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 |
|---|---|---|---|---|
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $835.80 | $1,393.00 | not published | 0 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $1,305.00 | $2,175.00 | not published | 0 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $837.00 | $1,395.00 | not published | 0 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $1,116.00 | $1,860.00 | not published | 0 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $725.40 | $1,209.00 | not published | 0 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $725.40 | $1,209.00 | not published | 0 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $725.40 | $1,209.00 | not published | 0 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $3,579.60 | $5,966.00 | not published | 0 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $725.40 | $1,209.00 | not published | 0 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $76.20 | $127.00 | not published | 0 |
| Ghs mbp CPT 83873 | $99.00 | $165.00 | not published | 0 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $259.20 | $432.00 | not published | 0 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $171.60 | $286.00 | not published | 0 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $196.20 | $327.00 | not published | 0 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $186.60 | $311.00 | not published | 0 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $196.20 | $327.00 | not published | 0 |
| Ghs nailbed repair/nail removal CPT 11760 | $1,297.20 | $2,162.00 | not published | 0 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $3,972.60 | $6,621.00 | not published | 0 |
| Ghs nerve blk intercostal, single level CPT 64420 | $1,301.40 | $2,169.00 | not published | 0 |
| Ghs nerve block axillary nerve CPT 64417 | $2,967.60 | $4,946.00 | not published | 0 |
| Ghs nerve block brachial plexus CPT 64415 | $2,919.00 | $4,865.00 | not published | 0 |
| Ghs nerve block celiac plexus CPT 64530 | $1,556.40 | $2,594.00 | not published | 0 |
| Ghs nerve block sciatic nerve CPT 64445 | $2,867.40 | $4,779.00 | not published | 0 |
| Ghs nerve block suprascapular CPT 64418 | $2,094.00 | $3,490.00 | not published | 0 |
| Ghs ng placement w fluoro guidance CPT 43752 | $628.20 | $1,047.00 | not published | 0 |
| Ghs o2 saturation CPT 82810 | $101.40 | $169.00 | not published | 0 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | $97.80 | $163.00 | not published | 0 |
| Ghs opcc repair cvp without subq port CPT 36575 | $1,500.60 | $2,501.00 | not published | 0 |
| Ghs opcc repair cvp w subq port CPT 36576 | $1,500.60 | $2,501.00 | not published | 0 |
| Ghs ot group caregiver training CPT 97552 | $32.40 | $54.00 | not published | 0 |
| Ghs ot prosthetic training/15 min CPT 97761 | $82.80 | $138.00 | not published | 0 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $142.20 | $237.00 | not published | 0 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $4,975.80 | $8,293.00 | not published | 0 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $2,689.20 | $4,482.00 | $876.90 – $894.44 | 4 |
| Ghs picc line insert < 5 CPT 36568 | $2,598.60 | $4,331.00 | not published | 0 |
| Ghs plngl fx pm cl CPT 26725 | $587.40 | $979.00 | not published | 0 |
| Ghs ppd (tb intradermal) CPT 86580 | $39.00 | $65.00 | not published | 0 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $21.60 | $36.00 | not published | 0 |
| Ghs protein, misc fluid CPT 84160 | $10.20 | $17.00 | not published | 0 |
| Ghs protoporphyrins fract CPT 84202 | $51.60 | $86.00 | not published | 0 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $26.40 | $44.00 | not published | 0 |
| Ghs quinidine CPT 80194 | $70.80 | $118.00 | not published | 0 |
| Ghs removal intranasal foreign body CPT 30300 | $283.80 | $473.00 | not published | 0 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $3,619.80 | $6,033.00 | not published | 0 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $5,304.60 | $8,841.00 | not published | 0 |
| Ghs sedimentation rate CPT 85651 | $35.40 | $59.00 | not published | 0 |
| Ghs semen analysis fert CPT 89320 | $288.00 | $480.00 | not published | 0 |
| Ghs sensitivity (per antimicro) CPT 87184 | $36.60 | $61.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $837.00 | $1,395.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $725.40 | $1,209.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $837.00 | $1,395.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $725.40 | $1,209.00 | not published | 0 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $465.00 | $775.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $460.80 | $768.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $462.60 | $771.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $408.00 | $680.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $408.00 | $680.00 | not published | 0 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $255.60 | $426.00 | not published | 0 |
| Ghs strapping shoulder - 29240 CPT 29240 | $281.40 | $469.00 | not published | 0 |
| Ghs st - re-eval for alt comm CPT 92597 | $297.60 | $496.00 | not published | 0 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,305.60 | $2,176.00 | not published | 0 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $725.40 | $1,209.00 | not published | 0 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $2,463.60 | $4,106.00 | not published | 0 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $604.80 | $1,008.00 | not published | 0 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $520.80 | $868.00 | not published | 0 |
| Ghs urine, porphyrins quant CPT 84120 | $73.80 | $123.00 | not published | 0 |
| Ghs windowing of cast CPT 29730 | $312.00 | $520.00 | not published | 0 |
| Giardia lamblia antibody CPT 86674 | $71.40 | $119.00 | not published | 0 |
| Gi inhouse confirmation CPT 87045 | $31.80 | $53.00 | not published | 0 |
| Glove finger flexion right lg xl HCPCS L3912 | $226.87 | $378.11 | not published | 0 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $1,140.12 | $1,900.20 | not published | 0 |
| Glucagon plasma - sendout CPT 82943 | $32.40 | $54.00 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $39.00 | $65.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $34.80 | $58.00 | not published | 0 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $17.88 | $29.80 | not published | 0 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $8,636.52 | $14,394.20 | not published | 0 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $135.60 | $226.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $159.60 | $266.00 | not published | 0 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $4,471.67 | $7,452.78 | not published | 0 |
| Graft axiofill 1000mg HCPCS J3590 | $11,021.22 | $18,368.70 | not published | 0 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $60,265.21 | $100,442.02 | not published | 0 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $43,438.72 | $72,397.86 | not published | 0 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $3,901.64 | $6,502.73 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $110,978.26 | $184,963.77 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $83,975.04 | $139,958.40 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $36,739.08 | $61,231.80 | not published | 0 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $13,462.25 | $22,437.08 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $22,830.71 | $38,051.19 | not published | 0 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $8,868.02 | $14,780.04 | not published | 0 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $3,936.33 | $6,560.55 | not published | 0 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $82,752.16 | $137,920.26 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $6,954.19 | $11,590.31 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $82,899.11 | $138,165.18 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $39,264.89 | $65,441.49 | not published | 0 |
| Granulocyte pheresis ea unit HCPCS P9050 | $2,309.40 | $3,849.00 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $827.40 | $1,379.00 | not published | 0 |
| Growth stimulation gene 2 CPT 83006 | $132.60 | $221.00 | not published | 0 |
| G-tube reposition CPT 43761 | $964.20 | $1,607.00 | not published | 0 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,622.40 | $2,704.00 | not published | 0 |
| Guided cath fluid drainage 10030 CPT 10030 | $5,061.60 | $8,436.00 | 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.