Springfield Medical Center
100 Medical Center Dr., Springfield, OH · Mercy · · NPI 1144286402
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 |
|---|---|---|---|---|
| Ot evaluation low complexity patient/family CPT 97165 | $439.80 | $733.00 | not published | 0 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $465.00 | $775.00 | not published | 0 |
| Other immunoelectrophoresis CPT 86325 | $519.00 | $865.00 | not published | 0 |
| Oth resp proc, group HCPCS G0239 | $640.80 | $1,068.00 | not published | 0 |
| Oth resp proc, indiv HCPCS G0238 | $454.80 | $758.00 | not published | 0 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $123.00 | $205.00 | not published | 0 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $219.00 | $365.00 | not published | 0 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $162.60 | $271.00 | not published | 0 |
| Ot re-evaluation patient/family CPT 97168 | $254.40 | $424.00 | not published | 0 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $146.40 | $244.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $40.80 | $68.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $40.80 | $68.00 | not published | 0 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $174.00 | $290.00 | not published | 0 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $162.60 | $271.00 | not published | 0 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $162.60 | $271.00 | not published | 0 |
| Outrigger HCPCS L1080 | $123.81 | $206.35 | not published | 0 |
| Outrigger bil with vert extens HCPCS L1085 | $414.44 | $690.74 | not published | 0 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $157.68 | $262.80 | not published | 0 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $209.82 | $349.70 | not published | 0 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $65,474.29 | $109,123.82 | not published | 0 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $131.40 | $219.00 | not published | 0 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $6,228.60 | $10,381.00 | not published | 0 |
| Palingen or palingen xplus HCPCS Q4173 | $15,246.72 | $25,411.20 | not published | 0 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $0.06 | $0.10 | not published | 0 |
| Palonosetron hcl HCPCS J2469 | $192.00 | $320.00 | not published | 0 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $153.00 | $255.00 | not published | 0 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $28,566.12 | $47,610.20 | not published | 0 |
| Papaverin hcl injection HCPCS J2440 | $88.92 | $148.20 | not published | 0 |
| Parathormone (pth) intact CPT 83970 | $282.60 | $471.00 | not published | 0 |
| Parathyrd planar w/spect&ct CPT 78072 | $1,024.20 | $1,707.00 | not published | 0 |
| Parathyroid planar imaging CPT 78070 | $689.40 | $1,149.00 | not published | 0 |
| Parathyroid planar img w/tomo spect CPT 78071 | $883.80 | $1,473.00 | not published | 0 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $500.40 | $834.00 | not published | 0 |
| Partial removal of rib CPT 21600 | $59,437.54 | $99,062.57 | $8,423.67 – $8,423.67 | 1 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $11,494.09 | $19,156.81 | not published | 0 |
| Passy muir valve metal trach HCPCS L8501 | $1,053.60 | $1,756.00 | not published | 0 |
| Patten bottom HCPCS L2370 | $757.24 | $1,262.07 | not published | 0 |
| Pca3/klk3 antigen CPT 81313 | $873.00 | $1,455.00 | not published | 0 |
| Pdgfra gene CPT 81314 | $873.00 | $1,455.00 | not published | 0 |
| Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 | $54.11 | $90.19 | not published | 0 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $24,645.12 | $41,075.20 | not published | 0 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $16,032.00 | $26,720.00 | not published | 0 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $8,016.06 | $13,360.10 | not published | 0 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | $9,600.06 | $16,000.10 | not published | 0 |
| Pelv band/spread bar thigh c HCPCS L1640 | $1,120.07 | $1,866.78 | not published | 0 |
| Pelvic control band & belt b HCPCS L2640 | $743.50 | $1,239.16 | not published | 0 |
| Pelvic control band & belt u HCPCS L2630 | $547.83 | $913.05 | not published | 0 |
| Pelvic control hip heavy dut HCPCS L2620 | $591.53 | $985.88 | not published | 0 |
