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 |
|---|---|---|---|---|
| Ghs ppd (tb intradermal) CPT 86580 | $45.50 | $70.00 | not published | 0 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $69.55 | $107.00 | $9.66 – $10.05 | 2 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $5.61 – $5.83 | 2 |
| Ghs protoporphyrins fract CPT 84202 | $65.65 | $101.00 | $14.35 – $14.92 | 2 |
| Ghs pr without cont pulse ox CPT 94625 | $143.00 | $220.00 | $55.81 – $58.04 | 3 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $29.90 | $46.00 | $12.25 – $12.74 | 2 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $183.95 | $283.00 | not published | 0 |
| Ghs quinidine CPT 80194 | $68.25 | $105.00 | $14.60 – $15.18 | 2 |
| Ghs refill of implantable pump CPT 95990 | $1,623.05 | $2,497.00 | $312.49 – $324.99 | 3 |
| Ghs removal intranasal foreign body CPT 30300 | $188.50 | $290.00 | $125.87 – $130.91 | 3 |
| Ghs removal pharyngeal foreign body CPT 42809 | $490.10 | $754.00 | not published | 0 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | not published | not published | $15.89 – $16.53 | 2 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $4.31 – $4.48 | 2 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $92.30 | $142.00 | $13.91 – $14.47 | 2 |
| Ghs sedimentation rate CPT 85651 | $52.65 | $81.00 | $4.27 – $4.44 | 2 |
| Ghs semen analysis fert CPT 89320 | $66.95 | $103.00 | $12.31 – $12.80 | 2 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.84 – $10.23 | 2 |
| Ghs sensitivity (per antimicro) CPT 87184 | not published | not published | $7.48 – $7.78 | 2 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $384.59 – $399.98 | 3 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $384.59 – $399.98 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $384.59 – $399.98 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $384.59 – $399.98 | 3 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $189.82 – $197.41 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $189.82 – $197.41 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $189.82 – $197.41 | 3 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $189.82 – $197.41 | 3 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $189.82 – $197.41 | 3 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $204.28 – $212.45 | 3 |
| Ghs somatosensory testing lower extremit CPT 95926 | $1,253.85 | $1,929.00 | $204.28 – $212.45 | 3 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $2,557.75 | $3,935.00 | $812.43 – $844.93 | 3 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $187.85 | $289.00 | $45.64 – $47.47 | 3 |
| Ghs sphenopalatine ganglion block CPT 64505 | $825.50 | $1,270.00 | $290.40 – $302.02 | 3 |
| Ghs spont nystagmus CPT 92541 | $86.45 | $133.00 | $125.87 – $130.91 | 3 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $221.00 | $340.00 | $98.01 – $101.93 | 3 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $35.34 – $36.75 | 3 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $125.87 – $130.91 | 3 |
| Ghs st - re-eval for alt comm CPT 92597 | $171.60 | $264.00 | $68.59 – $71.33 | 3 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $44.30 – $46.07 | 3 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $289.25 | $445.00 | $201.23 – $209.28 | 3 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $346.45 | $533.00 | $699.22 – $727.19 | 3 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $384.59 – $399.98 | 3 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.30 – $7.59 | 2 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $233.37 – $242.70 | 3 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $233.37 – $242.70 | 3 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $24.30 – $25.27 | 2 |
| Ghs urine, porphyrins quant CPT 84120 | $55.25 | $85.00 | $14.71 – $15.30 | 2 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $353.04 – $367.16 | 3 |
| Ghs windowing of cast CPT 29730 | not published | not published | $153.74 – $159.89 | 3 |
| Giardia lamblia antibody CPT 86674 | $76.05 | $117.00 | $14.72 – $15.31 | 2 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $225.74 – $234.77 | 3 |
| Gi inhouse confirmation CPT 87045 | $64.35 | $99.00 | $9.44 – $9.82 | 2 |
| Gi protein loss CPT 78282 | not published | not published | $378.21 – $393.34 | 3 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $1,630.20 | $2,508.00 | $858.08 – $892.40 | 3 |
| Gi trc img intral colon i&r CPT 91113 | $2,896.40 | $4,456.00 | $879.81 – $915.00 | 3 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $858.08 – $892.40 | 3 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $858.08 – $892.40 | 3 |
| Gjb2 gene full sequence CPT 81252 | $677.30 | $1,042.00 | $101.12 – $105.16 | 2 |
| Gjb2 gene known fam variants CPT 81253 | $820.30 | $1,262.00 | $61.52 – $63.98 | 2 |
| Gjb6 gene com variants CPT 81254 | $836.55 | $1,287.00 | $35.00 – $36.40 | 2 |
| Glassia injection HCPCS J0257 | not published | not published | $5.64 – $35.82 | 4 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $35.34 – $36.75 | 3 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $865.41 | $1,331.40 | $182.45 – $1,197.17 | 4 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $393.28 | $605.05 | $148.99 – $727.42 | 4 |
| Glucagon plasma - sendout CPT 82943 | $90.35 | $139.00 | $14.29 – $14.86 | 2 |
| Glucose 1 hr post dose CPT 82950 | $25.35 | $39.00 | $4.75 – $4.94 | 2 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $6.05 – $6.29 | 2 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | not published | not published | $3.28 – $3.41 | 2 |
| Glucose blood quantitative CPT 82947 | $22.10 | $34.00 | $3.93 – $4.09 | 2 |
| Glucose body fluid CPT 82945 | $50.70 | $78.00 | $3.93 – $4.09 | 2 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $55.81 – $58.04 | 3 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $76.70 | $118.00 | $12.87 – $13.38 | 2 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $28.60 | $44.00 | $3.92 – $4.08 | 2 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $33.44 | $51.45 | $0.98 – $3.77 | 2 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $6,354.72 | $9,776.50 | $11.04 – $68.51 | 4 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $84.50 | $130.00 | $18.58 – $19.32 | 2 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $87.75 | $135.00 | $18.52 – $19.26 | 2 |
| Gonioscopy CPT 92020 | not published | not published | $125.87 – $130.91 | 3 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $3,099.30 | $4,768.15 | $733.66 – $4,569.89 | 4 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $62.56 | $96.25 | $51.81 – $122.44 | 3 |
| Graft axiofill 1000mg HCPCS J3590 | $78.23 | $120.35 | not published | 0 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $117.73 – $122.44 | 3 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $533.09 | $820.14 | $117.73 – $122.44 | 3 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $6,401.23 | $9,848.05 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $111.19 – $122.44 | 3 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $599.64 | $922.53 | $117.73 – $122.44 | 3 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $658.88 | $1,013.66 | $117.73 – $122.44 | 3 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $349.41 | $537.55 | $82.37 – $122.44 | 3 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $658.88 | $1,013.66 | $117.73 – $122.44 | 3 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $1,378.44 | $2,120.67 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $19.50 – $19.50 | 1 |
| Granisetron hcl injection HCPCS J1626 | $28.50 | $43.85 | $0.39 – $1.50 | 2 |
| Granulocyte pheresis ea unit HCPCS P9050 | $9,782.50 | $15,050.00 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $233.37 – $242.70 | 3 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $1,952.02 – $2,030.10 | 3 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $12.04 – $12.52 | 3 |
| Growth hormone antibody CPT 86277 | not published | not published | $15.74 – $16.37 | 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.