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 |
|---|---|---|---|---|
| Wnd prep f/n/hf/g addl cm CPT 15005 | $1,713.60 | $2,856.00 | not published | 0 |
| Woman's shoe oxford brace HCPCS L3224 | $159.87 | $266.45 | not published | 0 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $1,110.60 | $1,851.00 | not published | 0 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $1,167.00 | $1,945.00 | not published | 0 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $597.60 | $996.00 | not published | 0 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $715.20 | $1,192.00 | not published | 0 |
| Wrist X-ray CPT 73110 | $329.40 | $549.00 | not published | 0 |
| Xcellistem, 1 mg HCPCS A2004 | $5,285.18 | $8,808.63 | not published | 0 |
| Xe133 xenon 10mci HCPCS A9558 | $34.80 | $58.00 | not published | 0 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | $19,587.52 | $32,645.87 | $1,936.01 – $1,936.01 | 2 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | $22,501.75 | $37,502.92 | $2,045.62 – $2,045.62 | 3 |
| X-ray abdomen 1 view CPT 74018 | $264.00 | $440.00 | not published | 0 |
| X-ray abdomen 2 views CPT 74019 | $264.00 | $440.00 | not published | 0 |
| X-ray abdomen >=3 views CPT 74021 | $282.00 | $470.00 | not published | 0 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $626.40 | $1,044.00 | not published | 0 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $294.00 | $490.00 | not published | 0 |
| X-ray ankle 2 views (both sides) CPT 73600 | $262.80 | $438.00 | not published | 0 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $730.20 | $1,217.00 | not published | 0 |
| X-ray bone age studies CPT 77072 | $248.40 | $414.00 | not published | 0 |
| X-ray bone length studies CPT 77073 | $364.80 | $608.00 | not published | 0 |
| X-ray bone survey complete CPT 77075 | $816.60 | $1,361.00 | not published | 0 |
| X-ray bone survey infant CPT 77076 | $354.00 | $590.00 | not published | 0 |
| X-ray cervical spine 2-3 views CPT 72040 | $382.80 | $638.00 | not published | 0 |
| X-ray cervical spine 4-5 views CPT 72050 | $552.60 | $921.00 | not published | 0 |
| X-ray cervical spine >= 6 views CPT 72052 | $702.60 | $1,171.00 | not published | 0 |
| X-ray clavicle complete (both sides) CPT 73000 | $251.40 | $419.00 | not published | 0 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $867.60 | $1,446.00 | not published | 0 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $1,260.60 | $2,101.00 | not published | 0 |
| X-ray elbow 2 views (both sides) CPT 73070 | $271.80 | $453.00 | not published | 0 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $364.20 | $607.00 | not published | 0 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $586.80 | $978.00 | not published | 0 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $415.20 | $692.00 | not published | 0 |
| X-ray exam entire spi 6/> vw CPT 72084 | $499.20 | $832.00 | not published | 0 |
| X-ray exam of arm infant CPT 73092 | $259.80 | $433.00 | not published | 0 |
| X-ray exam of eye sockets CPT 70200 | $474.00 | $790.00 | not published | 0 |
| X-ray exam of femur 1 CPT 73551 | $292.80 | $488.00 | not published | 0 |
| X-ray exam of jaw joint CPT 70332 | $885.60 | $1,476.00 | not published | 0 |
| X-ray exam of salivary gland CPT 70380 | $291.00 | $485.00 | not published | 0 |
| X-ray exam of sinuses CPT 70210 | $297.00 | $495.00 | not published | 0 |
| X-ray exam si joints CPT 72200 | $241.80 | $403.00 | not published | 0 |
| X-ray exam thorac spine4/>vw CPT 72074 | $400.80 | $668.00 | not published | 0 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $340.80 | $568.00 | not published | 0 |
| X-ray facial bones complete > 3 views CPT 70150 | $421.20 | $702.00 | not published | 0 |
| X-ray femur >=2 views (both sides) CPT 73552 | $292.80 | $488.00 | not published | 0 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $251.40 | $419.00 | not published | 0 |
| X-ray foot 2 views (both sides) CPT 73620 | $271.80 | $453.00 | not published | 0 |
| X-ray forearm 2 views (both sides) CPT 73090 | $270.00 | $450.00 | not published | 0 |