| Pelvic control pelvic sling HCPCS L2580 | $1,026.80 | $1,711.34 | not published | 0 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,926.60 | $3,211.00 | not published | 0 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,777.80 | $2,963.00 | not published | 0 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,579.80 | $2,633.00 | not published | 0 |
| Pelvic & hip control thigh c HCPCS L1680 | $2,512.27 | $4,187.12 | not published | 0 |
| Pelvic Ultrasound (complete) CPT 76856 | $1,073.40 | $1,789.00 | not published | 0 |
| Pelvic Ultrasound (limited) CPT 76857 | $435.60 | $726.00 | not published | 0 |
| Pelv & thor control gluteal HCPCS L2650 | $327.43 | $545.71 | not published | 0 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $23,713.86 | $39,523.10 | not published | 0 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $253.92 | $423.20 | not published | 0 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $2,903.88 | $4,839.80 | not published | 0 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $60.30 | $100.50 | not published | 0 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $31,123.99 | $51,873.31 | not published | 0 |
| Pentamidine 300 mg solution for injection HCPCS J2516 | $791.10 | $1,318.50 | not published | 0 |
| Pentamidine non-comp unit HCPCS J2545 | $791.10 | $1,318.50 | not published | 0 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | $11,634.00 | $19,390.00 | not published | 0 |
| Perc cryo ablate renal tum CPT 50593 | $10,371.00 | $17,285.00 | not published | 0 |
| Perc rf ablate renal tumor CPT 50592 | $6,384.60 | $10,641.00 | not published | 0 |
| Percut ablate liver rf CPT 47382 | $4,662.60 | $7,771.00 | not published | 0 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $1,525.20 | $2,542.00 | not published | 0 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,887.80 | $4,813.00 | not published | 0 |
| Peritoneogram rs&i CPT 74190 | $790.20 | $1,317.00 | not published | 0 |
| Perit-vens shunt pat tst CPT 78291 | $921.00 | $1,535.00 | not published | 0 |
| Permanent tear duct plug HCPCS A4263 | $301.79 | $502.98 | not published | 0 |
| Peroneal straps pair pre ots HCPCS L0980 | $40.44 | $67.40 | not published | 0 |
| Perq art m-thrombect &/nfs CPT 61645 | $6,524.40 | $10,874.00 | not published | 0 |
| Perq dev breast 1st strtctc CPT 19283 | $2,505.00 | $4,175.00 | not published | 0 |
| Pertussis ag if CPT 87265 | $135.00 | $225.00 | not published | 0 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $26,886.42 | $44,810.70 | not published | 0 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $252.05 | $420.09 | not published | 0 |
| Pet CT skull-mid thgh initial CPT 78815 | $7,822.20 | $13,037.00 | not published | 0 |
| Pet CT whole body initial CPT 78816 | $7,760.40 | $12,934.00 | not published | 0 |
| Pet fdg brain metoblic eval sb CPT 78608 | $5,263.80 | $8,773.00 | not published | 0 |
| Pet image full body CPT 78813 | $4,570.20 | $7,617.00 | not published | 0 |
| Pet image w/ct lmtd CPT 78814 | $8,151.60 | $13,586.00 | not published | 0 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $112,395.34 | $187,325.57 | not published | 0 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $52.80 | $88.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $78.00 | $130.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $27.00 | $45.00 | not published | 0 |
| Ph body fluid CPT 83986 | $86.40 | $144.00 | not published | 0 |
| Phencyclidine (pcp) CPT 83992 | $70.80 | $118.00 | not published | 0 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $162.12 | $270.20 | not published | 0 |
| Phenobarbital therapeutic drug level CPT 80184 | $126.00 | $210.00 | not published | 0 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $94.80 | $158.00 | not published | 0 |
| Phenytoin total therapeutic drug level CPT 80185 | $97.80 | $163.00 | not published | 0 |
| Phosphorus CPT 84100 | $52.20 | $87.00 | not published | 0 |
| Phosphorus 24 hour urine CPT 84105 | $68.40 | $114.00 | not published | 0 |
| Phys blood bank serv reactj CPT 86078 | $135.60 | $226.00 | not published | 0 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $46.44 | $77.40 | not published | 0 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | $747.30 | $1,245.50 | not published | 0 |
| Pik3ca gene trgt seq alys CPT 81309 | $463.20 | $772.00 | not published | 0 |
| Pillow shldr abduc inflat univ HCPCS L3960 | $1,717.48 | $2,862.46 | 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.