Southeastern Medical Center
1341 North Clark Street, Cambridge, OH · OhioHealth · · NPI 1053342816
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 |
|---|---|---|---|---|
| Cystoscopy inject material CPT 52327 | not published | not published | $5,072.67 – $5,275.58 | 3 |
| Cystoscopy prostatic imp 1-3 HCPCS C9739 | not published | not published | $5,072.67 – $5,275.58 | 3 |
| Cystoscopy removal of clots CPT 52001 | $2,865.85 | $4,409.00 | $3,334.90 – $3,468.30 | 3 |
| Cystoscopy & revise urethra CPT 52270 | not published | not published | $1,977.66 – $2,056.77 | 3 |
| Cystoscopy & revise urethra CPT 52275 | not published | not published | $1,977.66 – $2,056.77 | 3 |
| Cystoscopy stone removal CPT 52325 | not published | not published | $5,072.67 – $5,275.58 | 3 |
| Cystoscopy & ureter catheter CPT 52005 | not published | not published | $1,977.66 – $2,056.77 | 3 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | $4,129.45 | $6,353.00 | $1,977.66 – $2,056.77 | 3 |
| Cystotomy/cystostomy fulg+/insj radact matrl 51020 CPT 51020 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Cystotomy excise/incise/repair 51535 CPT 51535 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Cystouretero & or pyeloscope CPT 52351 | $4,462.90 | $6,866.00 | $3,334.90 – $3,468.30 | 3 |
| Cysto/uretero stricture tx CPT 52344 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $5,072.67 – $5,275.58 | 3 |
| Cystouretero w/excise tumor CPT 52355 | not published | not published | $5,072.67 – $5,275.58 | 3 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $5,072.67 – $5,275.58 | 3 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $5,072.67 – $5,275.58 | 3 |
| Cystouretero w/renal strict CPT 52346 | not published | not published | $5,072.67 – $5,275.58 | 3 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Cysto/uretero w/up stricture CPT 52345 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Cystourethro cut ejacul duct CPT 52402 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | not published | not published | $1,977.66 – $2,056.77 | 3 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $1,977.66 – $2,056.77 | 3 |
| Cysto w/renal stricture tx CPT 52343 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Cysto w/up stricture tx CPT 52342 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Cysto w/ureter stricture tx CPT 52341 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | not published | not published | $1.34 – $5.14 | 2 |
| Cytogenetics 25-99 CPT 88274 | $59.15 | $91.00 | $42.38 – $44.08 | 2 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $40.70 – $42.33 | 2 |
| Cytogenomic neo microra alys CPT 81277 | $4,368.00 | $6,720.00 | $1,160.00 – $1,206.40 | 2 |
| Cytogenom microarray copy nmbr var CPT 81228 | $3,234.40 | $4,976.00 | $900.00 – $936.00 | 2 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $90.35 | $139.00 | $14.39 – $14.97 | 2 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $95.55 | $147.00 | $16.85 – $17.52 | 2 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $13.42 – $13.96 | 2 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | not published | not published | $1,808.64 – $11,791.72 | 4 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $25.37 – $26.38 | 2 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $14.65 – $15.24 | 2 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $178.75 | $275.00 | not published | 0 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $61.75 | $95.00 | $26.61 – $27.67 | 2 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $48.10 | $74.00 | $20.26 – $21.07 | 2 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $100.75 | $155.00 | $35.34 – $36.75 | 3 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $124.80 | $192.00 | $35.34 – $36.75 | 3 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $169.00 | $260.00 | not published | 0 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $196.30 | $302.00 | $161.18 – $167.63 | 3 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $7,800.00 | $12,000.00 | not published | 0 |
| Cytopath smear oth prep screen & interp CPT 88161 | $840.45 | $1,293.00 | not published | 0 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $18.54 – $19.28 | 2 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $78.65 – $81.80 | 2 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $29.68 – $30.87 | 2 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $161.18 – $167.63 | 3 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | not published | not published | $7.10 – $27.11 | 2 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | not published | not published | $328.34 – $2,111.20 | 4 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | not published | not published | $15.61 – $101.40 | 4 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $23.57 – $90.09 | 2 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $63.64 | $97.90 | $0.06 – $0.26 | 2 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.07 – $0.26 | 2 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $32,891.50 | $50,602.31 | $55.57 – $334.04 | 4 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $7,371.55 | $11,340.85 | $2.93 – $19.31 | 4 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $2.93 – $19.31 | 4 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | not published | not published | $256.09 – $1,614.67 | 4 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | not published | not published | $39.98 – $152.88 | 2 |
| Dbrdmt prmlg les w/pdt CPT 96574 | not published | not published | $189.82 – $197.41 | 3 |
| D&c after delivery 59160 CPT 59160 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Dch glucoscan CPT 82948 | not published | not published | $5.04 – $5.24 | 2 |
| Dch pulmonary stress test CPT 94621 | $1,927.25 | $2,965.00 | $353.04 – $367.16 | 3 |
| Dch validity tests CPT 81002 | $72.80 | $112.00 | $3.48 – $3.62 | 2 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | $2,592.85 | $3,989.00 | $1,847.43 – $1,921.33 | 3 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $1,847.43 – $1,921.33 | 3 |
| D&c of cervical stump CPT 57558 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Deamidated gliadin antibody iga CPT 86258 | $79.95 | $123.00 | $12.05 – $12.53 | 2 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $505.05 | $777.00 | $384.59 – $399.98 | 3 |
| Debridement (>20 cm) charge pt CPT 97598 | $204.75 | $315.00 | not published | 0 |
| Debridement bone <= 20 sq cm CPT 11044 | $2,095.60 | $3,224.00 | $1,562.54 – $1,625.04 | 3 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $841.75 | $1,295.00 | not published | 0 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $915.20 | $1,408.00 | not published | 0 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $726.05 | $1,117.00 | $384.59 – $399.98 | 3 |
| Debride nail1-5 11720 CPT 11720 | $55.90 | $86.00 | $55.81 – $58.04 | 3 |
| Debride nail6 or more 11721 CPT 11721 | $118.30 | $182.00 | $55.81 – $58.04 | 3 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | not published | not published | $669.95 – $696.75 | 3 |
| Debride skin bone at fx site CPT 11012 | not published | not published | $2,748.08 – $2,858.01 | 3 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $456.95 | $703.00 | not published | 0 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | not published | not published | $189.82 – $197.41 | 3 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $798.20 | $1,228.00 | $669.95 – $696.75 | 3 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $1,615.25 | $2,485.00 | $699.22 – $727.19 | 3 |
| Decalcification CPT 88311 | $69.55 | $107.00 | not published | 0 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | not published | not published | $3.97 – $15.15 | 2 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $434.20 | $668.00 | $312.49 – $324.99 | 3 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Decomp forearm 1 space 25020 CPT 25020 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Decomp forearm 2 spaces w/debrid 25025 CPT 25025 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Decompress fasciotomyhand 26037 CPT 26037 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Decompress fingers/hand CPT 26035 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Decompress forearm 1 space CPT 25023 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Decompress forearm 2 spaces CPT 25024 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Decompression fasct forearm CPT 24495 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Decompression of leg CPT 27892 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Decompression of leg CPT 27893 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Decompression of leg CPT 27894 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Decompression of lower leg CPT 27600 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Decompression of lower leg CPT 27601 | not published | not published | $3,095.56 – $3,219.39 | 3 |
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.