Urbana Hospital
904 Scioto St., Urbana, OH · Mercy · · NPI 1144286352
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $63.00 | $105.00 | not published | 0 |
| 17-hydroxypregnenolone CPT 84143 | $82.80 | $138.00 | not published | 0 |
| 17-ketosteroids CPT 83586 | $65.40 | $109.00 | not published | 0 |
| 3d ech img cgen car anomal CPT 93319 | $1,066.80 | $1,778.00 | not published | 0 |
| 3d recon without postprocess indpndt CPT 76376 | $70.20 | $117.00 | not published | 0 |
| 5' nucleotidase - sendout CPT 83915 | $63.00 | $105.00 | not published | 0 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $171.60 | $286.00 | not published | 0 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $65.40 | $109.00 | not published | 0 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,842.60 | $3,071.00 | not published | 0 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,700.40 | $2,834.00 | not published | 0 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,512.00 | $2,520.00 | not published | 0 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,306.60 | $5,511.00 | not published | 0 |
| Abdominal MRI (with contrast) CPT 74182 | $2,856.00 | $4,760.00 | not published | 0 |
| Abdominal MRI (without contrast) CPT 74181 | $2,605.20 | $4,342.00 | not published | 0 |
| Abdominal pad HCPCS L1270 | $196.11 | $326.85 | not published | 0 |
| Abdominal paracentesis w/image guidance CPT 49083 | $3,688.80 | $6,148.00 | not published | 0 |
| Abdominal Ultrasound (complete) CPT 76700 | $2,063.40 | $3,439.00 | not published | 0 |
| Abdominal Ultrasound (limited) CPT 76705 | $825.60 | $1,376.00 | not published | 0 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,374.60 | $2,291.00 | not published | 0 |
| Abduct control hip semi-flex HCPCS L1630 | $499.86 | $833.10 | not published | 0 |
| Abduction bar jointed adjust HCPCS L2300 | $595.67 | $992.79 | not published | 0 |
| Abduction rotation bar shoe HCPCS L3140 | $210.65 | $351.08 | not published | 0 |
| Abduct rotation bar without shoe HCPCS L3150 | $192.62 | $321.03 | not published | 0 |
| Abl1 gene CPT 81170 | $732.60 | $1,221.00 | not published | 0 |
| Ablate pulm tumor perq rf CPT 32998 | $4,102.80 | $6,838.00 | not published | 0 |
| Ablation cryo pq liver tumor(s) CPT 47383 | $4,161.00 | $6,935.00 | not published | 0 |
| Ablation of upper extremity nerves rf CPT 64999 | $2,077.80 | $3,463.00 | not published | 0 |
| Acetaminophen level CPT 80143 | $130.80 | $218.00 | not published | 0 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $172.74 | $287.90 | not published | 0 |
| Acetone qualitative CPT 82009 | $34.80 | $58.00 | not published | 0 |
| Acetylcholine receptor modulating antibody CPT 86043 | $61.80 | $103.00 | not published | 0 |
| Acetylcholinesterase assay CPT 82013 | $91.80 | $153.00 | not published | 0 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $23.22 | $38.70 | not published | 0 |
| Acetylcysteine non-comp unit HCPCS J7608 | $66.36 | $110.60 | not published | 0 |
| Acne surgery 10040 CPT 10040 | $377.40 | $629.00 | not published | 0 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $110.40 | $184.00 | not published | 0 |
| Acute hepatitis panel CPT 80074 | $294.60 | $491.00 | not published | 0 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $48.96 | $81.60 | not published | 0 |
| #acylcarnitineprfl CPT 82017 | $45.60 | $76.00 | not published | 0 |
| Adapter b 8 channel 10cm HCPCS C1883 | $10,034.36 | $16,723.94 | not published | 0 |
| Add le poly knee custom kafo HCPCS L2387 | $451.68 | $752.80 | not published | 0 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $10.92 | $18.20 | not published | 0 |
| Adenovirus antibody,serum - quest CPT 86603 | $86.40 | $144.00 | not published | 0 |
| Adh-sendout CPT 84588 | $292.80 | $488.00 | not published | 0 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $189.66 | $316.10 | not published | 0 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $278.40 | $464.00 | not published | 0 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $229.80 | $383.00 | not published | 0 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $373.20 | $622.00 | not published | 0 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $394.80 | $658.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $160.20 | $267.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $168.00 | $280.00 | not published | 0 |
