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 |
|---|---|---|---|---|
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | $2,308.80 | $3,552.00 | not published | 0 |
| Hysterosalpingography s&i CPT 74740 | $412.10 | $634.00 | $225.74 – $234.77 | 3 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $4,732.70 – $4,922.01 | 3 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $4,732.70 – $4,922.01 | 3 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $4,732.70 – $4,922.01 | 3 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $4,732.70 – $4,922.01 | 3 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $4,732.70 – $4,922.01 | 3 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | not published | not published | $1,286.35 – $1,286.35 | 1 |
| I-123 iobenguane diag HCPCS A9582 | not published | not published | $2,317.50 – $33,204.67 | 4 |
| I-123 ioflupane diag HCPCS A9584 | not published | not published | $1,387.74 – $16,042.00 | 4 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | not published | not published | $622.96 – $622.96 | 1 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | not published | not published | $0.07 – $991.13 | 4 |
| Iaadi respiratory synctial virus CPT 87280 | $148.20 | $228.00 | $13.42 – $13.96 | 2 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | not published | not published | $35.09 – $36.49 | 2 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $18.09 – $18.81 | 2 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | not published | not published | $45.28 – $47.09 | 2 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $43.11 – $164.84 | 2 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $2,448.56 – $2,546.50 | 2 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $5.04 – $19.31 | 2 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $413.27 | $635.80 | $172.31 – $1,938.95 | 4 |
| Icatibant injection HCPCS J1744 | not published | not published | $605.74 – $605.74 | 1 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $204.28 – $212.45 | 3 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $35.34 – $36.75 | 3 |
| Icut allergy test drug/bug CPT 95024 | $149.50 | $230.00 | $55.81 – $58.04 | 3 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $79.56 – $304.20 | 2 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $1,562.54 – $1,625.04 | 3 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $0.07 – $579,610.65 | 4 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Idh1 common variants CPT 81120 | $650.65 | $1,001.00 | $193.25 – $200.98 | 2 |
| Idh2 common variants CPT 81121 | $650.65 | $1,001.00 | $295.79 – $307.62 | 2 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $2,625.99 – $2,731.03 | 3 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | not published | not published | $2,748.08 – $2,858.01 | 3 |
| Idursulfase injection HCPCS J1743 | not published | not published | $558.46 – $3,524.43 | 4 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $2,748.08 – $2,858.01 | 3 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $2,748.08 – $2,858.01 | 3 |
| Ifnl3 gene CPT 81283 | $590.20 | $908.00 | $73.37 – $76.30 | 2 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | not published | not published | $42.61 – $162.96 | 2 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $207.31 – $215.60 | 2 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $68.55 – $71.29 | 2 |
| Igh gene rearrange amp meth CPT 81261 | $612.95 | $943.00 | $197.99 – $205.91 | 2 |
| Igh@ var region somatic mutation analy CPT 81263 | $1,003.60 | $1,544.00 | $294.52 – $306.30 | 2 |
| Igk rearrangeabn clonal pop CPT 81264 | $613.60 | $944.00 | $172.73 – $179.64 | 2 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $302.25 | $465.00 | not published | 0 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $266.50 | $410.00 | $339.12 – $352.68 | 3 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $257.40 | $396.00 | $161.18 – $167.63 | 3 |
| Ikbkap gene CPT 81260 | $640.90 | $986.00 | $39.31 – $40.88 | 2 |
| Iliac/fem angio cath insert HCPCS G0278 | $2,728.70 | $4,198.00 | not published | 0 |
| Imatinib 100 mg tab HCPCS S0088 | not published | not published | $19.31 – $19.31 | 1 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | not published | not published | $57.03 – $341.71 | 4 |
