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 |
|---|---|---|---|---|
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $3,930.55 | $6,047.00 | not published | 0 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $1,726.40 | $2,656.00 | not published | 0 |
| Intubation endotracheal emergency procedure CPT 31500 | $643.50 | $990.00 | not published | 0 |
| Iodine i-123 sod iodide mil HCPCS A9509 | $421.85 | $649.00 | $0.07 – $0.07 | 1 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $3.65 | $5.61 | $0.76 – $2.67 | 2 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $15.57 | $23.95 | $0.26 – $0.91 | 2 |
| Ioxaglate 39.3%-19.6% inj 200 ml HCPCS Q9964 | not published | not published | $0.07 – $0.07 | 1 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $97,709.14 | $150,321.75 | $311.80 – $1,170.33 | 2 |
| Ipratropium bromide non-comp HCPCS J7644 | not published | not published | $0.67 – $2.41 | 2 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $90.97 | $139.95 | $2.37 – $12.81 | 2 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | not published | not published | $110.93 – $417.43 | 2 |
| Iron CPT 83540 | $98.15 | $151.00 | not published | 0 |
| Iron binding capacity CPT 83550 | $40.30 | $62.00 | not published | 0 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $55.81 | $85.86 | $30.64 – $113.10 | 2 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $128.44 | $197.60 | $0.38 – $1.50 | 2 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $252.20 | $388.00 | not published | 0 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $11,781.02 | $18,124.65 | $140.86 – $515.78 | 2 |
| Ivc venogram s&i CPT 75825 | $3,154.45 | $4,853.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $150.15 | $231.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $163.80 | $252.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $100.75 | $155.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $307.45 | $473.00 | not published | 0 |
| IV inj ra drug dx study CPT 78808 | $612.30 | $942.00 | not published | 0 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $713.05 | $1,097.00 | not published | 0 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $16,348.74 | $25,151.90 | $235.74 – $886.80 | 2 |
| Jak2 targeted sequence analysis CPT 81279 | $622.70 | $958.00 | not published | 0 |
| Jejunstmy tube plcmt CPT 44372 | $3,095.30 | $4,762.00 | not published | 0 |
| John cunningham antibody CPT 86711 | $3,677.70 | $5,658.00 | not published | 0 |
| Ketamine and metabolite screen - quest CPT 80357 | $729.95 | $1,123.00 | not published | 0 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $110.50 | $170.00 | not published | 0 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $22.85 | $35.15 | $0.59 – $4.88 | 2 |
| Kidney imaging morphology CPT 78700 | $1,420.25 | $2,185.00 | not published | 0 |
| Kidney imag w/bld flow multi CPT 78709 | $1,940.25 | $2,985.00 | not published | 0 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,539.85 | $2,369.00 | not published | 0 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $586.30 | $902.00 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $9,384.04 | $14,436.99 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | $967.20 | $1,488.00 | not published | 0 |
| Kit hfx iq ipg bundle HCPCS C1822 | $31,178.99 | $47,967.67 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $4,539.68 | $6,984.13 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,316.26 | $2,025.02 | not published | 0 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | not published | not published | $44.35 – $44.35 | 1 |
| Knee MRI (with and without contrast) CPT 73723 | $5,489.90 | $8,446.00 | not published | 0 |
| Knee MRI (with contrast) CPT 73722 | $4,989.40 | $7,676.00 | not published | 0 |
| Knee MRI (without contrast) CPT 73721 | $4,535.70 | $6,978.00 | not published | 0 |
| Knee X-ray CPT 73564 | $756.60 | $1,164.00 | not published | 0 |
| Kras gene addl variants CPT 81276 | $467.35 | $719.00 | not published | 0 |
| Kras gene variants exon 2 CPT 81275 | $2,273.70 | $3,498.00 | not published | 0 |
| Kyleena, 19.5 mg HCPCS J7296 | not published | not published | $7,895.10 – $7,895.10 | 1 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $42.38 | $65.20 | $0.66 – $1.89 | 2 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $0.49 | $0.75 | $1.30 – $1.30 | 1 |
