Mansfield Hospital
335 Glessner Avenue, Mansfield, OH · OhioHealth · · NPI 1790837235
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 |
|---|---|---|---|---|
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $546.00 | $840.00 | $68.75 – $71.50 | 3 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $570.70 | $878.00 | $68.75 – $71.50 | 3 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $1,126.45 | $1,733.00 | $315.39 – $328.01 | 3 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $648.05 | $997.00 | $315.39 – $328.01 | 3 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $325.00 | $500.00 | $68.75 – $71.50 | 3 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $325.00 | $500.00 | $68.75 – $71.50 | 3 |
| Administration immunization 1 vaccine CPT 90471 | $44.20 | $68.00 | $68.75 – $71.50 | 3 |
| Administration immunization each additional vaccine CPT 90472 | $21.45 | $33.00 | not published | 0 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $68.75 – $71.50 | 3 |
| Administration vaccine hepatitis b HCPCS G0010 | $35.75 | $55.00 | $44.71 – $46.50 | 3 |
| Administration vaccine influenza virus HCPCS G0008 | $35.75 | $55.00 | $44.71 – $46.50 | 3 |
| Administration vaccine pneumococcal HCPCS G0009 | $35.75 | $55.00 | $44.71 – $46.50 | 3 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $20.80 | $32.00 | not published | 0 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $17,264.68 | $26,561.05 | $42.16 – $266.31 | 4 |
| Adrenal cortex & medulla img CPT 78075 | $2,239.25 | $3,445.00 | $1,236.19 – $1,285.63 | 3 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $206.17 – $214.42 | 3 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $206.17 – $214.42 | 3 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $206.17 – $214.42 | 3 |
| _afb id by dna probe rflx ast CPT 87149 | $133.90 | $206.00 | $20.05 – $20.85 | 3 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $7.31 – $7.60 | 3 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $220.35 | $339.00 | $115.36 – $119.97 | 3 |
| Aflibercept injection HCPCS J0178 | not published | not published | $771.56 – $5,206.96 | 4 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $25,664.18 | $39,483.35 | $230.15 – $1,452.88 | 4 |
| Air conduction bilat CPT 92552 | $75.40 | $116.00 | $127.04 – $132.12 | 3 |
| Air injection into abdomen 49400 CPT 49400 | $2,207.40 | $3,396.00 | not published | 0 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $122.86 – $127.78 | 3 |
| Albumin body fluid quantitative each specimen CPT 82042 | $83.20 | $128.00 | $7.78 – $8.09 | 3 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $155.45 | $239.15 | $53.08 – $345.02 | 4 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.23 – $138.00 | 4 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $160.10 | $246.30 | $53.08 – $345.02 | 4 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $10.62 – $69.03 | 4 |
| Albumin ischemia modified CPT 82045 | not published | not published | $33.94 – $35.30 | 3 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $55.90 | $86.00 | $5.78 – $6.01 | 3 |
| Albumin serum plasma or whole blood CPT 82040 | $9.75 | $15.00 | $4.95 – $5.15 | 3 |
| Albuterol ipratrop non-comp HCPCS J7620 | not published | not published | $0.34 – $1.24 | 2 |
| Albuterol non-comp con HCPCS J7611 | not published | not published | $0.27 – $1.04 | 2 |
| Albuterol non-comp unit HCPCS J7613 | not published | not published | $0.13 – $0.46 | 2 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $137.15 | $211.00 | $17.27 – $17.96 | 3 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $27.62 – $28.72 | 3 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $3,338.87 – $36,084.56 | 4 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,429.89 – $15,686.84 | 4 |
| Alkaline phosphatase CPT 84075 | $9.75 | $15.00 | $5.18 – $5.39 | 3 |
| Allergen alpha lactalbumin ige CPT 86008 | $292.50 | $450.00 | $17.93 – $18.65 | 3 |
| Allergen egg white ige CPT 86003 | $54.60 | $84.00 | $5.22 – $5.43 | 3 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $7.97 – $8.29 | 3 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $44.71 – $46.50 | 3 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $44.71 – $46.50 | 3 |
