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 |
|---|---|---|---|---|
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $164.45 | $253.00 | $38.50 – $40.04 | 2 |
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $68.90 | $106.00 | $14.18 – $14.75 | 2 |
| Warde zinc CPT 84630 | $49.40 | $76.00 | $11.39 – $11.85 | 2 |
| Wash harvest stem cells CPT 38209 | not published | not published | $417.38 – $434.08 | 3 |
| Wbc automated CPT 85048 | $27.30 | $42.00 | $2.54 – $2.64 | 2 |
| Wedging of cast CPT 29740 | not published | not published | $264.61 – $275.19 | 3 |
| Wedging of clubfoot cast CPT 29750 | not published | not published | $264.61 – $275.19 | 3 |
| Western blot test CPT 84181 | $162.50 | $250.00 | $17.03 – $17.71 | 2 |
| Wet mounts/ w preparations HCPCS Q0111 | not published | not published | $18.54 – $19.28 | 2 |
| Whfo w/joint(s) custom fab HCPCS L3806 | $891.15 | $1,371.00 | not published | 0 |
| Whole blood for transfusion HCPCS P9010 | $297.70 | $458.00 | not published | 0 |
| Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit HCPCS P9054 | $1,409.85 | $2,169.00 | not published | 0 |
| Whole mitochondrial genome CPT 81460 | $3,528.85 | $5,429.00 | $1,287.00 – $1,338.48 | 2 |
| Whole mitochondrial genome CPT 81465 | $1,524.90 | $2,346.00 | $936.00 – $973.44 | 2 |
| Who nontorsion jnts pre cst HCPCS L3915 | $711.46 | $1,094.55 | not published | 0 |
| Wilate injection HCPCS J7183 | not published | not published | $1.29 – $8.32 | 4 |
| Woundfix biowound plus xplus HCPCS Q4217 | not published | not published | $117.73 – $122.44 | 3 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $280.80 | $432.00 | $384.59 – $399.98 | 3 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $284.05 | $437.00 | $384.59 – $399.98 | 3 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $247.00 | $380.00 | $189.82 – $197.41 | 3 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $284.05 | $437.00 | $384.59 – $399.98 | 3 |
| Wrist arthroscopy CPT 29840 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Wrist arthroscopy/surgery CPT 29843 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Wrist arthroscopy/surgery CPT 29844 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Wrist arthroscopy/surgery CPT 29845 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Wrist arthroscopy/surgery CPT 29846 | not published | not published | $3,095.56 – $3,219.39 | 3 |
| Wrist arthroscopy/surgery CPT 29847 | not published | not published | $6,864.94 – $7,139.54 | 3 |
| Wrist endoscopy/surgery CPT 29848 | not published | not published | $1,521.28 – $1,582.14 | 3 |
| Wrist X-ray CPT 73110 | $544.70 | $838.00 | $82.33 – $85.63 | 3 |
| Xe133 xenon 10mci HCPCS A9558 | not published | not published | $1,658.15 – $1,658.15 | 1 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $1,952.02 – $2,030.10 | 3 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | not published | not published | $1,952.02 – $2,030.10 | 3 |
| X-linked intellectual dblt CPT 81470 | not published | not published | $914.00 – $950.56 | 2 |
| X-linked intellectual dblt CPT 81471 | not published | not published | $914.00 – $950.56 | 2 |
| X-ray abdomen 1 view CPT 74018 | $254.80 | $392.00 | $82.33 – $85.63 | 3 |
| X-ray abdomen 2 views CPT 74019 | $326.30 | $502.00 | $98.91 – $102.86 | 3 |
| X-ray abdomen >=3 views CPT 74021 | $358.80 | $552.00 | $98.91 – $102.86 | 3 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $486.85 | $749.00 | $98.91 – $102.86 | 3 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $301.60 | $464.00 | $82.33 – $85.63 | 3 |
| X-ray ankle 2 views (both sides) CPT 73600 | $403.00 | $620.00 | $82.33 – $85.63 | 3 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $2,726.10 | $4,194.00 | $330.06 – $343.26 | 3 |
| X-ray assay calculus CPT 82370 | not published | not published | $12.52 – $13.02 | 2 |
| X-ray bone age studies CPT 77072 | $269.75 | $415.00 | $98.91 – $102.86 | 3 |
| X-ray bone length studies CPT 77073 | $305.50 | $470.00 | $98.91 – $102.86 | 3 |
| X-ray bone survey complete CPT 77075 | $545.35 | $839.00 | $98.91 – $102.86 | 3 |
| X-ray bone survey infant CPT 77076 | $315.90 | $486.00 | $98.91 – $102.86 | 3 |
| X-ray cervical spine 2-3 views CPT 72040 | $324.35 | $499.00 | $82.33 – $85.63 | 3 |
| X-ray cervical spine 4-5 views CPT 72050 | $432.25 | $665.00 | $98.91 – $102.86 | 3 |
| X-ray cervical spine >= 6 views CPT 72052 | $487.50 | $750.00 | $98.91 – $102.86 | 3 |
