GROVE CITY HOSPITAL
631 NORTH BROAD STREET EXT, GROVE CITY, PA · Ahn · · NPI 1023000296
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 |
|---|---|---|---|---|
| Ureter endoscopy & biopsy CPT 50955 | $225.40 | $980.00 | $283.41 – $13,925.53 | 17 |
| Ureter endoscopy & biopsy CPT 50974 | $301.99 | $1,313.00 | $325.00 – $13,925.53 | 16 |
| Ureter endoscopy & catheter CPT 50972 | $228.85 | $995.00 | $287.58 – $9,447.74 | 16 |
| Ureter endoscopy & treatment CPT 50957 | $226.55 | $985.00 | $284.81 – $13,925.53 | 17 |
| Ureter endoscopy & treatment CPT 50961 | $201.71 | $877.00 | $255.23 – $13,925.53 | 17 |
| Ureter endoscopy & treatment CPT 50976 | $298.08 | $1,296.00 | $325.00 – $13,925.53 | 16 |
| Ureter endoscopy & treatment CPT 50980 | $227.24 | $988.00 | $286.18 – $13,925.53 | 16 |
| Ureteroneocystostomy 50780 CPT 50780 | $717.83 | $3,121.00 | $72.13 – $3,648.65 | 8 |
| Ureteroureterostomy 50760 CPT 50760 | $727.26 | $3,162.00 | $73.18 – $3,616.40 | 8 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $972.51 | $1,263.00 | $12.77 – $662.14 | 16 |
| Urethrlys transvag with scope CPT 53500 | $483.23 | $2,101.00 | $73.10 – $9,447.74 | 16 |
| Urethrocystography void s&i CPT 74455 | $972.51 | $1,263.00 | $12.77 – $662.14 | 16 |
| Uric acid blood CPT 84550 | $30.03 | $39.00 | $2.98 – $12.60 | 18 |
| Uric acid urine CPT 84560 | $33.88 | $44.00 | $3.36 – $7.20 | 17 |
| Urinalysis glass test CPT 81020 | $3.22 | $14.00 | $3.10 – $6.88 | 17 |
| Urinalysis microscopic only CPT 81015 | $20.02 | $26.00 | $2.01 – $8.40 | 18 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $1.38 | $6.00 | $1.43 – $7.00 | 18 |
| Urinalysis (with microscopy) CPT 81001 | $21.56 | $28.00 | $2.09 – $9.45 | 18 |
| Urinalysis (without microscopy) CPT 81003 | $14.63 | $19.00 | $1.49 – $6.30 | 18 |
| Urinary bldr retent nuc study CPT 78730 | $4.83 | $21.00 | $6.12 – $49.89 | 10 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $2.29 – $8.13 | 13 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $4.33 – $15.37 | 13 |
| Urinary reflex study CPT 51792 | $36.11 | $157.00 | $39.48 – $162.71 | 16 |
| Urinary suspensory HCPCS A5105 | not published | not published | $29.37 – $104.26 | 13 |
| Urine Culture Test CPT 87086 | $53.13 | $69.00 | $5.32 – $22.05 | 18 |
| Urine flow measurement 51736 CPT 51736 | $5.29 | $23.00 | $4.50 – $353.10 | 16 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $4.69 – $16.67 | 13 |
| Urine pregnancy test CPT 81025 | $56.21 | $73.00 | $4.00 – $17.85 | 18 |
| Urine screen for bacteria CPT 81007 | $20.70 | $90.00 | $3.00 – $32.68 | 17 |
| Urine shunt to intestine CPT 50815 | $788.90 | $3,430.00 | $79.52 – $4,536.45 | 8 |
| Urine specimen collect mult HCPCS P9615 | $6.44 | $28.00 | $3.10 – $9.91 | 14 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $63.43 – $213.30 | 3 |
| Urography, antegrade CPT 74425 | $1,436.82 | $1,866.00 | $15.75 – $978.28 | 16 |
| Urography inf drip &/or bolus CPT 74410 | $716.10 | $930.00 | $18.84 – $487.65 | 16 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $457.73 – $1,248.50 | 3 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $9.16 – $159.04 | 3 |
| Use 1st target lesion CPT 76982 | $18.17 | $79.00 | $23.22 – $291.30 | 14 |
| User adjustable heel height HCPCS L5990 | not published | not published | $1,102.01 – $3,911.92 | 13 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $10.66 – $27.91 | 14 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $126.44 – $331.13 | 13 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $8,552.06 – $35,246.01 | 13 |
| Vaccine Administration (one shot) CPT 90471 | $182.49 | $237.00 | $0.66 – $194.96 | 15 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $40.00 – $187.89 | 11 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $40.00 – $170.92 | 10 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $40.00 – $181.19 | 10 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $40.00 – $102.03 | 10 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $40.00 – $76.19 | 10 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $10.00 – $59.85 | 11 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $10.00 – $180.60 | 11 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $10.00 – $112.35 | 11 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $10.00 – $226.31 | 10 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $10.00 – $206.85 | 11 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $10.00 – $44.21 | 10 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $10.00 – $29.40 | 11 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $10.00 – $145.95 | 11 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $10.00 – $253.59 | 11 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $10.00 – $69.30 | 11 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $28.24 – $36.00 | 2 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $10.00 – $87.34 | 11 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $32.89 | $142.98 | $10.00 – $156.07 | 11 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $71.64 | $311.50 | $10.00 – $319.80 | 11 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $10.00 – $54.60 | 11 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $10.00 – $573.34 | 11 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $160.92 – $362.00 | 4 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $10.00 – $144.74 | 11 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $10.00 – $97.10 | 10 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $10.00 – $25.41 | 10 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $10.00 – $25.98 | 10 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $10.00 – $24.27 | 10 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $10.00 – $94.70 | 10 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $10.00 – $27.57 | 10 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $10.00 – $25.98 | 10 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $9.68 – $16.50 | 10 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $10.00 – $32.30 | 10 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $10.00 – $89.85 | 10 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $76.23 | $99.00 | $10.00 – $42.83 | 10 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $10.00 – $16.00 | 10 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $10.00 – $433.43 | 11 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $10.00 – $300.84 | 10 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $10.00 – $474.77 | 11 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $10.00 – $474.77 | 11 |
| Vaccine mmr live subcutaneous CPT 90707 | $42.76 | $185.91 | $10.00 – $196.65 | 11 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $10.00 – $471.45 | 11 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $53.86 | $234.17 | $10.00 – $296.01 | 11 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $10.00 – $535.21 | 11 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $10.00 – $303.52 | 10 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $129.93 | $564.92 | $10.00 – $588.00 | 11 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $10.00 – $74.55 | 11 |
| Vaccine rabies im CPT 90675 | $199.92 | $869.22 | $10.00 – $655.26 | 17 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $10.00 – $445.48 | 10 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $10.00 – $807.51 | 10 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $10.00 – $807.51 | 10 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $10.00 – $426.89 | 10 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $10.00 – $213.29 | 11 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $10.00 – $175.35 | 11 |
| Vaccine tdap >=7 years im CPT 90715 | $37.43 | $162.74 | $10.00 – $92.40 | 11 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $18.74 | $81.50 | $10.00 – $66.15 | 11 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $10.00 – $274.27 | 11 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $10.00 – $341.22 | 11 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $10.00 – $325.20 | 11 |
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.