St Anne Hospital
3404 W. Sylvania Avenue, Toledo, OH · Mercy · · NPI 1467493551
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 |
|---|---|---|---|---|
| Liver Function Test CPT 80076 | $146.40 | $244.00 | not published | 0 |
| Liver imaging CPT 78201 | $2,098.20 | $3,497.00 | not published | 0 |
| Liver imag w/vasclr flow CPT 78202 | $2,098.20 | $3,497.00 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $2,976.00 | $4,960.00 | not published | 0 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $2,800.20 | $4,667.00 | not published | 0 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $71,119.07 | $118,531.78 | $3,178.60 – $3,242.17 | 4 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $36.00 | $60.00 | not published | 0 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $412.56 | $687.60 | not published | 0 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | $469.69 | $782.82 | not published | 0 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $193.02 | $321.70 | not published | 0 |
| Low back disk surgery CPT 63030 | $69,778.95 | $116,298.25 | $7,049.09 – $7,190.07 | 4 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,335.40 | $5,559.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $3,095.40 | $5,159.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,529.00 | $4,215.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,807.80 | $8,013.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $657.60 | $1,096.00 | not published | 0 |
| Lso corset front HCPCS L0972 | $286.57 | $477.62 | not published | 0 |
| Lso flex no ri stays pre ots HCPCS L0628 | $309.64 | $516.07 | not published | 0 |
| Lso full corset HCPCS L0976 | $407.09 | $678.49 | not published | 0 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $462.02 | $770.03 | not published | 0 |
| Lso sag-coronal panel custom HCPCS L0638 | $4,568.87 | $7,614.78 | not published | 0 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | $3,527.30 | $5,878.83 | not published | 0 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | $441.00 | $735.00 | not published | 0 |
| Lso sagit rigid panel prefab HCPCS L0635 | $2,720.60 | $4,534.34 | not published | 0 |
| Lso sagittal rigid panel cus HCPCS L0636 | $3,691.42 | $6,152.37 | not published | 0 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $710.21 | $1,183.69 | not published | 0 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | $780.76 | $1,301.26 | not published | 0 |
| Lso s/c shell/panel custom HCPCS L0640 | $2,591.60 | $4,319.34 | not published | 0 |
| L/s ratio fetal lung CPT 83661 | $244.80 | $408.00 | not published | 0 |
| Lumbar bolster pad HCPCS L1030 | $213.19 | $355.32 | not published | 0 |
| Lumbar derotation pad HCPCS L1240 | $247.62 | $412.70 | not published | 0 |
| Lumbar diskogram s&i CPT 72295 | $5,316.60 | $8,861.00 | not published | 0 |
| Lumbar or lumbar rib pad HCPCS L1040 | $241.40 | $402.33 | not published | 0 |
| Lumbar sling HCPCS L1090 | $273.98 | $456.64 | not published | 0 |
| Lumbar Spinal Fusion (single level) CPT 22612 | $109,403.05 | $182,338.42 | $17,033.32 – $17,373.98 | 3 |
| Lung perfusion imaging CPT 78580 | $2,178.60 | $3,631.00 | not published | 0 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $70,290.00 | $117,150.00 | not published | 0 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $35,043.96 | $58,406.60 | not published | 0 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $30,999.00 | $51,665.00 | not published | 0 |
| Lvad shower bag heartmate HCPCS Q0501 | $905.92 | $1,509.87 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $3,144.00 | $5,240.00 | not published | 0 |
| Lymphocyte culture mixed CPT 86821 | $60.00 | $100.00 | not published | 0 |
| Lymphocyte transformation mitogen CPT 86353 | $252.00 | $420.00 | not published | 0 |
| Lymph vessel x-ray arm/leg CPT 75801 | $1,137.60 | $1,896.00 | not published | 0 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,537.80 | $2,563.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75805 | $5,172.60 | $8,621.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75807 | $2,313.60 | $3,856.00 | not published | 0 |
| Macroscopic exam arthropod CPT 87168 | $48.00 | $80.00 | not published | 0 |
| Macroscopic exam parasite CPT 87169 | $80.40 | $134.00 | not published | 0 |
