Fairfield Hospital
3000 Mack Rd., Fairfield, OH · Mercy · · NPI 1467552471
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 |
|---|---|---|---|---|
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $103.80 | $173.00 | not published | 0 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $103.80 | $173.00 | not published | 0 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $164.40 | $274.00 | not published | 0 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $163.80 | $273.00 | not published | 0 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $118.80 | $198.00 | not published | 0 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $193.80 | $323.00 | not published | 0 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $162.00 | $270.00 | not published | 0 |
| Cytopath smear other source CPT 88160 | $144.00 | $240.00 | not published | 0 |
| Cytopath smear other source CPT 88162 | $190.20 | $317.00 | not published | 0 |
| Cytopath smear oth prep screen & interp CPT 88161 | $143.40 | $239.00 | not published | 0 |
| Cytopath tbs c/v manual CPT 88164 | $49.20 | $82.00 | not published | 0 |
| Cytotoxic antibody screening CPT 86807 | $243.60 | $406.00 | not published | 0 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $941.40 | $1,569.00 | not published | 0 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $90.00 | $150.00 | not published | 0 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $16,718.40 | $27,864.00 | not published | 0 |
| Deamidated gliadin antibody iga CPT 86258 | $19.80 | $33.00 | not published | 0 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $827.40 | $1,379.00 | not published | 0 |
| Debridement (>20 cm) charge pt CPT 97598 | $550.20 | $917.00 | not published | 0 |
| Debridement bone <= 20 sq cm CPT 11044 | $7,011.00 | $11,685.00 | $1,637.46 – $1,670.21 | 4 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $1,579.20 | $2,632.00 | not published | 0 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $5,005.20 | $8,342.00 | not published | 0 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $7,319.40 | $12,199.00 | $403.03 – $411.10 | 4 |
| Debride nail1-5 11720 CPT 11720 | $265.80 | $443.00 | not published | 0 |
| Debride nail6 or more 11721 CPT 11721 | $404.40 | $674.00 | not published | 0 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | $1,337.40 | $2,229.00 | not published | 0 |
| Debride skin bone at fx site CPT 11012 | $12,134.27 | $20,223.78 | $3,243.99 – $3,308.87 | 4 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $2,059.20 | $3,432.00 | not published | 0 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $1,476.60 | $2,461.00 | not published | 0 |
| Debr inf skin add-on 11001 CPT 11001 | $719.40 | $1,199.00 | not published | 0 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $7,588.37 | $12,647.28 | $732.74 – $747.40 | 4 |
| Decalcification CPT 88311 | $53.40 | $89.00 | not published | 0 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $324.60 | $541.00 | not published | 0 |
| Decompression of lower leg CPT 27601 | $19,136.76 | $31,894.60 | $7,194.09 – $7,337.97 | 4 |
| Decompression of thigh/knee CPT 27496 | $13,418.40 | $22,364.00 | $3,243.99 – $3,308.87 | 4 |
| Deep muscle biopsy 20205 CPT 20205 | $3,138.60 | $5,231.00 | not published | 0 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $56.40 | $94.00 | not published | 0 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $3,886.68 | $6,477.80 | not published | 0 |
| Delayed breast prosthesis 19342 CPT 19342 | $24,747.73 | $41,246.22 | $7,194.09 – $8,103.41 | 3 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $203.40 | $339.00 | not published | 0 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $14,902.92 | $24,838.20 | not published | 0 |
| Dermapure 1 square cm HCPCS Q4152 | $5,235.32 | $8,725.53 | not published | 0 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $91.56 | $152.60 | not published | 0 |
| Desoxycorticosterone CPT 82633 | $83.40 | $139.00 | not published | 0 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $8,934.58 | $14,890.97 | $1,936.01 – $1,974.73 | 4 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $8,954.68 | $14,924.47 | $1,936.01 – $1,974.73 | 4 |
| Destruction benign lesions < 14 lesions CPT 17110 | $10,555.50 | $17,592.50 | $198.92 – $202.90 | 4 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $8,768.08 | $14,613.47 | $1,936.01 – $1,974.73 | 4 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $8,744.80 | $14,574.67 | $1,936.01 – $1,974.73 | 4 |
