St Ritas Medical Center
730 W. Market St., Lima, OH · Mercy · · NPI 1811939887
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $193.20 | $322.00 | not published | 0 |
| 17-hydroxypregnenolone CPT 84143 | $183.60 | $306.00 | not published | 0 |
| 17-ketosteroids CPT 83586 | $117.00 | $195.00 | not published | 0 |
| 2nd order venous cath CPT 36012 | $384.60 | $641.00 | not published | 0 |
| 3-d radiotherapy plan CPT 77295 | $8,104.80 | $13,508.00 | not published | 0 |
| 3d recon without postprocess indpndt CPT 76376 | $364.20 | $607.00 | not published | 0 |
| 5' nucleotidase - sendout CPT 83915 | $88.80 | $148.00 | not published | 0 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $101.40 | $169.00 | not published | 0 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $5,998.50 | $9,997.50 | not published | 0 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $102.60 | $171.00 | not published | 0 |
| Abd aorta w/runoff s&i CPT 75630 | $6,830.40 | $11,384.00 | not published | 0 |
| Abd/low ext cath 1st CPT 36245 | $3,381.00 | $5,635.00 | not published | 0 |
| Abd/low ext cath 2nd CPT 36246 | $2,199.60 | $3,666.00 | not published | 0 |
| Abd/low ext cath 3rd CPT 36247 | $4,798.20 | $7,997.00 | not published | 0 |
| Abd/low ext cath addl CPT 36248 | $851.40 | $1,419.00 | not published | 0 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,158.20 | $3,597.00 | not published | 0 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,897.80 | $3,163.00 | not published | 0 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,636.80 | $2,728.00 | not published | 0 |
| Abdominal pad HCPCS L1270 | $722.01 | $1,203.35 | not published | 0 |
| Abdominal paracentesis w/image guidance CPT 49083 | $2,116.80 | $3,528.00 | not published | 0 |
| Abdominoplasty 15830 CPT 15830 | $35,681.22 | $59,468.70 | $6,583.32 – $6,583.32 | 1 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,293.60 | $2,156.00 | not published | 0 |
| Abduct control hip semi-flex HCPCS L1630 | $1,840.34 | $3,067.24 | not published | 0 |
| Abduction bar jointed adjust HCPCS L2300 | $2,193.09 | $3,655.15 | not published | 0 |
| Abduction rotation bar shoe HCPCS L3140 | $775.54 | $1,292.56 | not published | 0 |
| Abduct rotation bar without shoe HCPCS L3150 | $709.16 | $1,181.94 | not published | 0 |
| Abl1 gene CPT 81170 | $970.20 | $1,617.00 | not published | 0 |
| Ablate bone tumor(s) perq CPT 20982 | $15,314.40 | $25,524.00 | not published | 0 |
| Ablate inf turbinate submuc 30802 CPT 30802 | $47,125.19 | $78,541.98 | $3,287.07 – $3,352.82 | 4 |
| Ablate inf turbinate superf 30801 CPT 30801 | $36,252.65 | $60,421.08 | $1,538.30 – $5,986.53 | 4 |
| Ablate pulm tumor perq rf CPT 32998 | $8,028.00 | $13,380.00 | not published | 0 |
| Ablation of upper extremity nerves rf CPT 64999 | $106,185.43 | $176,975.72 | $3,243.99 – $3,308.87 | 4 |
| Abscess drain retroperitoneal surg code CPT 49406 | $3,403.20 | $5,672.00 | not published | 0 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $985.80 | $1,643.00 | not published | 0 |
| Acetaminophen level CPT 80143 | $137.40 | $229.00 | not published | 0 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $368.58 | $614.30 | not published | 0 |
| Acetone qualitative CPT 82009 | $36.60 | $61.00 | not published | 0 |
| Acetylcholine receptor modulating antibody CPT 86043 | $61.80 | $103.00 | not published | 0 |
| Acetylcholinesterase assay CPT 82013 | $91.80 | $153.00 | not published | 0 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $39.72 | $66.20 | not published | 0 |
| Acetylcysteine non-comp unit HCPCS J7608 | $31.68 | $52.80 | not published | 0 |
| Acute hepatitis panel CPT 80074 | $732.00 | $1,220.00 | not published | 0 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $245.70 | $409.50 | not published | 0 |
| #acylcarnitineprfl CPT 82017 | $402.00 | $670.00 | not published | 0 |
| Adapter b 8 channel 10cm HCPCS C1883 | $13,517.26 | $22,528.77 | not published | 0 |
| Add le poly knee custom kafo HCPCS L2387 | $1,662.96 | $2,771.60 | not published | 0 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $64.08 | $106.80 | not published | 0 |
| Adenovirus ag ia CPT 87301 | $34.20 | $57.00 | not published | 0 |
| Adenovirus antibody,serum - quest CPT 86603 | $89.40 | $149.00 | not published | 0 |
| Adh-sendout CPT 84588 | $140.40 | $234.00 | not published | 0 |
