Patient Price Information List

Disclaimer: AdventHealth Orlando determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, AdventHealth Orlando has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/18. AdventHealth Orlando charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Central Florida Regional Hospital

Sanford

FL

Health Central Hospital

Ocoee

FL

Leesburg Regional Medical Center

Leesburg

FL

Orlando Regional Medical Center

Orlando

FL

Osceola Regional Medical Center

Kissimmee

FL

Parrish Medical Center

Titusville

FL

Poinciana Medical Center

Kissimee

FL

South Lake Hospital

Clermont

FL

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Cash Price

Private Room

$2,348
$1,768

33% higher than market

Semi-Private Room

$2,348
$1,655

42% higher than market

Intensive Care Unit

$3,535
$2,556

38% higher than market

Coronary Care Unit

$3,010
$3,489

14% lower than market

INPATIENT LABOR AND DELIVERY CHARGES

The following list does not include charges for anesthesia, drugs, or supplies or charges outside the delivery room (i.e., room & board) required for a particular delivery room procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.

Description

Our Charge
Market Charge

Variance

Cash Price

Normal vaginal delivery without complications

$22,888
$18,241

25% higher than market

Cesarean Section without complications

$38,320
$31,739

21% higher than market

Other antepartum diagnoses w medical complications

$42,945
$55,672

23% lower than market

OUTPATIENT EMERGENCY DEPARTMENT CHARGES

Emergency Department charges are based on the level of emergency care provided to our patients. The levels, with Level 1 representing basic emergency care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. They also do not include fees for Emergency Department physicians, who will bill separately for their services.

Description

Our Charge
Market Charge

Variance

Cash Price

Emergency Critical Care, Each Additional 30 Minutes

$1,089
$1,727

37% lower than market

Emergency Critical Care, First 30 Minutes

$5,196
$5,782

10% lower than market

Emergency Department Visit - Level 1

$327
$512

36% lower than market

Emergency Department Visit - Level 2

$454
$1,104

59% lower than market

Emergency Department Visit - Level 3

$1,048
$1,682

38% lower than market

Emergency Department Visit - Level 4

$2,443
$2,749

11% lower than market

Emergency Department Visit - Level 5

$4,361
$4,405

1% lower than market

OUTPATIENT PHYSICAL THERAPY CHARGES

The following charges reflect the most common services offered by our Physical Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

Cash Price

Application of Electrical Stimulation - 15 Minutes

$147
$299

51% lower than market

$76

Gait Training - 15 Minutes

$137
$258

47% lower than market

Physical Therapy, complex evaluation

$606
$641

5% lower than market

Physical Therapy, standard evaluation - 20 minutes

$494
$494

Approximately equal to market

$100

PT Evaluation - Moderate Complexity

$551
$565

2% lower than market

PT to Re-Educate Brain to Muscle Function (15 min)

$137
$264

48% lower than market

Physical Therapy 1 or More Regions (15 min)

$146
$288

49% lower than market

$50

Physical Therapy Exercise, 15 Minutes

$137
$292

53% lower than market

$50

OUTPATIENT OCCUPATIONAL THERAPY CHARGES

The following charges reflect the most common services offered by our Occupational Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

Cash Price

Occupational Therapy, standard evaluation - 30 minutes

$494
$497

1% lower than market

$100

Occupational Therapy Evaluation - Moderate Complexity

$551
$568

3% lower than market

Paraffin Wax Bath

$82
$210

61% lower than market

Occupational Therapy, re-evaluation

$481
$433

11% higher than market

Self Care - Home Management Training - 15 Minutes

$154
$424

64% lower than market

Therapeutic Activities Involving Functional Activities (15 min)

$137
$247

45% lower than market

OUTPATIENT PULMONARY THERAPY CHARGES

The following charges reflect the most common services offered by our Pulmonary Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

Cash Price

Aerosol Treatment

$100
$89

12% higher than market

Routine EKG - Minimum 12 Leads

$494
$675

27% lower than market

$95

Spirometry - breathing test

$494
$687

28% lower than market

Spirometry - medicated breathing procedure

$744
$1,090

32% lower than market

Stress Test with EKG tracing

$2,141
$3,243

34% lower than market

$423

OUTPATIENT SPEECH THERAPY CHARGES

Description

Our Charge
Market Charge

Variance

Cash Price

Swallow Evaluation

$491
$627

22% lower than market

Swallow Treatment

$225
$432

48% lower than market

OUTPATIENT LABORATORY AND PATHOLOGY CHARGES

The following charges reflect our most common laboratory procedures. For all lab specimens collected via blood draw, the venipuncture will be charged separately.

