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 |
|---|---|---|---|---|
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,240.90 | $4,986.00 | $333.12 – $346.44 | 3 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,946.45 | $4,533.00 | $227.83 – $236.94 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $396.50 | $610.00 | $99.82 – $103.82 | 3 |
| Lower jaw bone graft CPT 21215 | not published | not published | $5,652.51 – $5,878.61 | 3 |
| Low frequency non-thermal Ultrasound CPT 97610 | $524.55 | $807.00 | $191.57 – $199.24 | 3 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $15.90 – $97.50 | 4 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $10,149.82 – $10,555.81 | 3 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $10,149.82 – $10,555.81 | 3 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $10,149.82 – $10,555.81 | 3 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $10,149.82 – $10,555.81 | 3 |
| Lso flex no ri stays pre ots HCPCS L0628 | $45.26 | $69.63 | not published | 0 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $335.43 | $516.05 | not published | 0 |
| Lso s/c shell/panel prefab HCPCS L0639 | $1,999.93 | $3,076.82 | not published | 0 |
| L/s ratio fetal lung CPT 83661 | $475.80 | $732.00 | $21.99 – $22.87 | 3 |
| Lumbar diskogram s&i CPT 72295 | $2,373.80 | $3,652.00 | $1,864.55 – $1,939.13 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $16,742.04 – $17,411.72 | 3 |
| Lumizyme injection HCPCS J0221 | not published | not published | $206.59 – $1,310.66 | 4 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $56.33 – $58.58 | 3 |
| Lung Function Test (Spirometry) CPT 94010 | $246.35 | $379.00 | $206.17 – $214.42 | 3 |
| Lung perfusion imaging CPT 78580 | $825.50 | $1,270.00 | $381.72 – $396.99 | 3 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $22,297.54 | $34,303.90 | $207.13 – $1,331.85 | 4 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $40,040.94 | $61,601.45 | $41.98 – $268.32 | 4 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $316.99 – $1,907.43 | 4 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $255.84 – $1,545.90 | 4 |
| Lvad shower bag heartmate HCPCS Q0501 | $563.71 | $867.24 | not published | 0 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $27.62 – $28.72 | 3 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $20.85 | 3 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $7,804.30 – $8,116.47 | 3 |
| Lymphatics/lymph node imaging CPT 78195 | $1,275.30 | $1,962.00 | $518.45 – $539.19 | 3 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $38.02 | 3 |
| Lymphocyte transformation mitogen CPT 86353 | $577.85 | $889.00 | $49.03 – $50.99 | 3 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $189.51 – $197.09 | 3 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $49.49 | 3 |
| Lymph vessel x-ray arm/leg CPT 75801 | $2,785.90 | $4,286.00 | $598.98 – $622.93 | 3 |
| Lymph vessel x-ray arms/legs CPT 75803 | $3,998.15 | $6,151.00 | $1,503.07 – $1,563.19 | 3 |
| Lymph vessel x-ray trunk CPT 75805 | $8,139.95 | $12,523.00 | $3,014.90 – $3,135.49 | 3 |
| Lymph vessel x-ray trunk CPT 75807 | $8,139.95 | $12,523.00 | $3,014.90 – $3,135.49 | 3 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $514.97 – $535.57 | 3 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $3,090.95 – $3,214.58 | 3 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $1,995.99 – $2,075.83 | 3 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $25.96 – $100.62 | 2 |
| Macroscopic exam arthropod CPT 87168 | $92.30 | $142.00 | $4.27 – $4.44 | 3 |
| Macroscopic exam parasite CPT 87169 | $81.90 | $126.00 | $4.31 – $4.48 | 3 |
| Magnesium CPT 83735 | $51.35 | $79.00 | $6.70 – $6.97 | 3 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $51.80 | $79.70 | $0.85 – $3.19 | 2 |
| Magnetic image bone marrow CPT 77084 | $1,840.80 | $2,832.00 | $227.83 – $236.94 | 3 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $127.73 – $127.73 | 1 |
| Malaria antibody CPT 86750 | $32.50 | $50.00 | $13.19 – $13.72 | 3 |
