Shelby Hospital
199 West Main Street, Shelby, OH · OhioHealth · · NPI 1487706016
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 |
|---|---|---|---|---|
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $46.80 | $72.00 | not published | 0 |
| Ghs protoporphyrins fract CPT 84202 | $296.40 | $456.00 | not published | 0 |
| Ghs pr without cont pulse ox CPT 94625 | $143.00 | $220.00 | not published | 0 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $101.40 | $156.00 | not published | 0 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $128.05 | $197.00 | not published | 0 |
| Ghs quinidine CPT 80194 | $81.90 | $126.00 | not published | 0 |
| Ghs refill of implantable pump CPT 95990 | $798.85 | $1,229.00 | not published | 0 |
| Ghs removal intranasal foreign body CPT 30300 | $200.85 | $309.00 | not published | 0 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $52.65 | $81.00 | not published | 0 |
| Ghs semen analysis fert CPT 89320 | $121.55 | $187.00 | not published | 0 |
| Ghs sleep study unattended CPT 95800 | $1,292.85 | $1,989.00 | not published | 0 |
| Ghs somatosensory testing lower extremit CPT 95926 | $1,211.60 | $1,864.00 | not published | 0 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $2,453.75 | $3,775.00 | not published | 0 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $100.10 | $154.00 | not published | 0 |
| Ghs sphenopalatine ganglion block CPT 64505 | $492.70 | $758.00 | not published | 0 |
| Ghs spont nystagmus CPT 92541 | $197.60 | $304.00 | not published | 0 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $254.15 | $391.00 | not published | 0 |
| Ghs st - re-eval for alt comm CPT 92597 | $193.70 | $298.00 | not published | 0 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $221.00 | $340.00 | not published | 0 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $443.30 | $682.00 | not published | 0 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,324.70 | $2,038.00 | not published | 0 |
| Ghs urine, porphyrins quant CPT 84120 | $261.30 | $402.00 | not published | 0 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $5,276.70 | $8,118.00 | not published | 0 |
| Giardia lamblia antibody CPT 86674 | $148.85 | $229.00 | not published | 0 |
| Gi inhouse confirmation CPT 87045 | $87.75 | $135.00 | not published | 0 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $2,471.30 | $3,802.00 | not published | 0 |
| Gi trc img intral colon i&r CPT 91113 | $2,284.10 | $3,514.00 | not published | 0 |
| Gjb2 gene full sequence CPT 81252 | $837.20 | $1,288.00 | not published | 0 |
| Gjb2 gene known fam variants CPT 81253 | $633.10 | $974.00 | not published | 0 |
| Gjb6 gene com variants CPT 81254 | $669.50 | $1,030.00 | not published | 0 |
| Glassia injection HCPCS J0257 | not published | not published | $9.71 – $35.82 | 2 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $332.84 – $1,197.17 | 2 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $393.28 | $605.05 | $246.30 – $727.42 | 2 |
| Glucagon plasma - sendout CPT 82943 | $81.90 | $126.00 | not published | 0 |
| Glucose 1 hr post dose CPT 82950 | $16.25 | $25.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $9.75 | $15.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $47.45 | $73.00 | not published | 0 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $35.10 | $54.00 | not published | 0 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $35.10 | $54.00 | not published | 0 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $28.89 | $44.45 | $0.74 – $3.77 | 2 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $6,354.72 | $9,776.50 | $18.75 – $68.51 | 2 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $39.00 | $60.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $195.00 | $300.00 | not published | 0 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $2,889.66 | $4,445.63 | $1,248.06 – $4,569.89 | 2 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $60.56 | $93.17 | $51.52 – $51.52 | 1 |
