University Hospitals Portage Medical Center
6847 N. Chestnut Street, Ravenna OH 44266, OH · University Hospitals · · NPI 1043641897
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 |
|---|---|---|---|---|
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $3,342.87 – $6,017.17 | 16 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $3,342.87 – $6,017.17 | 16 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $1,222.56 – $2,200.61 | 16 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $3,387.27 – $6,097.09 | 16 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,897.50 | $2,530.00 | $1,687.37 – $3,037.27 | 17 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $1,002.77 – $1,804.99 | 16 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $935.49 – $1,683.89 | 16 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $617.43 – $1,111.38 | 16 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $1,454.22 – $2,617.60 | 16 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $1,585.19 – $2,853.34 | 16 |
| Drng salivary gland submax/subling 42310 CPT 42310 | $596.25 | $795.00 | $551.01 – $991.82 | 17 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $1,907.03 | $2,542.70 | $4.30 – $4.30 | 1 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | not published | not published | $13.80 – $34.58 | 2 |
| Drop lock knee HCPCS L2182 | not published | not published | $140.43 – $252.77 | 16 |
| Drop lock retainer each HCPCS L2785 | not published | not published | $36.42 – $65.56 | 16 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $1,956.48 | $2,608.64 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $31.87 – $228.85 | 16 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $530.83 | $707.76 | $30.12 – $228.85 | 17 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $983.03 | $1,310.70 | $6.38 – $228.85 | 17 |
| Drsg sht 5.625x4.625in std HCPCS A6025 | $639.00 | $852.00 | not published | 0 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | not published | not published | $15.59 – $28.06 | 16 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $127.14 – $228.85 | 16 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | not published | not published | $43.53 – $228.85 | 16 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $26,932.05 | $35,909.40 | $127.14 – $228.85 | 17 |
| Drsg wound/burn 18x10cm suprathel resorb cost per sq cm HCPCS A2012 | not published | not published | $127.14 – $228.85 | 16 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | $22,027.50 | $29,370.00 | $127.14 – $228.85 | 17 |
| Drug admin & hemodynmic meas CPT 93463 | $3,098.25 | $4,131.00 | $93.63 – $168.54 | 17 |
| Drug assay caffeine CPT 80155 | $59.25 | $79.00 | $7.72 – $69.43 | 17 |
| Drug assay posaconazole CPT 80187 | $186.00 | $248.00 | $27.11 – $48.80 | 17 |
| Drug assay rufinamide CPT 80210 | $135.75 | $181.00 | $27.11 – $48.80 | 17 |
| Drug assay vedolizumab CPT 80280 | $949.50 | $1,266.00 | $38.57 – $69.43 | 17 |
| Drug assay voriconazole CPT 80285 | $186.00 | $248.00 | $27.11 – $48.80 | 17 |
| Drug asy hydroxychloroquine CPT 80220 | $531.75 | $709.00 | $18.64 – $33.55 | 17 |
| Drug of abuse screen urine CPT 80305 | $63.75 | $85.00 | $12.60 – $22.68 | 17 |
| Drug screening tapentadol CPT 80372 | $50.25 | $67.00 | $0.03 – $25.87 | 3 |
| Drug screen quant tiagabine CPT 80199 | $260.25 | $347.00 | $9.85 – $48.80 | 17 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $0.03 – $0.03 | 1 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $198.74 – $357.73 | 16 |
| Drug test def 1-7 classes HCPCS G0480 | not published | not published | $114.43 – $205.97 | 16 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $246.92 – $444.46 | 16 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $156.59 – $281.86 | 16 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $62.14 – $111.85 | 16 |
| Drug test prsmv instrmnt CPT 80306 | not published | not published | $17.14 – $30.85 | 16 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $732.00 | $976.00 | $62.14 – $111.85 | 17 |
| Drvvt confirm - quest CPT 85597 | $255.75 | $341.00 | $9.23 – $32.36 | 17 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $4,016.55 – $7,229.79 | 16 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $1,746.75 | $2,329.00 | $1,995.02 – $3,591.04 | 17 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $415.32 – $747.58 | 16 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $415.32 – $747.58 | 16 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $755.08 – $1,359.14 | 16 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $755.08 – $1,359.14 | 16 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $561.91 – $1,011.44 | 16 |
