fairview hospital
18101 Lorain Avenue, Cleveland, OH · Cleveland Clinic · · NPI 1215989611
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 |
|---|---|---|---|---|
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $477.10 | $734.00 | $0.87 – $660.60 | 44 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $1,601.60 | $2,464.00 | $0.87 – $2,217.60 | 44 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,601.60 | $2,464.00 | $0.87 – $2,217.60 | 44 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $1,084.20 | $1,668.00 | $0.87 – $1,501.20 | 44 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $477.10 | $734.00 | $0.87 – $660.60 | 44 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $477.10 | $734.00 | $0.87 – $660.60 | 44 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $2,803.45 | $4,313.00 | $0.01 – $3,881.70 | 44 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $2,803.45 | $4,313.00 | $219.13 – $3,881.70 | 44 |
| Upper ext fx orthosis rad/ul HCPCS L3982 | $156.00 | $240.00 | $52.32 – $803.25 | 37 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $3,935.20 – $4,556.55 | 9 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $798.20 | $1,228.00 | $0.87 – $1,105.20 | 44 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $798.20 | $1,228.00 | $0.87 – $1,105.20 | 44 |
| Uppr gi scope w/submuc inj CPT 43236 | $2,803.45 | $4,313.00 | $219.13 – $3,881.70 | 44 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $1,996.43 – $6,291.49 | 22 |
| Urea nitrogen CPT 84520 | $17.55 | $27.00 | $0.95 – $24.30 | 44 |
| Urea nitrogen 24 hour urine CPT 84540 | $24.70 | $38.00 | $0.95 – $34.20 | 44 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $7.20 – $40.50 | 23 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $5.13 – $15.24 | 23 |
| Ureteral embolization/occl CPT 50705 | $392.60 | $604.00 | $131.67 – $5,383.10 | 37 |
| Ureteral reflux study CPT 78740 | not published | not published | $255.11 – $416.04 | 22 |
| Ureter endoscopy CPT 50970 | not published | not published | $822.91 – $3,668.39 | 22 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $1,734.84 – $5,579.94 | 22 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $1,734.84 – $5,579.94 | 22 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $822.91 – $3,668.39 | 22 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $1,734.84 – $5,579.94 | 22 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $1,734.84 – $5,579.94 | 22 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $1,734.84 – $5,579.94 | 22 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $1,734.84 – $5,579.94 | 22 |
| Ureteroneocystostomy 50780 CPT 50780 | $4,457.05 | $6,857.00 | $1,494.83 – $6,171.30 | 37 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $4,649.04 – $5,383.10 | 9 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $1,084.20 | $1,668.00 | $0.87 – $1,501.20 | 44 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $1,730.43 – $3,668.39 | 22 |
| Urethrocystography void s&i CPT 74455 | $1,084.20 | $1,668.00 | $0.87 – $1,501.20 | 44 |
| Uric acid blood CPT 84550 | $20.15 | $31.00 | $0.95 – $27.90 | 44 |
| Uric acid urine CPT 84560 | $22.75 | $35.00 | $0.95 – $31.50 | 44 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.70 – $14.92 | 23 |
| Urinalysis microscopic only CPT 81015 | $13.65 | $21.00 | $0.95 – $18.90 | 44 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $9.75 | $15.00 | $0.95 – $13.50 | 44 |
| Urinalysis (with microscopy) CPT 81001 | $14.30 | $22.00 | $0.95 – $19.80 | 44 |
| Urinalysis (without microscopy) CPT 81003 | $10.40 | $16.00 | $0.95 – $16.03 | 44 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $204.71 – $295.39 | 10 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $4.67 – $16.09 | 9 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $8.98 – $16.09 | 9 |
| Urinary reflex study CPT 51792 | not published | not published | $53.07 – $371.67 | 22 |
| Urinary suspensory HCPCS A5105 | not published | not published | $29.93 – $34.65 | 9 |
| Urine Culture Test CPT 87086 | $36.40 | $56.00 | $0.95 – $50.40 | 44 |
| Urine flow measurement 51736 CPT 51736 | $385.45 | $593.00 | $0.01 – $533.70 | 44 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $9.74 – $16.09 | 9 |
| Urine pregnancy test CPT 81025 | $38.35 | $59.00 | $0.95 – $53.10 | 44 |
| Urine screen for bacteria CPT 81007 | not published | not published | $5.23 – $32.98 | 23 |