| Lactate dehydrogenase (ldh) CPT 83615 | $29.90 | $46.00 | not published | 0 |
| Lactated ringers intravenous solution HCPCS J7120 | $44.45 | $68.38 | $4.19 – $15.67 | 2 |
| Lactic acid CPT 83605 | $128.70 | $198.00 | not published | 0 |
| Lactoferrin fecal qualitative CPT 83630 | $133.90 | $206.00 | not published | 0 |
| Lactoferrin fecal quant CPT 83631 | $459.55 | $707.00 | not published | 0 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $268.96 | $413.78 | $62.32 – $292.37 | 2 |
| Lanthanum carbonate oral 5mg HCPCS J0607 | not published | not published | $0.33 – $0.33 | 1 |
| Laronidase injection HCPCS J1931 | not published | not published | $67.80 – $251.03 | 2 |
| Laryngoscopy telescopic CPT 31579 | $970.45 | $1,493.00 | not published | 0 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $3,061.46 | $4,709.94 | not published | 0 |
| Lead capillary CPT 83655 | $9.10 | $14.00 | not published | 0 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $604.12 | $929.41 | not published | 0 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $5,282.77 | $8,127.34 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $920.40 | $1,416.00 | not published | 0 |
| Leishmania antibody CPT 86717 | $91.00 | $140.00 | not published | 0 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $91.55 | $140.85 | $6.71 – $27.04 | 2 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $2,852.85 | $4,389.00 | $264.21 – $1,175.14 | 2 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $4,799.28 | $7,383.50 | $2,953.06 – $10,834.07 | 2 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $375.26 – $1,529.32 | 2 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $87.39 – $363.42 | 2 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.15 – $0.59 | 2 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $95.68 | $147.20 | $0.08 – $0.33 | 2 |
| Levetiracetam therapeutic drug level CPT 80177 | $150.80 | $232.00 | not published | 0 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $53.72 | $82.65 | $3.33 – $12.29 | 2 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $274.85 | $422.85 | $13.09 – $35.04 | 2 |
| Liberta rc ipg HCPCS C1820 | $33,582.70 | $51,665.70 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $49.11 | $75.55 | $0.01 – $0.01 | 1 |
| Lidocaine therapeutic drug level CPT 80176 | $144.30 | $222.00 | not published | 0 |
| Lift heel adj small gl60404sm HCPCS L3332 | $16.64 | $25.60 | not published | 0 |
| Lift heel adjustable med HCPCS L3334 | $57.90 | $89.08 | not published | 0 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $2,447.90 | $3,766.00 | not published | 0 |
| Liletta, 52 mg HCPCS J7297 | not published | not published | $5,767.84 – $5,767.84 | 1 |
| Lincomycin injection HCPCS J2010 | not published | not published | $9.54 – $43.75 | 2 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $58.63 | $90.20 | $5.90 – $19.37 | 2 |
| Lipase CPT 83690 | $57.85 | $89.00 | not published | 0 |
| Lipoprotein blood high res frac & quant CPT 83701 | $144.95 | $223.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $79.30 | $122.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $39.00 | $60.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $48.10 | $74.00 | not published | 0 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $0.07 – $920,780.62 | 2 |
| Listeria monocytogenes CPT 86723 | $213.20 | $328.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $53.30 | $82.00 | not published | 0 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $1,950.00 | $3,000.00 | not published | 0 |
| Liver Function Test CPT 80076 | $24.05 | $37.00 | not published | 0 |
| Liver imaging CPT 78201 | $1,665.95 | $2,563.00 | not published | 0 |
| Liver imag w/vasclr flow CPT 78202 | $1,665.95 | $2,563.00 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $1,605.50 | $2,470.00 | not published | 0 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $6.76 | $10.40 | $3.06 – $7.80 | 2 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $555.33 | $854.36 | $368.46 – $1,378.78 | 2 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $23.76 | $36.55 | $2.24 – $8.78 | 2 |
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.