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 |
|---|---|---|---|---|
| Osteochondral knee allograft CPT 27415 | not published | not published | $12,146.38 – $12,632.24 | 3 |
| Osteochondral knee autograft CPT 27416 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Osteochondral talus autogrft CPT 28446 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | $476.45 | $733.00 | not published | 0 |
| Osteoplasty humerus CPT 24420 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Osteot dsc ant 1 vrt sgm crv CPT 22220 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Osteot dsc ant 1vrt sgm lmbr CPT 22224 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Osteot dsc ant 1vrt sgm thrc CPT 22222 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Osteot mlt relignmt imed rod CPT 27712 | not published | not published | $12,146.38 – $12,632.24 | 3 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Ot evaluation high complexity patient/family CPT 97167 | $249.60 | $384.00 | $96.30 – $100.15 | 3 |
| Ot evaluation low complexity patient/family CPT 97165 | $187.20 | $288.00 | $96.30 – $100.15 | 3 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $218.40 | $336.00 | $96.30 – $100.15 | 3 |
| Other bone graft microvasc CPT 20962 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Other immunoelectrophoresis CPT 86325 | not published | not published | $23.13 – $24.06 | 2 |
| Oth resp proc, group HCPCS G0239 | $72.80 | $112.00 | $35.34 – $36.75 | 3 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $116.35 | $179.00 | $47.17 – $49.06 | 3 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $141.70 | $218.00 | $43.57 – $45.31 | 3 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $85.15 | $131.00 | $26.59 – $27.65 | 3 |
| Ot re-evaluation patient/family CPT 97168 | $96.85 | $149.00 | $65.34 – $67.95 | 3 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $87.10 | $134.00 | $33.33 – $34.66 | 3 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $52.00 | $80.00 | $18.17 – $18.90 | 3 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $131.30 | $202.00 | $19.48 – $20.26 | 3 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $97.50 | $150.00 | $27.87 – $28.98 | 3 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $96.85 | $149.00 | $31.37 – $32.62 | 3 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $90.35 | $139.00 | $30.92 – $32.16 | 3 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $4,732.70 – $4,922.01 | 3 |
| Ovine, 1000 usp units HCPCS J3472 | not published | not published | $0.07 – $0.07 | 1 |
| Ovulation tests CPT 84830 | not published | not published | $12.70 – $13.21 | 2 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | not published | not published | $1.81 – $6.96 | 2 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $302.44 | $465.29 | $0.13 – $0.52 | 2 |
| Oxymorphone hcl injection HCPCS J2410 | not published | not published | $0.07 – $0.07 | 1 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $93.40 | $143.70 | $9.10 – $9.10 | 1 |
| P-32 sod phosphate ther per mci HCPCS A9563 | not published | not published | $278.24 – $1,981.72 | 4 |
| Pabpn1 gene detc abnor allel CPT 81312 | not published | not published | $137.00 – $142.48 | 2 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $231.46 | $356.10 | $0.19 – $0.72 | 2 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $4,216.78 | $6,487.35 | $10.54 – $88.01 | 4 |
| Palb2 gene full gene seq CPT 81307 | not published | not published | $676.50 – $703.56 | 2 |
| Palb2 gene known famil vrnt CPT 81308 | $1,136.20 | $1,748.00 | $301.35 – $313.40 | 2 |
| Palifermin injection HCPCS J2425 | not published | not published | $35.55 – $220.94 | 4 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | not published | not published | $15.11 – $95.75 | 4 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | not published | not published | $436.75 – $11,834.29 | 4 |
| Palonosetron hcl HCPCS J2469 | $27.14 | $41.75 | $1.00 – $3.84 | 2 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $134.22 | $206.50 | $21.39 – $81.77 | 2 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $19,146.17 | $29,455.65 | $173.03 – $1,077.12 | 4 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $24.83 | $38.20 | $29.58 – $29.58 | 1 |
| Papaverin hcl injection HCPCS J2440 | $71.50 | $110.00 | $243.75 – $243.75 | 1 |
| Parathormone (pth) intact CPT 83970 | $144.30 | $222.00 | $41.28 – $42.93 | 2 |
