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 |
|---|---|---|---|---|
| X-ray mandible complete > 4 views CPT 70110 | $450.45 | $693.00 | $98.91 – $102.86 | 3 |
| X-ray mandible ltd <4 views CPT 70100 | $176.15 | $271.00 | $82.33 – $85.63 | 3 |
| X-ray nasal bones complete > 3 views CPT 70160 | $309.40 | $476.00 | $82.33 – $85.63 | 3 |
| X-ray neck soft tissue CPT 70360 | $323.70 | $498.00 | $82.33 – $85.63 | 3 |
| X-ray nose to rectum for foreign body child CPT 76010 | $326.95 | $503.00 | $82.33 – $85.63 | 3 |
| X-ray of mammary ducts CPT 77054 | $712.40 | $1,096.00 | $225.74 – $234.77 | 3 |
| X-ray optic foramina CPT 70190 | $527.80 | $812.00 | $82.33 – $85.63 | 3 |
| X-ray pelvis 1-2 views CPT 72170 | $236.60 | $364.00 | $98.91 – $102.86 | 3 |
| X-ray pelvis complete > 3 views CPT 72190 | $323.05 | $497.00 | $98.91 – $102.86 | 3 |
| Xray place dist ext thor ao CPT 75959 | $1,014.65 | $1,561.00 | not published | 0 |
| Xray place prox ext thor ao CPT 75958 | $1,164.15 | $1,791.00 | not published | 0 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $716.95 | $1,103.00 | $330.06 – $343.26 | 3 |
| X-ray ribs 2 views left CPT 71100 | $253.50 | $390.00 | $82.33 – $85.63 | 3 |
| X-ray ribs 3 views bilateral CPT 71110 | $337.35 | $519.00 | $98.91 – $102.86 | 3 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $292.50 | $450.00 | $98.91 – $102.86 | 3 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $375.05 | $577.00 | $98.91 – $102.86 | 3 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $313.95 | $483.00 | $98.91 – $102.86 | 3 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $332.80 | $512.00 | $82.33 – $85.63 | 3 |
| X-ray scapula complete (both sides) CPT 73010 | $581.10 | $894.00 | $98.91 – $102.86 | 3 |
| X-ray sella turcica CPT 70240 | $190.45 | $293.00 | $82.33 – $85.63 | 3 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $411.45 | $633.00 | $82.33 – $85.63 | 3 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $409.50 | $630.00 | $82.33 – $85.63 | 3 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $525.85 | $809.00 | $516.95 – $537.63 | 3 |
| X-ray skull < 4 views CPT 70250 | $261.95 | $403.00 | $98.91 – $102.86 | 3 |
| X-ray skull > 4 views complete CPT 70260 | $399.10 | $614.00 | $98.91 – $102.86 | 3 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $513.50 | $790.00 | $98.91 – $102.86 | 3 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $747.50 | $1,150.00 | $165.94 – $172.58 | 3 |
| X-ray small intestine follow-through study CPT 74248 | $616.85 | $949.00 | not published | 0 |
| X-ray spine single view CPT 72020 | $273.00 | $420.00 | $82.33 – $85.63 | 3 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $232.05 | $357.00 | $82.33 – $85.63 | 3 |
| X-ray sternum > 2 views CPT 71120 | $351.65 | $541.00 | $82.33 – $85.63 | 3 |
| X-ray surgical specimen CPT 76098 | $668.20 | $1,028.00 | $516.95 – $537.63 | 3 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $652.60 | $1,004.00 | $165.94 – $172.58 | 3 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $354.90 | $546.00 | $82.33 – $85.63 | 3 |
| X-ray thoracic spine 2 views CPT 72070 | $302.25 | $465.00 | $98.91 – $102.86 | 3 |
| X-ray thoracic spine 3 views CPT 72072 | $419.90 | $646.00 | $98.91 – $102.86 | 3 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $289.25 | $445.00 | $82.33 – $85.63 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $293.80 | $452.00 | $82.33 – $85.63 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $352.95 | $543.00 | $98.91 – $102.86 | 3 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $586.95 | $903.00 | $82.33 – $85.63 | 3 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $425.75 | $655.00 | $82.33 – $85.63 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $1,001.00 | $1,540.00 | $165.94 – $172.58 | 3 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $934.70 | $1,438.00 | $165.94 – $172.58 | 3 |
| X-ray wrist 2 views (both sides) CPT 73100 | $462.15 | $711.00 | $82.33 – $85.63 | 3 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $165.94 – $172.58 | 3 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.91 – $13.43 | 2 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.67 – $9.75 | 4 |
| Yersinia antibody CPT 86793 | $165.10 | $254.00 | $13.19 – $13.72 | 2 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $56,824.55 – $421,582.72 | 4 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $117.73 – $122.44 | 3 |
| Ziconotide injection HCPCS J2278 | not published | not published | $10.14 – $63.57 | 4 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $109.40 | $168.30 | $1.51 – $9.82 | 4 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $9.82 – $9.82 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | $343.85 | $529.00 | $51.31 – $53.36 | 2 |
| Zika virus igm antibody CPT 86794 | $137.15 | $211.00 | $16.85 – $17.52 | 2 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $76.77 | $118.11 | $12.22 – $46.74 | 2 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $7.88 – $51.87 | 4 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $167.86 | $258.25 | $9.53 – $36.40 | 2 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $0.07 – $0.07 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.25 – $200.98 | 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.