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 |
|---|---|---|---|---|
| Talymed HCPCS Q4127 | not published | not published | $116.43 – $122.44 | 3 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | not published | not published | $1.24 – $1.24 | 1 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,885.35 | $4,439.00 | $759.53 – $789.91 | 2 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $6,844.50 | $10,530.00 | $2,919.60 – $3,036.38 | 2 |
| Target gsa panel organ neop CPT 81445 | $3,953.95 | $6,083.00 | $597.91 – $621.83 | 2 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,564.64 – $9,750.00 | 4 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $699.22 – $727.19 | 3 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.28 – $2.60 | 4 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $142.48 | 2 |
| Tbs techl calculation only CPT 77091 | not published | not published | $82.33 – $85.63 | 3 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $82.33 – $85.63 | 3 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $98.15 | $151.00 | $100.00 – $104.00 | 2 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $241.15 | $371.00 | $61.98 – $64.46 | 2 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $0.07 – $0.07 | 1 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $775.52 – $23,831.15 | 4 |
| Tc-99m disofenin HCPCS A9510 | not published | not published | $0.07 – $0.07 | 1 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $934.13 – $11,140.81 | 4 |
| Tc-99m exametazime diag HCPCS A9521 | not published | not published | $927.71 – $11,140.81 | 4 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $328.60 – $2,015.00 | 4 |
| Tc-99m labeled rbc HCPCS A9560 | not published | not published | $650.00 – $650.00 | 1 |
| Tc-99m maa HCPCS A9540 | not published | not published | $195.00 – $195.00 | 1 |
| Tc-99m mebrofenin HCPCS A9537 | not published | not published | $367.25 – $367.25 | 1 |
| Tc-99m medronate HCPCS A9503 | not published | not published | $84.50 – $84.50 | 1 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $0.65 | $1.00 | not published | 0 |
| Tc-99m pentetate dtpa HCPCS A9539 | not published | not published | $0.07 – $0.07 | 1 |
| Tc-99m pertechnetate per mci HCPCS A9512 | not published | not published | $10.99 – $10.99 | 1 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | not published | not published | $416.33 – $416.33 | 1 |
| Tc-99m sulfur colloid HCPCS A9541 | not published | not published | $1,737.91 – $1,737.91 | 1 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | not published | not published | $554.26 – $554.26 | 1 |
| Tc-99m tilmanocept diag HCPCS A9520 | not published | not published | $4,300.21 – $4,300.21 | 1 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $699.22 – $727.19 | 3 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $98.91 – $102.86 | 3 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $98.91 – $102.86 | 3 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $417.38 – $434.08 | 3 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $205.40 | $316.00 | $46.98 – $48.86 | 2 |
| T cells absolute cd 4 count CPT 86361 | $329.55 | $507.00 | $26.78 – $27.85 | 2 |
| T cells total count CPT 86359 | $464.10 | $714.00 | $37.73 – $39.24 | 2 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $204.28 – $212.45 | 3 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $204.28 – $212.45 | 3 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $204.28 – $212.45 | 3 |
| Team conf w/pat by hc prof CPT 99366 | $94.25 | $145.00 | not published | 0 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $217.09 – $1,395.94 | 4 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $741.65 – $771.32 | 3 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $741.65 – $771.32 | 3 |
| Telavancin injection HCPCS J3095 | not published | not published | $7.11 – $48.10 | 4 |
| Telehealth original site facility fee HCPCS Q3014 | $114.40 | $176.00 | not published | 0 |
| Telethx isodose plan cplx CPT 77307 | $626.60 | $964.00 | $354.24 – $368.41 | 3 |
| Telethx isodose plan simple CPT 77306 | $349.70 | $538.00 | $354.24 – $368.41 | 3 |
| Temozolomide HCPCS J8700 | not published | not published | $0.45 – $1.76 | 2 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $10.39 – $67.67 | 4 |
| Temperature gradient studies CPT 93740 | not published | not published | $121.73 – $126.60 | 3 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $26.71 – $191.88 | 4 |
| Tendon lengthening CPT 26476 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Tendon shortening CPT 26477 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Tendon transfer with graft CPT 26492 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $20,874.78 | $32,115.05 | $172.22 – $1,055.80 | 4 |
| Teniposide, 50 mg HCPCS Q2017 | not published | not published | $16,223.68 – $16,223.68 | 1 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Tenolysis triceps CPT 24332 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $66.70 | $102.61 | $3.64 – $13.91 | 2 |
| Teriparatide injection HCPCS J3110 | not published | not published | $327.15 – $327.15 | 1 |
| Tert gene targeted seq alys CPT 81345 | $1,459.90 | $2,246.00 | $185.20 – $192.61 | 2 |
| Test for chlorohydrocarbons CPT 82441 | $98.15 | $151.00 | $6.01 – $6.25 | 2 |
| Test for porphobilinogen CPT 84106 | $54.60 | $84.00 | $5.82 – $6.05 | 2 |
| Test for urine cystines CPT 82615 | not published | not published | $9.55 – $9.93 | 2 |
| Testicular imaging w/vasc flow CPT 78761 | $588.25 | $905.00 | $378.21 – $393.34 | 3 |
| Testosterone pellet 75 mg HCPCS S0189 | not published | not published | $683.35 – $683.35 | 1 |
| Testosterone response panel CPT 80414 | not published | not published | $51.64 – $53.71 | 2 |
| Testosterone undecanoate 1mg HCPCS J3145 | not published | not published | $2.07 – $12.48 | 4 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $113.75 | $175.00 | $55.81 – $58.04 | 3 |
| Test stress cardiovascular tracing only CPT 93017 | $878.15 | $1,351.00 | $204.28 – $212.45 | 3 |
| Test urine for lactose CPT 83633 | not published | not published | $11.25 – $11.70 | 2 |
| Test urine for porphyrins CPT 84119 | not published | not published | $13.36 – $13.89 | 2 |
| Test urine urobilinogen CPT 84578 | not published | not published | $4.47 – $4.65 | 2 |
| Tetanus ig im CPT 90389 | not published | not published | $4,219.61 – $4,219.61 | 1 |
| Tetanus immune globulin inj HCPCS J1670 | $1,804.06 | $2,775.47 | $593.00 – $3,718.46 | 4 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $14,189.56 | $21,830.10 | $18.01 – $118.04 | 4 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $137.00 – $142.48 | 2 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $759.53 – $789.91 | 2 |
| Tgsap so/hl 51/< rna alys CPT 81456 | $6,119.75 | $9,415.00 | $2,919.60 – $3,036.38 | 2 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $597.91 – $621.83 | 2 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $161.18 – $167.63 | 3 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $161.18 – $167.63 | 3 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $161.18 – $167.63 | 3 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $417.38 – $434.08 | 3 |
| Theophylline therapeutic drug level CPT 80198 | $96.85 | $149.00 | $14.14 – $14.71 | 2 |
| Therapeutic procd strg endur HCPCS G0237 | $53.95 | $83.00 | not published | 0 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $29.90 | $46.00 | $25.66 – $26.69 | 3 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $29.90 | $46.00 | $21.47 – $22.33 | 3 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | not published | not published | $189.82 – $197.41 | 3 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $741.65 | $1,141.00 | $165.94 – $172.58 | 3 |
| Ther/proph/diag inj ia CPT 96373 | $156.00 | $240.00 | $201.23 – $209.28 | 3 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $29.80 | $45.84 | $3.00 – $11.44 | 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.