| X-ray hand 2 views (both sides) CPT 73120 | $260.40 | $434.00 | not published | 0 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $266.40 | $444.00 | not published | 0 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $496.80 | $828.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $391.80 | $653.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $496.80 | $828.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $745.20 | $1,242.00 | not published | 0 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $294.00 | $490.00 | not published | 0 |
| X-ray humerus >= 2 views left CPT 73060 | $277.20 | $462.00 | not published | 0 |
| X-ray joint survey 1 view CPT 77077 | $479.40 | $799.00 | not published | 0 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $285.00 | $475.00 | not published | 0 |
| X-ray knee 3 views (both sides) CPT 73562 | $363.60 | $606.00 | not published | 0 |
| X-ray knee ap standing bilateral CPT 73565 | $363.60 | $606.00 | not published | 0 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $282.00 | $470.00 | not published | 0 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $404.40 | $674.00 | not published | 0 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $519.00 | $865.00 | not published | 0 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $568.20 | $947.00 | not published | 0 |
| X-ray mandible complete > 4 views CPT 70110 | $307.20 | $512.00 | not published | 0 |
| X-ray mandible ltd <4 views CPT 70100 | $231.60 | $386.00 | not published | 0 |
| X-ray nasal bones complete > 3 views CPT 70160 | $303.00 | $505.00 | not published | 0 |
| X-ray neck soft tissue CPT 70360 | $312.00 | $520.00 | not published | 0 |
| X-ray nose to rectum for foreign body child CPT 76010 | $268.80 | $448.00 | not published | 0 |
| X-ray optic foramina CPT 70190 | $285.00 | $475.00 | not published | 0 |
| X-ray pelvis 1-2 views CPT 72170 | $306.60 | $511.00 | not published | 0 |
| X-ray pelvis complete > 3 views CPT 72190 | $310.80 | $518.00 | not published | 0 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $996.60 | $1,661.00 | not published | 0 |
| X-ray ribs 2 views left CPT 71100 | $325.20 | $542.00 | not published | 0 |
| X-ray ribs 3 views bilateral CPT 71110 | $393.60 | $656.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $442.20 | $737.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $632.40 | $1,054.00 | not published | 0 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $288.60 | $481.00 | not published | 0 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $354.00 | $590.00 | not published | 0 |
| X-ray scapula complete (both sides) CPT 73010 | $271.80 | $453.00 | not published | 0 |
| X-ray sella turcica CPT 70240 | $231.60 | $386.00 | not published | 0 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $241.80 | $403.00 | not published | 0 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $709.80 | $1,183.00 | not published | 0 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $845.40 | $1,409.00 | not published | 0 |
| X-ray skull < 4 views CPT 70250 | $339.60 | $566.00 | not published | 0 |
| X-ray skull > 4 views complete CPT 70260 | $463.80 | $773.00 | not published | 0 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $763.20 | $1,272.00 | not published | 0 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $734.40 | $1,224.00 | not published | 0 |
| X-ray small intestine follow-through study CPT 74248 | $1,178.40 | $1,964.00 | not published | 0 |
| X-ray spine single view CPT 72020 | $235.20 | $392.00 | not published | 0 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $335.40 | $559.00 | not published | 0 |
| X-ray sternum > 2 views CPT 71120 | $319.80 | $533.00 | not published | 0 |
| X-ray surgical specimen CPT 76098 | $378.60 | $631.00 | not published | 0 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $676.80 | $1,128.00 | not published | 0 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $345.60 | $576.00 | not published | 0 |
| X-ray thoracic spine 2 views CPT 72070 | $364.20 | $607.00 | not published | 0 |
| X-ray thoracic spine 3 views CPT 72072 | $381.60 | $636.00 | not published | 0 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $328.80 | $548.00 | not published | 0 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $252.00 | $420.00 | not published | 0 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $334.20 | $557.00 | not published | 0 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $279.00 | $465.00 | 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.