| Administration immunization 1 vaccine CPT 90471 | $48.00 | $80.00 | not published | 0 |
| Administration immunization each additional vaccine CPT 90472 | $48.00 | $80.00 | not published | 0 |
| Administration vaccine hepatitis b HCPCS G0010 | $91.80 | $153.00 | not published | 0 |
| Administration vaccine influenza virus HCPCS G0008 | $35.40 | $59.00 | not published | 0 |
| Administration vaccine pneumococcal HCPCS G0009 | $35.40 | $59.00 | not published | 0 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $14,841.48 | $24,735.80 | not published | 0 |
| _afb id by dna probe rflx ast CPT 87149 | $66.00 | $110.00 | not published | 0 |
| #afb mycobacteria suscep. #1 CPT 87190 | $82.20 | $137.00 | not published | 0 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $156.00 | $260.00 | not published | 0 |
| Afo molded ankle gauntlet HCPCS L1904 | $1,067.98 | $1,779.96 | not published | 0 |
| Afo molded plas rig ant tib HCPCS L1945 | $2,437.93 | $4,063.21 | not published | 0 |
| Afo molded to patient plasti HCPCS L1940 | $1,019.72 | $1,699.53 | not published | 0 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | $2,111.34 | $3,518.90 | not published | 0 |
| Afo sing bar clasp attach sh HCPCS L1910 | $663.56 | $1,105.93 | not published | 0 |
| Afo sing solid stirrup calf HCPCS L1980 | $955.35 | $1,592.25 | not published | 0 |
| Afo sing upright with adjust s HCPCS L1920 | $972.01 | $1,620.02 | not published | 0 |
| Afo spiral molded to pt plas HCPCS L1950 | $1,819.66 | $3,032.77 | not published | 0 |
| Afo sprng wir drsflx calf bd HCPCS L1900 | $675.05 | $1,125.09 | not published | 0 |
| Afo supramalleolar custom HCPCS L1907 | $1,331.42 | $2,219.04 | not published | 0 |
| Afo tib fx cast plaster mold HCPCS L2106 | $1,864.98 | $3,108.30 | not published | 0 |
| Afo tibial fracture rigid HCPCS L2116 | $1,823.68 | $3,039.46 | not published | 0 |
| Afo tibial fracture soft HCPCS L2112 | $1,193.71 | $1,989.51 | not published | 0 |
| Afo, walk boot type, cus fab HCPCS L4631 | $3,754.63 | $6,257.72 | not published | 0 |
| Afo w/ankle joint, prefab HCPCS L1971 | $1,511.55 | $2,519.25 | not published | 0 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $316.80 | $528.00 | not published | 0 |
| Ak/knee disartic pelvic band HCPCS L5697 | $185.56 | $309.26 | not published | 0 |
| Ak/knee disartic silesian ba HCPCS L5698 | $230.77 | $384.62 | not published | 0 |
| Ak sleeve susp neoprene/equa HCPCS L5695 | $418.06 | $696.77 | not published | 0 |
| Albumin body fluid quantitative each specimen CPT 82042 | $96.00 | $160.00 | not published | 0 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $208.80 | $348.00 | not published | 0 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $96.00 | $160.00 | not published | 0 |
| Albumin serum plasma or whole blood CPT 82040 | $42.00 | $70.00 | not published | 0 |
| Albuterol ipratrop non-comp HCPCS J7620 | $1.56 | $2.60 | not published | 0 |
| Albuterol non-comp con HCPCS J7611 | $1.92 | $3.20 | not published | 0 |
| Albuterol non-comp unit HCPCS J7613 | $5.16 | $8.60 | not published | 0 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $139.20 | $232.00 | not published | 0 |
| Alcohol/subs interv >30 min HCPCS G0397 | $64.20 | $107.00 | not published | 0 |
| Alkaline phosphatase CPT 84075 | $46.80 | $78.00 | not published | 0 |
| Allergen alpha lactalbumin ige CPT 86008 | $33.60 | $56.00 | not published | 0 |
| Allergen egg white ige CPT 86003 | $36.60 | $61.00 | not published | 0 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $23.40 | $39.00 | not published | 0 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $6,611.20 | $11,018.66 | not published | 0 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $13,037.12 | $21,728.54 | not published | 0 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $16,359.20 | $27,265.34 | not published | 0 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $12,541.67 | $20,902.79 | not published | 0 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $10,174.10 | $16,956.83 | not published | 0 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $46,185.43 | $76,975.72 | not published | 0 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $31,006.47 | $51,677.45 | not published | 0 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $26,239.58 | $43,732.63 | 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.