| Parathyrd planar w/spect&ct CPT 78072 | $975.65 | $1,501.00 | $513.69 – $534.24 | 3 |
| Parathyroid planar imaging CPT 78070 | $430.30 | $662.00 | $378.21 – $393.34 | 3 |
| Parathyroid planar img w/tomo spect CPT 78071 | $848.25 | $1,305.00 | $378.21 – $393.34 | 3 |
| Paravaginal defect repair 57284 CPT 57284 | not published | not published | $4,732.70 – $4,922.01 | 3 |
| Parial mast w/lymph removal 19302 CPT 19302 | not published | not published | $6,282.11 – $6,533.39 | 3 |
| Paricalcitol HCPCS J2501 | not published | not published | $1.53 – $5.85 | 2 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $118.30 | $182.00 | $189.82 – $197.41 | 3 |
| Part exc/post vert comp/sng/thorac 22101 CPT 22101 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Partial exc bone humerus CPT 24140 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial hip replacement CPT 27125 | not published | not published | $12,146.38 – $12,632.24 | 3 |
| Partial removal finger bone CPT 26235 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Partial removal finger bone CPT 26236 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Partial removal foot fascia CPT 28060 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal leg bone(s) CPT 27360 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of fibula CPT 27641 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of foot bone CPT 28288 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of hand bone CPT 26230 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of penis CPT 54120 | not published | not published | $3,334.90 – $3,468.30 | 3 |
| Partial removal of radius CPT 25151 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of radius CPT 25230 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of rib CPT 21600 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Partial removal of sternum CPT 21620 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of thyroid CPT 60220 | not published | not published | $5,719.53 – $5,948.32 | 3 |
| Partial removal of thyroid CPT 60225 | not published | not published | $5,719.53 – $5,948.32 | 3 |
| Partial removal of tibia CPT 27640 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of toe CPT 28160 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of ulna CPT 25119 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of ulna CPT 25150 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of ulna CPT 25240 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Partial removal of vaginal wall 57106 CPT 57106 | not published | not published | $3,062.57 – $3,185.07 | 3 |
| Partial thyroid excision CPT 60210 | not published | not published | $5,719.53 – $5,948.32 | 3 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | not published | not published | $5,719.53 – $5,948.32 | 3 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | not published | not published | $4.32 – $4.32 | 1 |
| Part removal hip bone deep CPT 27071 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Part removal of metatarsal CPT 28110 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Part removal of metatarsal CPT 28113 | $2,601.95 | $4,003.00 | $3,095.56 – $3,219.39 | 3 |
| Part removal of metatarsal 28112 CPT 28112 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Part remove hip bone super CPT 27070 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Passy muir valve metal trach HCPCS L8501 | $149.75 | $230.38 | not published | 0 |
| Path clin consltj high 41-60 CPT 80505 | not published | not published | $161.18 – $167.63 | 3 |
| Path clin consltj mod 21-40 CPT 80504 | not published | not published | $161.18 – $167.63 | 3 |
| Patient recorded spirometry CPT 94015 | not published | not published | $204.28 – $212.45 | 3 |
| Pca3/klk3 antigen CPT 81313 | not published | not published | $255.05 – $265.25 | 2 |
| Pcv21 vaccine im CPT 90684 | not published | not published | $557.42 – $2,131.29 | 2 |
| Pdgfra gene CPT 81314 | $1,121.90 | $1,726.00 | $329.51 – $342.69 | 2 |
| Pdt dstr prmlg les phys/qhp CPT 96573 | not published | not published | $189.82 – $197.41 | 3 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | not published | not published | $1,952.02 – $2,030.10 | 3 |
| Ped home apnea mntr att only CPT 94775 | not published | not published | $121.73 – $126.60 | 3 |
| Ped home apnea mntr dl&alys CPT 94776 | not published | not published | $121.73 – $126.60 | 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.