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 |
|---|---|---|---|---|
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | not published | not published | $1,730.32 – $10,834.07 | 4 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $399.98 – $1,529.32 | 4 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $78.92 – $363.42 | 4 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.14 – $0.59 | 2 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $59.74 | $91.90 | $0.09 – $0.33 | 2 |
| Levetiracetam therapeutic drug level CPT 80177 | $102.70 | $158.00 | $13.25 – $13.78 | 2 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $53.72 | $82.65 | $3.21 – $12.29 | 2 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $193.05 | $297.00 | $9.16 – $35.04 | 2 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $49.11 | $75.55 | $0.01 – $0.01 | 1 |
| Lidocaine therapeutic drug level CPT 80176 | $75.40 | $116.00 | $14.69 – $15.28 | 2 |
| Ligate leg veins open CPT 37761 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $3,224.00 | $4,960.00 | $1,562.54 – $1,625.04 | 3 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligation major artery neck CPT 37615 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligation of femoral vein CPT 37650 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligation of neck artery CPT 37606 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $2,987.22 – $3,106.71 | 3 |
| Liletta, 52 mg HCPCS J7297 | not published | not published | $5,767.84 – $5,767.84 | 1 |
| Limb exercise test CPT 95875 | not published | not published | $121.73 – $126.60 | 3 |
| Limited visual field xm CPT 92081 | not published | not published | $55.81 – $58.04 | 3 |
| Lincomycin injection HCPCS J2010 | not published | not published | $11.44 – $43.75 | 2 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $55.35 | $85.15 | $5.06 – $19.37 | 2 |
| Lipase CPT 83690 | $61.10 | $94.00 | $6.89 – $7.17 | 2 |
| Lipoprotein blood high res frac & quant CPT 83701 | $79.95 | $123.00 | $33.86 – $35.21 | 2 |
| Lipoprotein blood quant CPT 83704 | $67.60 | $104.00 | $34.19 – $35.56 | 2 |
| Lipoprotein direct measurement hdl CPT 83718 | $55.90 | $86.00 | $8.19 – $8.52 | 2 |
| Lipoprotein direct measurement ldl CPT 83721 | $47.45 | $73.00 | $10.50 – $10.92 | 2 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $34.19 – $35.56 | 2 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $0.07 – $585,039.71 | 4 |
| Listeria monocytogenes CPT 86723 | $107.90 | $166.00 | $13.19 – $13.72 | 2 |
| Lithium therapeutic drug level CPT 80178 | $48.10 | $74.00 | $6.61 – $6.87 | 2 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $260.65 | $401.00 | $176.19 – $183.24 | 2 |
| Liver elastography 91200 CPT 91200 | $328.90 | $506.00 | $121.73 – $126.60 | 3 |
| Liver Function Test CPT 80076 | $35.75 | $55.00 | $8.17 – $8.50 | 2 |
| Liver imaging CPT 78201 | $986.70 | $1,518.00 | $513.69 – $534.24 | 3 |
| Liver imag w/vasclr flow CPT 78202 | $1,134.90 | $1,746.00 | $513.69 – $534.24 | 3 |
| Liver/spleen imag static only CPT 78215 | $655.20 | $1,008.00 | $378.21 – $393.34 | 3 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $378.21 – $393.34 | 3 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $6.08 | $9.36 | $2.05 – $7.80 | 2 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $216.90 – $1,378.78 | 4 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $22.30 | $34.30 | $2.30 – $8.78 | 2 |
| Loudness balance test CPT 92562 | not published | not published | $204.28 – $212.45 | 3 |
| Low back disk surgery CPT 63030 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Low cost skin substitute app HCPCS C5271 | $491.40 | $756.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5273 | $640.25 | $985.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5275 | $706.55 | $1,087.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,297.75 | $3,535.00 | $165.94 – $172.58 | 3 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,896.70 | $2,918.00 | $330.06 – $343.26 | 3 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,666.60 | $2,564.00 | $98.91 – $102.86 | 3 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,138.85 | $4,829.00 | $330.06 – $343.26 | 3 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,970.50 | $4,570.00 | $330.06 – $343.26 | 3 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,802.80 | $4,312.00 | $225.74 – $234.77 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $317.85 | $489.00 | $98.91 – $102.86 | 3 |
| Low frequency non-thermal Ultrasound CPT 97610 | $547.95 | $843.00 | $189.82 – $197.41 | 3 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $10,056.64 – $10,458.91 | 3 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $10,056.64 – $10,458.91 | 3 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $10,056.64 – $10,458.91 | 3 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $10,056.64 – $10,458.91 | 3 |
| L/s ratio fetal lung CPT 83661 | $261.95 | $403.00 | $21.99 – $22.87 | 2 |
| Lumbar diskogram s&i CPT 72295 | $3,316.30 | $5,102.00 | $1,847.43 – $1,921.33 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $16,588.34 – $17,251.88 | 3 |
| Lumizyme injection HCPCS J0221 | not published | not published | $206.59 – $1,310.66 | 4 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $55.81 – $58.04 | 3 |
| Lung Function Test (Spirometry) CPT 94010 | $226.20 | $348.00 | $204.28 – $212.45 | 3 |
| Lung perfusion imaging CPT 78580 | $624.00 | $960.00 | $378.21 – $393.34 | 3 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $207.13 – $1,331.85 | 4 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $40,040.94 | $61,601.45 | $41.98 – $268.32 | 4 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $316.99 – $1,907.43 | 4 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $255.84 – $1,545.90 | 4 |
| Lvad shower bag heartmate HCPCS Q0501 | $584.34 | $898.98 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $937.30 | $1,442.00 | $513.69 – $534.24 | 3 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $38.02 | 2 |
| Lymphocyte transformation mitogen CPT 86353 | $433.55 | $667.00 | $49.03 – $50.99 | 2 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $189.51 – $197.09 | 2 |
| Lymph vessel x-ray arm/leg CPT 75801 | $753.35 | $1,159.00 | $593.48 – $617.22 | 3 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,814.15 | $2,791.00 | $1,489.27 – $1,548.84 | 3 |
| Lymph vessel x-ray trunk CPT 75805 | $2,107.95 | $3,243.00 | $2,987.22 – $3,106.71 | 3 |
| Lymph vessel x-ray trunk CPT 75807 | $3,080.35 | $4,739.00 | $2,987.22 – $3,106.71 | 3 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $1,977.66 – $2,056.77 | 3 |
| Macroscopic exam arthropod CPT 87168 | $77.35 | $119.00 | $4.27 – $4.44 | 2 |
| Macroscopic exam parasite CPT 87169 | $65.00 | $100.00 | $4.31 – $4.48 | 2 |
| Magnesium CPT 83735 | $31.20 | $48.00 | $6.70 – $6.97 | 2 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $51.80 | $79.70 | $0.83 – $3.19 | 2 |
| Magnetic image bone marrow CPT 77084 | $1,421.55 | $2,187.00 | $225.74 – $234.77 | 3 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $127.73 – $127.73 | 1 |
| Malaria antibody CPT 86750 | $16.25 | $25.00 | $13.19 – $13.72 | 2 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,521.28 – $1,582.14 | 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.