| Magnesium CPT 83735 | $130.20 | $217.00 | not published | 0 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $233.64 | $389.40 | not published | 0 |
| Malaria antibody CPT 86750 | $94.80 | $158.00 | not published | 0 |
| Mammosite ced HCPCS C1728 | $9,134.71 | $15,224.52 | not published | 0 |
| Manipulate finger w/anesth CPT 26340 | $29,366.56 | $48,944.27 | $1,562.09 – $1,593.33 | 4 |
| Manipulate wrist w/anesthes CPT 25259 | $28,775.26 | $47,958.77 | $1,562.09 – $1,593.33 | 4 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $229.80 | $383.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $585.00 | $975.00 | not published | 0 |
| Man's shoe oxford brace HCPCS L3225 | $200.96 | $334.94 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $177,408.15 | $295,680.25 | $6,450.62 – $6,579.64 | 4 |
| Map tachycard site(s) CPT 93609 | $3,734.40 | $6,224.00 | not published | 0 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $22,779.78 | $37,966.30 | not published | 0 |
| Marker biop eviva buckle ss HCPCS A4648 | $17,061.53 | $28,435.89 | not published | 0 |
| Mastectomy partial CPT 19301 | $66,577.74 | $110,962.90 | $3,803.67 – $3,879.74 | 4 |
| Mastoids complete CPT 70130 | $598.80 | $998.00 | not published | 0 |
| Mastopexy CPT 19316 | $64,958.94 | $108,264.90 | $6,450.62 – $7,940.08 | 3 |
| Mast simple complete CPT 19303 | $137,046.80 | $228,411.33 | $6,450.62 – $6,579.64 | 4 |
| Matrion 1 sq cm HCPCS Q4201 | $23,357.69 | $38,929.48 | not published | 0 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $98,111.35 | $163,518.92 | not published | 0 |
| M.avium-intra dna amp prob CPT 87561 | $99.60 | $166.00 | not published | 0 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $145.20 | $242.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $192.00 | $320.00 | not published | 0 |
| Mayo activated protein c resistance assay CPT 85307 | $121.20 | $202.00 | not published | 0 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $148.80 | $248.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $148.20 | $247.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $246.00 | $410.00 | not published | 0 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $265.80 | $443.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $457.20 | $762.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $345.00 | $575.00 | not published | 0 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $595.20 | $992.00 | not published | 0 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $2,615.40 | $4,359.00 | not published | 0 |
| Mayo androstenedione CPT 82157 | $240.60 | $401.00 | not published | 0 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $213.60 | $356.00 | not published | 0 |
| Mayo antithrombin iii antigen CPT 85301 | $120.60 | $201.00 | not published | 0 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $122.40 | $204.00 | not published | 0 |
| Mayo avwpr vw factor activity CPT 85397 | $149.40 | $249.00 | not published | 0 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $93.00 | $155.00 | not published | 0 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $100.80 | $168.00 | not published | 0 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $543.60 | $906.00 | not published | 0 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $280.80 | $468.00 | not published | 0 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $122.40 | $204.00 | not published | 0 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $91.20 | $152.00 | not published | 0 |
| Mayo brcmg brucella antibody igm CPT 86622 | $100.80 | $168.00 | not published | 0 |
| Mayo c1 esterase inhibitor CPT 83883 | $176.40 | $294.00 | not published | 0 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $154.20 | $257.00 | not published | 0 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $92.40 | $154.00 | not published | 0 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $459.00 | $765.00 | not published | 0 |
| Mayo ceruloplasmin CPT 82390 | $183.60 | $306.00 | not published | 0 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $183.00 | $305.00 | not published | 0 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $133.20 | $222.00 | not published | 0 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $124.20 | $207.00 | 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.