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 |
|---|---|---|---|---|
| Diagnostic laryngoscopy 31575 CPT 31575 | $239.85 | $369.00 | not published | 0 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $491.40 | $756.00 | $101.00 – $105.04 | 3 |
| Diagnostic Mammogram (one breast) CPT 77065 | $440.05 | $677.00 | $78.71 – $81.86 | 3 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $82.33 – $85.63 | 3 |
| Dialysis one evaluation CPT 90945 | $410.15 | $631.00 | $394.76 – $410.55 | 3 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.91 – $7.19 | 3 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.12 – $0.46 | 2 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $99.68 | $153.36 | $14.53 – $55.58 | 2 |
| Dicyclomine injection HCPCS J0500 | $284.58 | $437.82 | $25.34 – $96.85 | 2 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $1.50 – $1.50 | 1 |
| Diffusing capacity CPT 94729 | $230.75 | $355.00 | not published | 0 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $23.76 | $36.55 | $14.99 – $57.33 | 2 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $15,014.28 | $23,098.90 | $5,168.23 – $32,954.87 | 4 |
| Digoxin total therapeutic drug level CPT 80162 | $92.30 | $142.00 | $13.28 – $13.81 | 2 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $96.75 | $148.85 | $69.76 – $266.76 | 2 |
| Dilate biliary duct/ampulla CPT 47542 | $8,580.00 | $13,200.00 | not published | 0 |
| Dilate esophagus CPT 43453 | not published | not published | $1,815.43 – $1,888.05 | 3 |
| Dilate esophagus 1/mult pass CPT 43450 | $2,968.55 | $4,567.00 | $858.08 – $892.40 | 3 |
| Dilate urethra stricture CPT 53600 | not published | not published | $236.38 – $245.83 | 3 |
| Dilate urethra stricture CPT 53601 | not published | not published | $125.87 – $130.91 | 3 |
| Dilate urethra stricture CPT 53605 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Dilate urethra stricture CPT 53621 | not published | not published | $236.38 – $245.83 | 3 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $121.73 – $126.60 | 3 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,132.12 – $1,177.40 | 3 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,132.12 – $1,177.40 | 3 |
| Dilation of salivary duct CPT 42660 | $187.85 | $289.00 | not published | 0 |
| Dilation of urethra CPT 53661 | not published | not published | $125.87 – $130.91 | 3 |
| Dilation of urethra CPT 53665 | not published | not published | $1,977.66 – $2,056.77 | 3 |
| Dilation of vagina CPT 57400 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $659.70 – $686.08 | 3 |
| Dilator fascial 10fx20cm HCPCS C2627 | $335.13 | $515.59 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $5,912.40 | $9,096.00 | $3,334.90 – $3,468.30 | 3 |
| Dilat xst trc new access rcs CPT 50437 | $11,824.80 | $18,192.00 | $3,334.90 – $3,468.30 | 3 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $92.66 | $142.55 | not published | 0 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $366.73 – $366.73 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $14.74 – $56.36 | 2 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $748.84 – $4,650.04 | 4 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.13 – $0.13 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $21.71 | $33.40 | $1.25 – $4.75 | 2 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $429.59 – $429.59 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $35.34 – $36.75 | 3 |
| Disability dlco CPT 94727 | $267.15 | $411.00 | $204.28 – $212.45 | 3 |
| Disaccharidases CPT 82657 | $674.70 | $1,038.00 | $22.17 – $23.06 | 2 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $1,952.02 – $2,030.10 | 3 |
| Discography cerv/thor spine CPT 72285 | $3,316.30 | $5,102.00 | $1,847.43 – $1,921.33 | 3 |
| Dmd dup/delet analysis CPT 81161 | $1,745.25 | $2,685.00 | $279.00 – $290.16 | 2 |
| Dmpk gene detc abnor allele CPT 81234 | $1,414.40 | $2,176.00 | $137.00 – $142.48 | 2 |
| Dna antibody native/double stranded CPT 86225 | $74.10 | $114.00 | $13.74 – $14.29 | 2 |
| Dna gardnerella CPT 87510 | $80.60 | $124.00 | $20.05 – $20.85 | 2 |