| Device ablt adv novasure HCPCS C1886 | $12,727.47 | $21,212.45 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $6,560.55 | $10,934.25 | not published | 0 |
| Device sut capio slim opn HCPCS C2631 | $3,002.11 | $5,003.51 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $2,430.68 | $4,051.14 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $503.40 | $839.00 | not published | 0 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $3.06 | $5.10 | not published | 0 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $284.76 | $474.60 | not published | 0 |
| Dextran 40 infusion HCPCS J7100 | $300.06 | $500.10 | not published | 0 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $37.80 | $63.00 | not published | 0 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $37.80 | $63.00 | not published | 0 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $37.80 | $63.00 | not published | 0 |
| Dextrose 5 % IV bolus HCPCS J7070 | $37.80 | $63.00 | not published | 0 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $139.80 | $233.00 | not published | 0 |
| Diabetes (HbA1c) Test CPT 83036 | $90.60 | $151.00 | not published | 0 |
| Diag laparo separate proc 49320 CPT 49320 | $33,084.19 | $55,140.32 | $5,993.77 – $6,113.65 | 4 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $380.40 | $634.00 | not published | 0 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $426.60 | $711.00 | not published | 0 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $369.00 | $615.00 | not published | 0 |
| Diagnostic Mammogram (one breast) CPT 77065 | $335.40 | $559.00 | not published | 0 |
| Diagnostic radio unlisted proc CPT 76499 | $772.80 | $1,288.00 | not published | 0 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $15,156.00 | $25,260.00 | not published | 0 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $37.98 | $63.30 | not published | 0 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $6.24 | $10.40 | not published | 0 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $21,487.68 | $35,812.80 | not published | 0 |
| Dilate biliary duct/ampulla CPT 47542 | $1,223.40 | $2,039.00 | not published | 0 |
| Dilate esophagus 1/mult pass CPT 43450 | $6,228.60 | $10,381.00 | $899.22 – $917.20 | 4 |
| Dilator fascial 10fx20cm HCPCS C2627 | $832.93 | $1,388.21 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $2,270.40 | $3,784.00 | not published | 0 |
| Dilat xst trc new access rcs CPT 50437 | $2,270.40 | $3,784.00 | not published | 0 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $51.54 | $85.90 | not published | 0 |
| Dimenhydrinate injection HCPCS J1240 | $29.70 | $49.50 | not published | 0 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $6.00 | $10.00 | not published | 0 |
| Disaccharidases CPT 82657 | $175.20 | $292.00 | not published | 0 |
| Dise eval slp do brth flx dx CPT 42975 | $7,803.70 | $13,006.17 | $1,764.66 – $1,799.95 | 4 |
| Dist revas ligation hemo CPT 36838 | $44,992.66 | $74,987.77 | $5,516.85 – $5,627.18 | 4 |
| Dmd dup/delet analysis CPT 81161 | $499.20 | $832.00 | not published | 0 |
| Dna antibody native/double stranded CPT 86225 | $58.20 | $97.00 | not published | 0 |
| Dna gardnerella CPT 87510 | $33.60 | $56.00 | not published | 0 |
| Dna trichomonas CPT 87660 | $33.60 | $56.00 | not published | 0 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $180.48 | $300.80 | not published | 0 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $1,606.50 | $2,677.50 | not published | 0 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $64.32 | $107.20 | not published | 0 |
| Dornase alfa non-comp unit HCPCS J7639 | $603.60 | $1,006.00 | not published | 0 |
| Dornhoffer fixed part w/window HCPCS L8614 | $67,573.67 | $112,622.78 | not published | 0 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $2,295.00 | $3,825.00 | not published | 0 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $118.86 | $198.10 | not published | 0 |
| Dpyd gene common variants CPT 81232 | $351.60 | $586.00 | not published | 0 |
| Drainage of arm bursa 23931 CPT 23931 | $3,010.80 | $5,018.00 | not published | 0 |
| Drainage of kidney lesion CPT 50390 | $1,361.40 | $2,269.00 | not published | 0 |
| Drainage of nose lesion sept 30020 CPT 30020 | $847.20 | $1,412.00 | not published | 0 |
| Drain blood from under nail 11740 CPT 11740 | $283.80 | $473.00 | not published | 0 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $2,786.40 | $4,644.00 | not published | 0 |
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.