| Img rta detcj/mntr ds staff CPT 92227 | not published | not published | $55.81 – $58.04 | 3 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | not published | not published | $35.34 – $36.75 | 3 |
| Img rta detc/mntr ds poc aly CPT 92229 | not published | not published | $55.81 – $58.04 | 3 |
| Immobilizer lwr extrem nylon 20in reinforc 21-35in HCPCS L2999 | $426.61 | $656.32 | not published | 0 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $130.03 | $200.04 | not published | 0 |
| Immune complex assay CPT 86332 | $644.80 | $992.00 | $24.37 – $25.34 | 2 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $3,890.32 | $5,985.10 | $45.31 – $301.99 | 4 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | not published | not published | $78.80 – $529.30 | 4 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $47.52 – $320.45 | 4 |
| Immune globulin ig human im use 90281 CPT 90281 | not published | not published | $618.02 – $618.02 | 1 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $106.60 | $164.00 | $20.81 – $21.64 | 2 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $87.75 | $135.00 | $20.81 – $21.64 | 2 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $25.57 – $26.59 | 2 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $164.45 | $253.00 | $11.98 – $12.46 | 2 |
| Immunodiffusion nes CPT 86329 | not published | not published | $14.05 – $14.61 | 2 |
| Immunofixation electrophoresis serum CPT 86334 | $124.80 | $192.00 | $22.34 – $23.23 | 2 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $221.00 | $340.00 | not published | 0 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $221.00 | $340.00 | $161.18 – $167.63 | 3 |
| Immunoglobulin assay CPT 86023 | $78.00 | $120.00 | $12.46 – $12.96 | 2 |
| Impedence cardiogram CPT 93701 | not published | not published | $125.87 – $130.91 | 3 |
| Imp extar knee shck absrb HCPCS C8003 | not published | not published | $16,588.34 – $17,251.88 | 3 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | $1,332.40 | $2,049.85 | not published | 0 |
| Implant neuroelectrodes CPT 63655 | not published | not published | $18,354.00 – $19,088.16 | 3 |
| Implant neuroelectrodes CPT 64553 | $17,747.60 | $27,304.00 | not published | 0 |
| Implant neuroelectrodes CPT 64555 | $9,730.50 | $14,970.00 | not published | 0 |
| Implant neurostim arrays CPT 61886 | $47,931.65 | $73,741.00 | not published | 0 |
| Implant spinal canal cath CPT 62351 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Implant spine infusion pump CPT 62362 | $26,902.20 | $41,388.00 | not published | 0 |
| Impl ear abutment ba300 9mm HCPCS L8693 | not published | not published | $1,867.13 – $1,941.82 | 3 |
| Impl neurostim electr perc CPT 63650 | $7,910.50 | $12,170.00 | not published | 0 |
| Implnt spinl canal catheter 62350 CPT 62350 | $9,003.80 | $13,852.00 | not published | 0 |
| Impl oi implt sk tc esp<100 CPT 69716 | not published | not published | $12,146.38 – $12,632.24 | 3 |
| Impl oi implt sk tc esp>=100 CPT 69729 | not published | not published | $12,146.38 – $12,632.24 | 3 |
| Impl oi implt skull perq esp CPT 69714 | not published | not published | $12,146.38 – $12,632.24 | 3 |
| Imported lipodox inj HCPCS Q2049 | not published | not published | $0.07 – $310.69 | 4 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $43.19 – $281.97 | 4 |
| In-111 autologous plt stdy dx HCPCS A9571 | not published | not published | $27,364.74 – $27,364.74 | 1 |
| In-111 autol wbc diag per dose HCPCS A9570 | not published | not published | $1,103.19 – $27,364.74 | 4 |
| In-111 capromab pendet HCPCS A9507 | not published | not published | $0.07 – $1,799.50 | 4 |
| In-111 ibritumomab tiux dx HCPCS A9542 | not published | not published | $0.07 – $0.07 | 1 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | not published | not published | $831.46 – $13,682.37 | 4 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | not published | not published | $745.62 – $5,755.75 | 4 |
| Inc dp bone crtx f/arm&/wrst CPT 25035 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Incis 1 vertebral seg lumbar CPT 22214 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Incise diaphragm nerve CPT 64746 | not published | not published | $1,847.43 – $1,921.33 | 3 |
| Incise flexor carpi radialis CPT 25001 | 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.