| Allergy Skin Testing CPT 95004 | not published | not published | $819.96 – $852.76 | 3 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $819.96 – $852.76 | 3 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $12,258.92 – $12,749.28 | 3 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $302.32 | $465.11 | $118.83 – $123.58 | 3 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $118.83 – $123.58 | 3 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $5,098.58 | $7,843.97 | not published | 0 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | not published | not published | $52.19 – $123.58 | 3 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $547.07 | $841.65 | $118.83 – $123.58 | 3 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $156.98 | $241.51 | not published | 0 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | not published | not published | $118.83 – $123.58 | 3 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $478.27 | $735.80 | $118.83 – $123.58 | 3 |
| Alloskin HCPCS Q4115 | not published | not published | $24.61 – $123.58 | 3 |
| All tstg perq&iq drugs/biol CPT 95018 | $128.70 | $198.00 | $35.66 – $37.09 | 3 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $27.62 – $28.72 | 3 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $5.46 – $33.09 | 4 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $266.50 | $410.00 | $64.41 – $66.99 | 3 |
| Alpha-fetoprotein amniotic CPT 82106 | $77.35 | $119.00 | $17.00 – $17.68 | 3 |
| Alpha-fetoprotein tumor marker CPT 82105 | $68.90 | $106.00 | $16.77 – $17.44 | 3 |
| Alprostadil for injection HCPCS J0270 | $367.90 | $566.00 | $66.76 – $66.76 | 1 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $23,242.18 | $35,757.20 | $94.45 – $594.62 | 4 |
| Alt/sgpt CPT 84460 | $9.75 | $15.00 | $5.30 – $5.51 | 3 |
| Altuviiio per factor viii iu HCPCS J7214 | not published | not published | $4.66 – $30.16 | 4 |
| Aluminum - quest CPT 82108 | $86.45 | $133.00 | $25.48 – $26.50 | 3 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $3,165.74 – $3,292.37 | 3 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $1,367.60 | $2,104.00 | not published | 0 |
| Amantadine (symmetrel)-sendout CPT 80375 | $477.75 | $735.00 | not published | 0 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $127.04 – $132.12 | 3 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $28.63 | $44.05 | $1.05 – $3.51 | 2 |
| Amino acid screen, urine CPT 82128 | not published | not published | $13.87 – $14.42 | 3 |
| Amino acid single qual CPT 82127 | not published | not published | $14.18 – $14.75 | 3 |
| Amino acids quant 2-5 CPT 82136 | $159.90 | $246.00 | $19.61 – $20.39 | 3 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $42.84 | $65.90 | $2.54 – $2.54 | 1 |
| Aminolevulinic acid, 10% gel HCPCS J7345 | not published | not published | $1.79 – $11.18 | 4 |
| Aminolevulinic acid delta CPT 82135 | $141.70 | $218.00 | $16.45 – $17.11 | 3 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $392.09 – $2,569.19 | 4 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $58.92 | $90.65 | $14.11 – $33.61 | 2 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $79.59 | $122.45 | $4.44 – $16.38 | 2 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $23.56 | $36.25 | $0.86 – $2.54 | 2 |
| Amitriptyline (elavil) -sendout CPT 80335 | $115.70 | $178.00 | not published | 0 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $10,317.19 | $15,872.60 | $22.54 – $140.14 | 4 |
| Ammonia CPT 82140 | $245.70 | $378.00 | $14.57 – $15.15 | 3 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $867.10 | $1,334.00 | not published | 0 |
| Amniocentesis therapeutic CPT 59001 | $910.00 | $1,400.00 | $290.97 – $302.61 | 3 |
| Amniotic fluid scan CPT 82143 | not published | not published | $9.35 – $9.72 | 3 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $3,124.25 – $3,249.22 | 3 |
| Amphetamine confirm urine -sendout CPT 80324 | $83.85 | $129.00 | not published | 0 |
| Amphetamines 5 or more CPT 80326 | $286.00 | $440.00 | not published | 0 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $135.78 | $208.90 | $58.01 – $325.46 | 2 |
| Amphotericin b lipid complex HCPCS J0287 | not published | not published | $10.30 – $68.25 | 4 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $268.58 | $413.20 | $21.48 – $155.87 | 4 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $35.72 | $54.95 | $0.83 – $4.62 | 2 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $30.22 | $46.50 | $2.54 – $10.66 | 2 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $262.99 – $273.51 | 3 |
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.