| Dna probe chlamydia CPT 87490 | $23.40 | $36.00 | $22.75 – $23.66 | 2 |
| Dna probe gc CPT 87590 | $122.20 | $188.00 | $26.88 – $27.96 | 2 |
| Dna trichomonas CPT 87660 | $80.60 | $124.00 | $20.05 – $20.85 | 2 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $130.68 | $201.05 | $12.56 – $48.04 | 2 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $261.85 | $402.85 | $1.25 – $4.75 | 2 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $50.78 – $339.37 | 4 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $0.07 – $0.07 | 1 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $392.08 – $392.08 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $64.77 | $99.65 | $1.31 – $5.01 | 2 |
| Doppler echo complete CPT 93320 | $354.90 | $546.00 | not published | 0 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $468.65 | $721.00 | $204.28 – $212.45 | 3 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $341.90 | $526.00 | $125.87 – $130.91 | 3 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $0.07 – $0.07 | 1 |
| Dornase alfa non-comp unit HCPCS J7639 | not published | not published | $91.11 – $348.34 | 2 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $32,490.15 | $49,984.85 | $243.71 – $1,560.39 | 4 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $100.85 | $155.15 | $5.64 – $21.58 | 2 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $1,181.02 | $1,816.95 | $108.47 – $884.33 | 4 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $48.59 | $74.75 | not published | 0 |
| Dpyd gene common variants CPT 81232 | $1,097.20 | $1,688.00 | $174.81 – $181.80 | 2 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $337.35 | $519.00 | $669.95 – $696.75 | 3 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $669.95 – $696.75 | 3 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $1,562.54 – $1,625.04 | 3 |
| Drainage external ear simple 69000 CPT 69000 | $692.90 | $1,066.00 | $669.95 – $696.75 | 3 |
| Drainage lymph node lesion 38300 CPT 38300 | not published | not published | $2,748.08 – $2,858.01 | 3 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $2,748.08 – $2,858.01 | 3 |
| Drainage of arm bursa 23931 CPT 23931 | not published | not published | $1,562.54 – $1,625.04 | 3 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $2,748.08 – $2,858.01 | 3 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Drainage of kidney lesion CPT 50390 | $4,427.80 | $6,812.00 | $669.95 – $696.75 | 3 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Drainage of pelvis lesion 26990 CPT 26990 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Drainage of rectal abscess CPT 45005 | not published | not published | $1,132.12 – $1,177.40 | 3 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $2,625.99 – $2,731.03 | 3 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Drainage of urethra abscess 53060 CPT 53060 | not published | not published | $1,977.66 – $2,056.77 | 3 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $659.70 – $686.08 | 3 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $1,977.66 – $2,056.77 | 3 |
| Drain bladder by trocar/cath CPT 51101 | not published | not published | $812.43 – $844.93 | 3 |
| Drain blood from under nail 11740 CPT 11740 | $337.35 | $519.00 | $125.87 – $130.91 | 3 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $952.90 | $1,466.00 | $1,562.54 – $1,625.04 | 3 |
| Drain cath image guided visceral pq CPT 49405 | $1,278.55 | $1,967.00 | $1,562.54 – $1,625.04 | 3 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $739.70 | $1,138.00 | $667.82 – $694.53 | 3 |
| Drain chest lesion CPT 21502 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Drain finger abscess;simple 26010 CPT 26010 | $791.05 | $1,217.00 | $189.82 – $197.41 | 3 |
| Drain lower leg bursa CPT 27604 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Drain lower leg lesion 27603 CPT 27603 | $3,001.05 | $4,617.00 | $2,748.08 – $2,858.01 | 3 |
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | $2,748.08 – $2,858.01 | 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.