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 |
|---|---|---|---|---|
| Larynscop w/tumr exc + scope CPT 31541 | $12,177.60 | $20,296.00 | $3,696.43 – $3,770.36 | 4 |
| Lateral thoracic extension HCPCS L1210 | $578.90 | $964.84 | not published | 0 |
| Lateral trochanteric pad HCPCS L1290 | $183.85 | $306.42 | not published | 0 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $52,484.40 | $87,474.00 | not published | 0 |
| Lead capillary CPT 83655 | $39.00 | $65.00 | not published | 0 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $58,108.10 | $96,846.84 | not published | 0 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $14,433.21 | $24,055.35 | not published | 0 |
| Legg perthes orthosis trilat HCPCS L1720 | $3,490.40 | $5,817.33 | not published | 0 |
| Legg perthes orth scottish r HCPCS L1730 | $2,946.68 | $4,911.14 | not published | 0 |
| Legg perthes patten bottom t HCPCS L1755 | $4,236.49 | $7,060.81 | not published | 0 |
| Leg perthes orth toronto typ HCPCS L1700 | $3,681.23 | $6,135.38 | not published | 0 |
| Lens, intraocular (new tech) HCPCS C1780 | $223.06 | $371.76 | not published | 0 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $2,624.22 | $4,373.70 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $3,135.94 | $5,226.57 | not published | 0 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $787.27 | $1,312.11 | not published | 0 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $90.00 | $150.00 | not published | 0 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $4,652.58 | $7,754.30 | not published | 0 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $27,557.22 | $45,928.70 | not published | 0 |
| Levalbuterol non-comp con HCPCS J7612 | $16.08 | $26.80 | not published | 0 |
| Levalbuterol non-comp unit HCPCS J7614 | $4.80 | $8.00 | not published | 0 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $63.18 | $105.30 | not published | 0 |
| Levetiracetam therapeutic drug level CPT 80177 | $131.40 | $219.00 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $81,180.25 | $135,300.41 | not published | 0 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $26.64 | $44.40 | not published | 0 |
| Lidocaine therapeutic drug level CPT 80176 | $49.80 | $83.00 | not published | 0 |
| Lift heel adj small gl60404sm HCPCS L3332 | $174.51 | $290.85 | not published | 0 |
| Lift heel adjustable med HCPCS L3334 | $90.22 | $150.37 | not published | 0 |
| Lifts elevation metal extens HCPCS L3330 | $1,339.06 | $2,231.77 | not published | 0 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $20,299.32 | $33,832.20 | $1,637.46 – $1,670.21 | 4 |
| Lig/band angioaccess av fistula CPT 37607 | $44,992.66 | $74,987.77 | $3,130.45 – $3,193.06 | 4 |
| Limited ankle motion ea jnt HCPCS L2200 | $351.65 | $586.08 | not published | 0 |
| Limited motion knee joint HCPCS L2184 | $274.07 | $456.79 | not published | 0 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $158.40 | $264.00 | not published | 0 |
| Lipase CPT 83690 | $68.40 | $114.00 | not published | 0 |
| Lipoprotein blood high res frac & quant CPT 83701 | $72.00 | $120.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $90.60 | $151.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $84.00 | $140.00 | not published | 0 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $444.00 | $740.00 | not published | 0 |
| Liver Function Test CPT 80076 | $73.80 | $123.00 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $1,113.00 | $1,855.00 | not published | 0 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $1,287.60 | $2,146.00 | not published | 0 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $88,385.98 | $147,309.97 | $3,243.99 – $26,901.72 | 4 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | $408.17 | $680.29 | not published | 0 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $167.74 | $279.57 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,740.00 | $2,900.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,527.60 | $2,546.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $989.40 | $1,649.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $404.40 | $674.00 | not published | 0 |
| Lso corset front HCPCS L0972 | $249.04 | $415.06 | not published | 0 |