| X-ray clavicle complete (both sides) CPT 73000 | $581.10 | $894.00 | $82.33 – $85.63 | 3 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $618.80 | $952.00 | $165.94 – $172.58 | 3 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $928.20 | $1,428.00 | $165.94 – $172.58 | 3 |
| X-ray elbow 2 views (both sides) CPT 73070 | $537.55 | $827.00 | $82.33 – $85.63 | 3 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $575.25 | $885.00 | $82.33 – $85.63 | 3 |
| Xray endovasc thor ao repr CPT 75956 | $1,014.65 | $1,561.00 | not published | 0 |
| Xray endovasc thor ao repr CPT 75957 | $869.70 | $1,338.00 | not published | 0 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $546.00 | $840.00 | $165.94 – $172.58 | 3 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $388.05 | $597.00 | $98.91 – $102.86 | 3 |
| X-ray exam entire spi 6/> vw CPT 72084 | $427.05 | $657.00 | $98.91 – $102.86 | 3 |
| X-ray exam of arm infant CPT 73092 | $771.55 | $1,187.00 | $98.91 – $102.86 | 3 |
| X-ray exam of eye sockets CPT 70200 | $364.00 | $560.00 | $98.91 – $102.86 | 3 |
| X-ray exam of femur 1 CPT 73551 | $284.05 | $437.00 | $82.33 – $85.63 | 3 |
| X-ray exam of jaw joint CPT 70328 | $157.95 | $243.00 | $82.33 – $85.63 | 3 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $225.74 – $234.77 | 3 |
| X-ray exam of mastoids CPT 70120 | not published | not published | $98.91 – $102.86 | 3 |
| X-ray exam of middle ear CPT 70134 | $213.85 | $329.00 | $516.95 – $537.63 | 3 |
| X-ray exam of penis CPT 74445 | $1,034.80 | $1,592.00 | $98.91 – $102.86 | 3 |
| X-ray exam of perineum CPT 74775 | $577.85 | $889.00 | $225.74 – $234.77 | 3 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $82.33 – $85.63 | 3 |
| X-ray exam of sinuses CPT 70210 | $243.75 | $375.00 | $82.33 – $85.63 | 3 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $225.74 – $234.77 | 3 |
| X-ray exam of teeth CPT 70300 | not published | not published | $82.33 – $85.63 | 3 |
| X-ray exam of teeth CPT 70310 | not published | not published | $225.74 – $234.77 | 3 |
| X-ray exam si joints CPT 72200 | $186.55 | $287.00 | $98.91 – $102.86 | 3 |
| X-ray exam thorac spine4/>vw CPT 72074 | $500.50 | $770.00 | $98.91 – $102.86 | 3 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $360.10 | $554.00 | $82.33 – $85.63 | 3 |
| X-ray facial bones complete > 3 views CPT 70150 | $417.95 | $643.00 | $98.91 – $102.86 | 3 |
| X-ray fallopian tube CPT 74742 | $2,332.20 | $3,588.00 | not published | 0 |
| X-ray femur >=2 views (both sides) CPT 73552 | $670.80 | $1,032.00 | $82.33 – $85.63 | 3 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $466.05 | $717.00 | $82.33 – $85.63 | 3 |
| X-ray foot 2 views (both sides) CPT 73620 | $453.70 | $698.00 | $82.33 – $85.63 | 3 |
| X-ray forearm 2 views (both sides) CPT 73090 | $554.45 | $853.00 | $82.33 – $85.63 | 3 |
| X-ray hand 2 views (both sides) CPT 73120 | $550.55 | $847.00 | $98.91 – $102.86 | 3 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $82.33 – $85.63 | 3 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $542.10 | $834.00 | $82.33 – $85.63 | 3 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $391.30 | $602.00 | $98.91 – $102.86 | 3 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $230.10 | $354.00 | $98.91 – $102.86 | 3 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $337.35 | $519.00 | $98.91 – $102.86 | 3 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $447.20 | $688.00 | $98.91 – $102.86 | 3 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $221.65 | $341.00 | $82.33 – $85.63 | 3 |
| X-ray humerus >= 2 views left CPT 73060 | $305.50 | $470.00 | $82.33 – $85.63 | 3 |
| X-ray joint survey 1 view CPT 77077 | $230.75 | $355.00 | $98.91 – $102.86 | 3 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $586.95 | $903.00 | $82.33 – $85.63 | 3 |
| X-ray knee 3 views (both sides) CPT 73562 | $777.40 | $1,196.00 | $82.33 – $85.63 | 3 |
| X-ray knee ap standing bilateral CPT 73565 | $224.25 | $345.00 | $82.33 – $85.63 | 3 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $325.00 | $500.00 | $82.33 – $85.63 | 3 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $373.75 | $575.00 | $98.91 – $102.86 | 3 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $456.30 | $702.00 | $98.91 – $102.86 | 3 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $570.05 | $877.00 | $98.91 – $102.86 | 3 |
| X-ray male genital tract CPT 74440 | not published | not published | $225.74 – $234.77 | 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.