| Urine shunt to intestine CPT 50815 | not published | not published | $4,649.04 – $5,383.10 | 9 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $2.17 – $8.77 | 10 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $127.26 – $342.41 | 10 |
| Urography, antegrade CPT 74425 | $1,601.60 | $2,464.00 | $0.87 – $2,217.60 | 44 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $116.86 – $182.54 | 22 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $466.36 – $1,181.45 | 11 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $7.89 – $23.62 | 11 |
| Use 1st target lesion CPT 76982 | $477.10 | $734.00 | $0.87 – $660.60 | 44 |
| User adjustable heel height HCPCS L5990 | not published | not published | $548.77 – $635.42 | 9 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $190.77 | $293.49 | $2.17 – $4,632.42 | 44 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $68,214.47 | $104,945.34 | $2.17 – $94,450.73 | 39 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $1,663.31 – $33,402.55 | 21 |
| Vaccine Administration (one shot) CPT 90471 | $139.10 | $214.00 | $9.33 – $74.93 | 44 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $8.19 – $368.56 | 12 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $1,207.44 | $1,857.60 | $8.19 – $418.86 | 37 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $1,324.79 | $2,038.14 | $8.19 – $479.43 | 37 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $180.70 | $278.00 | $8.19 – $250.20 | 37 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $91.00 | $140.00 | $8.19 – $126.00 | 37 |
| Vaccine dtap < 7 years im CPT 90700 | $136.99 | $210.75 | $8.19 – $91.80 | 37 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $502.91 | $773.70 | $8.19 – $280.80 | 37 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | $291.15 | $447.93 | $8.19 – $189.00 | 37 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | $762.18 | $1,172.58 | $8.19 – $473.45 | 37 |
| Vaccine dtap-ipv/hib im CPT 90698 | $303.99 | $467.67 | $8.19 – $333.00 | 37 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $143.79 | $221.22 | $8.19 – $97.20 | 37 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $30.79 | $47.37 | $7.30 – $42.30 | 37 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $207.83 | $319.74 | $8.19 – $268.87 | 37 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $327.83 | $504.36 | $13.80 – $424.80 | 37 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $185.00 | $284.61 | $8.19 – $124.20 | 37 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $8.19 – $70.11 | 10 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $8.19 – $171.34 | 12 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $173.98 | $267.66 | $8.19 – $231.55 | 37 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $728.91 | $1,121.40 | $8.19 – $505.80 | 37 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $137.40 | $211.38 | $8.19 – $93.60 | 37 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $1,536.64 | $2,364.06 | $13.80 – $995.40 | 37 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | $287.30 | $442.00 | $13.80 – $397.80 | 37 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $264.24 | $406.53 | $8.19 – $182.97 | 37 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $8.19 – $190.36 | 12 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $45.31 | $69.70 | $8.19 – $62.73 | 37 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $97.11 | $149.40 | $8.19 – $67.23 | 37 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $43.55 | $67.00 | $8.19 – $60.30 | 37 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | $157.95 | $243.00 | $8.19 – $218.70 | 37 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | $23.40 | $36.00 | $5.59 – $32.40 | 37 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $45.50 | $70.00 | $8.19 – $63.00 | 37 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $8.19 – $21.30 | 11 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $37.05 | $57.00 | $8.19 – $51.30 | 37 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $151.45 | $233.00 | $8.19 – $209.70 | 37 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $8.19 – $94.54 | 12 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $8.19 – $24.92 | 12 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $1,172.61 | $1,804.02 | $13.80 – $766.80 | 37 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $1,053.74 | $1,621.14 | $13.80 – $543.60 | 37 |
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.