| Graft axiofill 1000mg HCPCS J3590 | $83.99 | $129.22 | not published | 0 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $2,023.75 – $2,023.75 | 1 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $514.46 | $791.47 | $112.74 – $112.74 | 1 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $86.87 | $133.65 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $1,811.36 | $2,786.70 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $1,494.91 | $2,299.86 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $111.19 – $111.19 | 1 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $579.01 | $890.79 | $167.52 – $167.52 | 1 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $636.25 | $978.85 | $231.50 – $231.50 | 1 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $349.41 | $537.55 | $83.05 – $83.05 | 1 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $69.26 | $106.56 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $636.25 | $978.85 | $151.61 – $151.61 | 1 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $1,532.68 | $2,357.97 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $2,255.17 | $3,469.49 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $19.50 – $19.50 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.38 – $1.50 | 2 |
| Granulocyte pheresis ea unit HCPCS P9050 | $6,425.25 | $9,885.00 | not published | 0 |
| G-tube reposition CPT 43761 | $910.00 | $1,400.00 | not published | 0 |
| Gu dilat ureter/urethra s&i CPT 74485 | $4,607.20 | $7,088.00 | not published | 0 |
| Guided cath fluid drainage 10030 CPT 10030 | $495.30 | $762.00 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $161.61 | $248.63 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $86.77 | $133.49 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $1,296.75 | $1,995.00 | not published | 0 |
| Gw stiffened micro access kit HCPCS C1894 | $1,176.67 | $1,810.26 | not published | 0 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $92.41 | $142.17 | $7.96 – $36.08 | 2 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $24.41 | $37.55 | $1.42 – $7.87 | 2 |
| Hand X-ray CPT 73130 | $587.60 | $904.00 | not published | 0 |
| Haptoglobin quantitative CPT 83010 | $57.85 | $89.00 | not published | 0 |
| Harvest stem cell concentrte CPT 38215 | $1,355.25 | $2,085.00 | not published | 0 |
| Hast w/i&r phys/qhp CPT 94452 | $406.25 | $625.00 | not published | 0 |
| Hast w/oxygen titrate CPT 94453 | $406.25 | $625.00 | not published | 0 |
| Hba1/hba2 full gene sequence CPT 81259 | $990.60 | $1,524.00 | not published | 0 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $633.75 | $975.00 | not published | 0 |
| Hba1/hba2 gene fam vrnt CPT 81258 | $633.10 | $974.00 | not published | 0 |
| Hbb full gene sequence CPT 81364 | $696.15 | $1,071.00 | not published | 0 |
| Hbb gene dup/del variants CPT 81363 | $682.50 | $1,050.00 | not published | 0 |
| Hbb gene known fam variant CPT 81362 | $633.10 | $974.00 | not published | 0 |
| Hbot, full body chamber, 30m HCPCS G0277 | $687.70 | $1,058.00 | not published | 0 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $580.45 | $893.00 | not published | 0 |
| Hcg qualitative CPT 84703 | $30.55 | $47.00 | not published | 0 |
| Hcg quantitative CPT 84702 | $384.15 | $591.00 | not published | 0 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | $1,513.85 | $2,329.00 | not published | 0 |
| Hc nm kidney imaging with flow CPT 78701 | $1,420.25 | $2,185.00 | not published | 0 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $1,327.95 | $2,043.00 | not published | 0 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $373.75 | $575.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $9,842.30 | $15,142.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $9,842.30 | $15,142.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $9,842.30 | $15,142.00 | not published | 0 |
| Head CT scan (with and without contrast) CPT 70470 | $1,654.25 | $2,545.00 | not published | 0 |
| Head CT scan (with contrast) CPT 70460 | $1,370.20 | $2,108.00 | not published | 0 |
| Head CT scan (without contrast) CPT 70450 | $1,085.50 | $1,670.00 | not published | 0 |
| Heart image spect CPT 78494 | $1,352.65 | $2,081.00 | not published | 0 |
| Heart infarct image CPT 78466 | $1,231.75 | $1,895.00 | not published | 0 |
| Heart infarct image (ef) CPT 78468 | $1,327.95 | $2,043.00 | not published | 0 |
| Heinz bodies direct CPT 85441 | $38.35 | $59.00 | 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.