| Adj gastric band via subq port CPT 43999 | $17,925.06 | $29,875.10 | $899.22 – $899.22 | 3 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $17,496.72 | $29,161.20 | $2,045.62 – $2,086.53 | 4 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $861.30 | $1,435.50 | not published | 0 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $428.40 | $714.00 | not published | 0 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $363.00 | $605.00 | not published | 0 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $419.40 | $699.00 | not published | 0 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $649.80 | $1,083.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $241.80 | $403.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $241.80 | $403.00 | not published | 0 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $25,469.82 | $42,449.70 | not published | 0 |
| _afb id by dna probe rflx ast CPT 87149 | $162.00 | $270.00 | not published | 0 |
| #afb mycobacteria suscep. #1 CPT 87190 | $86.40 | $144.00 | not published | 0 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $180.60 | $301.00 | not published | 0 |
| Afo molded ankle gauntlet HCPCS L1904 | $3,931.99 | $6,553.32 | not published | 0 |
| Afo molded plas rig ant tib HCPCS L1945 | $7,320.91 | $12,201.52 | not published | 0 |
| Afo molded to patient plasti HCPCS L1940 | $3,754.31 | $6,257.19 | not published | 0 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | $6,340.21 | $10,567.01 | not published | 0 |
| Afo sing bar clasp attach sh HCPCS L1910 | $2,443.04 | $4,071.73 | not published | 0 |
| Afo sing solid stirrup calf HCPCS L1980 | $3,517.31 | $5,862.19 | not published | 0 |
| Afo sing upright with adjust s HCPCS L1920 | $3,578.66 | $5,964.44 | not published | 0 |
| Afo spiral molded to pt plas HCPCS L1950 | $5,464.31 | $9,107.18 | not published | 0 |
| Afo sprng wir drsflx calf bd HCPCS L1900 | $2,485.36 | $4,142.26 | not published | 0 |
| Afo supramalleolar custom HCPCS L1907 | $3,998.17 | $6,663.62 | not published | 0 |
| Afo tib fx cast plaster mold HCPCS L2106 | $5,600.40 | $9,334.00 | not published | 0 |
| Afo tibial fracture rigid HCPCS L2116 | $5,476.36 | $9,127.27 | not published | 0 |
| Afo tibial fracture soft HCPCS L2112 | $4,394.88 | $7,324.80 | not published | 0 |
| Afo, walk boot type, cus fab HCPCS L4631 | $6,419.11 | $10,698.51 | not published | 0 |
| Afo w/ankle joint, prefab HCPCS L1971 | $4,539.08 | $7,565.13 | not published | 0 |
| Air injection into abdomen 49400 CPT 49400 | $579.60 | $966.00 | not published | 0 |
| Ak/knee disartic pelvic band HCPCS L5697 | $683.17 | $1,138.62 | not published | 0 |
| Ak/knee disartic silesian ba HCPCS L5698 | $849.64 | $1,416.07 | not published | 0 |
| Ak sleeve susp neoprene/equa HCPCS L5695 | $1,539.19 | $2,565.32 | not published | 0 |
| Albumin body fluid quantitative each specimen CPT 82042 | $55.20 | $92.00 | not published | 0 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $1,053.00 | $1,755.00 | not published | 0 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $1,053.00 | $1,755.00 | not published | 0 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $544.08 | $906.80 | not published | 0 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $67.80 | $113.00 | not published | 0 |
| Albumin serum plasma or whole blood CPT 82040 | $27.60 | $46.00 | not published | 0 |
| Albuterol ipratrop non-comp HCPCS J7620 | $4.80 | $8.00 | not published | 0 |
| Albuterol non-comp con HCPCS J7611 | $4.80 | $8.00 | not published | 0 |
| Albuterol non-comp unit HCPCS J7613 | $4.80 | $8.00 | not published | 0 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $146.40 | $244.00 | not published | 0 |
| Alkaline phosphatase CPT 84075 | $27.60 | $46.00 | not published | 0 |
| Allergen alpha lactalbumin ige CPT 86008 | $34.20 | $57.00 | not published | 0 |
| Allergen egg white ige CPT 86003 | $37.20 | $62.00 | not published | 0 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $11.40 | $19.00 | not published | 0 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $11,302.84 | $18,838.07 | not published | 0 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $17,562.28 | $29,270.46 | not published | 0 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $22,037.44 | $36,729.07 | not published | 0 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $16,894.85 | $28,158.09 | 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.