| Lso flex no ri stays pre ots HCPCS L0628 | $269.09 | $448.48 | not published | 0 |
| Lso full corset HCPCS L0976 | $353.77 | $589.62 | not published | 0 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $401.51 | $669.18 | not published | 0 |
| Lso sag-coronal panel custom HCPCS L0638 | $3,970.45 | $6,617.41 | not published | 0 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | $3,065.30 | $5,108.83 | not published | 0 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | $383.24 | $638.74 | not published | 0 |
| Lso sagit rigid panel prefab HCPCS L0635 | $2,364.26 | $3,940.44 | not published | 0 |
| Lso sagittal rigid panel cus HCPCS L0636 | $3,207.92 | $5,346.54 | not published | 0 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $617.19 | $1,028.65 | not published | 0 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | $678.49 | $1,130.82 | not published | 0 |
| Lso s/c shell/panel custom HCPCS L0640 | $2,252.16 | $3,753.60 | not published | 0 |
| Lumbar bolster pad HCPCS L1030 | $185.27 | $308.78 | not published | 0 |
| Lumbar derotation pad HCPCS L1240 | $215.18 | $358.64 | not published | 0 |
| Lumbar or lumbar rib pad HCPCS L1040 | $209.78 | $349.63 | not published | 0 |
| Lumbar sling HCPCS L1090 | $238.10 | $396.83 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $974.40 | $1,624.00 | not published | 0 |
| Lvad shower bag heartmate HCPCS Q0501 | $787.27 | $1,312.11 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $674.40 | $1,124.00 | not published | 0 |
| Lymphocyte transformation mitogen CPT 86353 | $236.40 | $394.00 | not published | 0 |
| Lymphocytotoxicity assay CPT 86805 | $237.60 | $396.00 | not published | 0 |
| Lymph vessel x-ray arm/leg CPT 75801 | $973.80 | $1,623.00 | not published | 0 |
| Lymph vessel x-ray arms/legs CPT 75803 | $2,446.80 | $4,078.00 | not published | 0 |
| Macroscopic exam arthropod CPT 87168 | $49.80 | $83.00 | not published | 0 |
| Macroscopic exam parasite CPT 87169 | $29.40 | $49.00 | not published | 0 |
| Magnesium CPT 83735 | $55.80 | $93.00 | not published | 0 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $58.02 | $96.70 | not published | 0 |
| Mammosite ced HCPCS C1728 | $7,938.26 | $13,230.44 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $87.00 | $145.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $126.00 | $210.00 | not published | 0 |
| Man's shoe oxford brace HCPCS L3225 | $174.64 | $291.07 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $127,664.68 | $212,774.47 | $6,583.32 – $6,714.99 | 4 |
| Marker biop eviva buckle ss HCPCS A4648 | $14,826.85 | $24,711.41 | not published | 0 |
| Mastectomy partial CPT 19301 | $48,843.82 | $81,406.37 | $3,881.91 – $3,959.55 | 3 |
| Mastoids complete CPT 70130 | $441.00 | $735.00 | not published | 0 |
| Mastopexy CPT 19316 | $22,590.52 | $37,650.87 | $7,194.09 – $7,194.09 | 2 |
| Mast simple complete CPT 19303 | $127,664.68 | $212,774.47 | $6,583.32 – $6,714.99 | 3 |
| Matrion 1 sq cm HCPCS Q4201 | $20,298.34 | $33,830.57 | not published | 0 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $85,260.91 | $142,101.51 | not published | 0 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $30.60 | $51.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $150.60 | $251.00 | not published | 0 |
| Mayo activated protein c resistance assay CPT 85307 | $151.80 | $253.00 | not published | 0 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $357.60 | $596.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $62.40 | $104.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $126.00 | $210.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $379.20 | $632.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $209.40 | $349.00 | not published | 0 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $219.60 | $366.00 | not published | 0 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $2,315.40 | $3,859.00 | not published | 0 |
| Mayo androstenedione CPT 82157 | $66.60 | $111.00 | not published | 0 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $66.00 | $110.00 | not published | 0 |
| Mayo antithrombin iii antigen CPT 85301 | $28.80 | $48.00 | 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.