| Ductogram sgl duct CPT 77053 | $515.25 | $687.00 | $243.77 – $438.79 | 17 |
| Duodenal exclusion CPT 48547 | not published | not published | $1,631.41 – $2,936.54 | 16 |
| Duodenal motility study CPT 91022 | $1,729.50 | $2,306.00 | $381.24 – $686.23 | 17 |
| Duplex scan bilateral study 93985 CPT 93985 | $657.75 | $877.00 | $243.77 – $438.79 | 17 |
| Duplex scan unilateral study 93986 CPT 93986 | $124.50 | $166.00 | $106.81 – $192.26 | 17 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $835.50 | $1,114.00 | $106.81 – $192.26 | 17 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $963.75 | $1,285.00 | $220.60 – $397.08 | 17 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $782.25 | $1,043.00 | $243.77 – $438.79 | 17 |
| Duragen 1x1 5ea/bx HCPCS C9354 | not published | not published | $67.83 – $67.83 | 1 |
| Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm HCPCS Q4432 | $23,482.80 | $31,310.40 | $127.14 – $228.85 | 17 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $86.15 – $155.06 | 16 |
| Dxa bone density axl vrt fx CPT 77085 | $591.75 | $789.00 | $96.82 – $192.26 | 17 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | $183.00 | $244.00 | $131.46 – $236.63 | 17 |
| Dx aly aud oi snd prcsr each CPT 92623 | $45.75 | $61.00 | $19.26 – $34.66 | 17 |
| Dx bronchoscope/brush 31623 CPT 31623 | $2,283.00 | $3,044.00 | $1,818.45 – $3,273.21 | 17 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $2,886.75 | $3,849.00 | $1,818.45 – $3,273.21 | 17 |
| Dx bronchoscope/wash 31622 CPT 31622 | $2,734.50 | $3,646.00 | $1,818.45 – $3,273.21 | 17 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $456.40 – $821.52 | 16 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $926.63 – $1,667.93 | 16 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $926.63 – $1,667.93 | 16 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $220.60 – $397.08 | 16 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $131.46 – $236.63 | 16 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $399.59 – $719.26 | 16 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $1,818.45 – $3,273.21 | 16 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $255.26 – $459.47 | 16 |
| Dynamic surface emg CPT 96002 | not published | not published | $220.60 – $397.08 | 16 |
| Ear and throat examination CPT 92502 | $579.00 | $772.00 | $551.01 – $991.82 | 17 |
| Ear canal biopsy 69105 CPT 69105 | $1,768.50 | $2,358.00 | $1,585.19 – $2,853.34 | 17 |
| Ear cartilage graft CPT 21235 | not published | not published | $6,048.05 – $10,886.49 | 16 |
| Ear irrigation 69209 CPT 69209 | $216.75 | $289.00 | $60.27 – $108.49 | 17 |
| Ear protector evaluation CPT 92596 | not published | not published | $38.16 – $68.69 | 16 |
| Ecallantide injection HCPCS J1290 | not published | not published | $578.75 – $1,041.74 | 16 |
| Ecg/1-3 leads/interp & report only 93042 CPT 93042 | not published | not published | $6.87 – $12.37 | 16 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | not published | not published | $60.27 – $108.49 | 16 |
| Ecg < 30 days transmission & analysis CPT 93271 | $624.75 | $833.00 | $97.13 – $174.83 | 17 |
| Ecg external < 48 hours recording CPT 93225 | $500.25 | $667.00 | $135.93 – $244.67 | 17 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $567.00 | $756.00 | $60.27 – $108.49 | 17 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $238.50 | $318.00 | $38.16 – $68.69 | 17 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $238.50 | $318.00 | $38.16 – $68.69 | 17 |
| Ecg record/review CPT 93268 | not published | not published | $156.52 – $281.74 | 16 |
| Ecg/review interpret only CPT 93272 | not published | not published | $23.20 – $41.75 | 16 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,126.25 | $2,835.00 | $558.25 – $1,004.85 | 17 |
| Echocardiogram (Limited Follow-Up Heart Ultrasound) CPT 93308 | $939.00 | $1,252.00 | $243.77 – $438.79 | 17 |
| Echocardiography doppler color flow mapping CPT 93325 | $407.25 | $543.00 | $21.85 – $39.34 | 17 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,126.25 | $2,835.00 | $800.90 – $1,441.62 | 17 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $939.00 | $1,252.00 | $356.43 – $641.57 | 17 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $350.25 | $467.00 | $23.64 – $42.56 | 17 |
| Echo exam of eye CPT 76516 | not published | not published | $60.70 – $192.26 | 16 |
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.