| Male sling procedure CPT 53440 | not published | not published | $12,597.68 – $13,101.59 | 3 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $1,535.38 – $1,596.79 | 3 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,535.38 – $1,596.79 | 3 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $163.15 | $251.00 | $127.04 – $132.12 | 3 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $163.15 | $251.00 | $127.04 – $132.12 | 3 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,535.38 – $1,596.79 | 3 |
| Manipulation of spine CPT 22505 | not published | not published | $1,535.38 – $1,596.79 | 3 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $235.53 – $244.95 | 3 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $3.80 – $16.51 | 2 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $42.77 – $42.77 | 1 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $5.07 – $5.27 | 3 |
| Map tachycard site(s) CPT 93609 | $6,898.45 | $10,613.00 | not published | 0 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $52.49 – $321.10 | 4 |
| Marker biop eviva buckle ss HCPCS A4648 | $202.33 | $311.27 | not published | 0 |
| Mastectomy form HCPCS L8020 | $71.88 | $110.58 | not published | 0 |
| Mastectomy partial CPT 19301 | not published | not published | $3,738.62 – $3,888.17 | 3 |
| Mast mod rad CPT 19307 | not published | not published | $6,340.32 – $6,593.93 | 3 |
| Mastoidectomy CPT 69501 | not published | not published | $5,652.51 – $5,878.61 | 3 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $5,652.51 – $5,878.61 | 3 |
| Mastoids complete CPT 70130 | $1,162.20 | $1,788.00 | $99.82 – $103.82 | 3 |
| Mastoid surgery revision CPT 69603 | not published | not published | $5,652.51 – $5,878.61 | 3 |
| Mastopexy CPT 19316 | not published | not published | $6,340.32 – $6,593.93 | 3 |
| Mast simple complete CPT 19303 | not published | not published | $6,340.32 – $6,593.93 | 3 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $118.83 – $123.58 | 3 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $35.44 – $123.58 | 3 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $35.09 – $36.49 | 3 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $27.29 – $28.38 | 3 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $42.84 – $44.55 | 3 |
| Maxillofacial fixation CPT 21100 | not published | not published | $5,652.51 – $5,878.61 | 3 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $70.85 | $109.00 | $14.46 – $15.04 | 3 |
| Mayo aathr protein s free CPT 85306 | $414.70 | $638.00 | $15.32 – $15.93 | 3 |
| Mayo activated protein c resistance assay CPT 85307 | $100.75 | $155.00 | $15.32 – $15.93 | 3 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $491.40 | $756.00 | $38.57 – $40.11 | 3 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $163.80 | $252.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $76.70 | $118.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $54.60 | $84.00 | $14.78 – $15.37 | 3 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $313.30 | $482.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $76.70 | $118.00 | $13.44 – $13.98 | 3 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $61.10 | $94.00 | $15.08 – $15.68 | 3 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $48.10 | $74.00 | not published | 0 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $63.05 | $97.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $585.00 | $900.00 | $121.63 – $126.50 | 3 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $487.50 | $750.00 | $91.66 – $95.33 | 3 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $780.00 | $1,200.00 | $137.00 – $142.48 | 3 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $5,796.70 | $8,918.00 | $1,160.00 – $1,206.40 | 3 |
| Mayo androstenedione CPT 82157 | $51.35 | $79.00 | $29.28 – $30.45 | 3 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $52.00 | $80.00 | $14.60 – $15.18 | 3 |
| Mayo antithrombin iii antigen CPT 85301 | $62.40 | $96.00 | $10.81 – $11.24 | 3 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $70.20 | $108.00 | $15.05 – $15.65 | 3 |
| Mayo avwpr vw factor activity CPT 85397 | $728.65 | $1,121.00 | $30.86 – $32.09 | 3 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $107.25 | $165.00 | $35.09 – $36.49 | 3 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $100.75 | $155.00 | 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.