 | $231.40 – $416.51 | 16 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $306.75 | $409.00 | $101.39 – $182.50 | 17 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $307.50 | $410.00 | $101.39 – $182.50 | 17 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $1,857.75 | $2,477.00 | $879.59 – $1,583.27 | 16 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $2,078.25 | $2,771.00 | $879.59 – $1,583.27 | 16 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $589.50 | $786.00 | $170.10 – $356.07 | 17 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $488.25 | $651.00 | $170.10 – $356.07 | 17 |
| Uppr gi scope w/submuc inj CPT 43236 | $1,764.00 | $2,352.00 | $879.59 – $1,583.27 | 16 |
| Urea nitrogen CPT 84520 | $38.25 | $51.00 | $3.95 – $7.11 | 17 |
| Urea nitrogen 24 hour urine CPT 84540 | $39.75 | $53.00 | $5.56 – $10.01 | 17 |
| Urea nitrogen clearance CPT 84545 | $57.00 | $76.00 | $7.20 – $12.96 | 17 |
| Ureteral reflux study CPT 78740 | $609.00 | $812.00 | $387.70 – $697.86 | 17 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $613.50 | $818.00 | $231.40 – $416.51 | 17 |
| Urethrocystography void s&i CPT 74455 | $634.50 | $846.00 | $231.40 – $416.51 | 17 |
| Uric acid blood CPT 84550 | $41.25 | $55.00 | $4.52 – $8.14 | 17 |
| Uric acid urine CPT 84560 | $35.25 | $47.00 | $5.08 – $9.14 | 17 |
| Urinalysis (with microscopy) CPT 81001 | $27.00 | $36.00 | $3.17 – $5.71 | 17 |
| Urinalysis (without microscopy) CPT 81003 | $49.50 | $66.00 | $2.25 – $4.05 | 17 |
| Urine Culture Test CPT 87086 | $65.25 | $87.00 | $8.07 – $14.53 | 17 |
| Urine pregnancy test CPT 81025 | $41.25 | $55.00 | $8.61 – $15.50 | 17 |
| Urography, antegrade CPT 74425 | $780.00 | $1,040.00 | $338.34 – $609.01 | 17 |
| Use 1st target lesion CPT 76982 | $151.50 | $202.00 | $101.39 – $182.50 | 16 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $8,225.22 | $10,966.96 | $11.62 – $32.35 | 17 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $109,781.59 | $146,375.45 | $379.41 – $1,385.64 | 2 |
| Vaccine Administration (one shot) CPT 90471 | $36.75 | $49.00 | $69.83 – $125.69 | 16 |
| Vaccine dtap < 7 years im CPT 90700 | $62.25 | $83.00 | $310.68 – $310.68 | 1 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $233.91 | $311.87 | $1,024.29 – $1,024.29 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $99.92 | $133.22 | $319.50 – $319.50 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $45.33 | $60.44 | $137.52 – $137.52 | 1 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $241.96 | $322.61 | $176.90 – $632.34 | 2 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $354.74 | $472.98 | $1,163.97 – $1,163.97 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $100.79 | $134.38 | $374.85 – $374.85 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $54.75 | $73.00 | $75.15 – $182.89 | 17 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $162.07 | $216.09 | $75.15 – $171.28 | 17 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $118.50 | $158.00 | $177.56 – $432.16 | 17 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $75.39 | $100.52 | $33.20 – $77.08 | 17 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $1,044.16 | $1,392.21 | $3,104.01 – $3,104.01 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $67.50 | $90.00 | $98.16 – $203.21 | 17 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $203.21 – $203.21 | 1 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $53.18 – $53.18 | 1 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $45.75 | $61.00 | $23.22 – $54.40 | 17 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $50.80 – $50.80 | 1 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $188.27 – $188.27 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $52.65 – $52.65 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $25.50 | $34.00 | $54.40 – $201.15 | 2 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $25.39 – $25.39 | 1 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $72.75 | $97.00 | $67.62 – $250.11 | 2 |
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.