Description

Our Charge
Market Charge

Variance

Cash Price

ADH (antidiuretic hormone) level

$22
$60

63% lower than market

Activated protein resistance assay

$52
$112

53% lower than market

Acute hepatitis panel

$162
$193

16% lower than market

$162

Adrenocorticotropic hormone (ACTH) level

$6
$27

78% lower than market

Albumin (protein) level

$14
$141

90% lower than market

$14

Aldolase (enzyme) level

$5
$15

66% lower than market

Alpha-1-antitrypsin; phenotype

$26
$32

20% lower than market

Alpha-Fetoprotein (AFP) Level, Serum

$57
$132

57% lower than market

Alpha-fetoprotein (AFP) analysis

$150
$238

37% lower than market

Amikacin (antibiotic) level

$51
$85

40% lower than market

Ammonia level

$50
$323

85% lower than market

$50

Amylase (enzyme) level

$22
$323

93% lower than market

$22

Analysis for antibody (IgM) to Cytomegalovirus (CMV)

$57
$110

48% lower than market

Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria)

$8
$22

64% lower than market

Analysis for antibody to Chlamydia (bacteria)

$8
$8

4% higher than market

Analysis for antibody to Cytomegalovirus (CMV)

$49
$88

45% lower than market

Antibody; Epstein-Barr (EB) virus, early antigen (EA)

$45
$50

10% lower than market

Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA)

$52
$54

4% lower than market

Antibody; Epstein-Barr (EB) virus, viral capsid (VCA)

$31
$51

40% lower than market

Analysis for antibody to HIV-1 and HIV-2 virus

$62
$87

28% lower than market

Analysis for antibody to Herpes simplex virus, type 2

$8
$33

77% lower than market

Analysis for antibody to Mycoplasma (bacteria)

$45
$134

66% lower than market

Analysis for antibody to mumps virus

$44
$40

10% higher than market

Analysis for antibody to varicella-zoster virus (chicken pox)

$44
$90

51% lower than market

Analysis for antibody to virus

$11
$45

75% lower than market

Analysis for detection of tumor marker

$40
$88

55% lower than market

Analysis test for HIV-1 virus; reverse transcriptase and protease regions

$270
$302

10% lower than market

Analysis test for Hepatitis C virus

$542
$488

11% higher than market

Antibody Screen

$558
$244

128% higher than market

Antithrombin III antigen (clotting inhibitor) activity

$51
$76

32% lower than market

Arterial Blood Gases Measurement

$427
$472

10% lower than market

Automated white blood cell count

$50
$141

94% lower than market

$50

Bacterial Blood Culture

$440
$580

24% lower than market

Bacterial culture and colony count

$325
$321

1% higher than market

Bacterial culture for anaerobic isolates

$109
$104

5% higher than market

Bacterial urine culture

$28
$132

79% lower than market

$28

Blood test, basic group of blood chemicals

$170
$421

60% lower than market

$29

Bilirubin level (Total)

$55
$85

36% lower than market

$17

Bilirubin level (Direct)

$17
$221

92% lower than market

$17

Blood creatinine level

$54
$206

74% lower than market

$17

Blood glucose (sugar) level

$50
$179

72% lower than market

$13

Blood osmolality (concentration) measurement

$23
$94

75% lower than market

$23

Blood potassium level

$54
$112

52% lower than market

$16

Blood sodium level

$54
$130

58% lower than market

$16

Blood Typing, ABO

$155
$85

83% higher than market

Blood Typing, Rh (D)

$54
$60

9% lower than market

Blood chloride level

$16
$56

71% lower than market

$16

Blood glucose (sugar) level after receiving dose of glucose

$16
$69

77% lower than market

$16

Glucose; tolerance test (GTT), 3 specimens (includes glucose)

$44
$170

74% lower than market

Blood glucose (sugar) tolerance test (Added Samples)

$13
$72

82% lower than market

$13

Blood test, basic group of blood chemicals

$647
$580

12% higher than market

Blood viscosity measurement

$10
$25

60% lower than market

Bone marrow, smear interpretation

$353
$308

15% higher than market

Calcium level

$18
$212

92% lower than market

$18

Carbamazepine level

$50
$404

88% lower than market

$50

Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen

$50
$92

46% lower than market

Carbon dioxide (bicarbonate) level

$55
$32

72% higher than market

$17

Carcinoembryonic antigen (CEA) protein level

$88
$248

64% lower than market

$65

Cardiolipin antibody (tissue antibody) measurement

$19
$34

45% lower than market

Carotene level

$13
$50

74% lower than market

Catecholamines (organic nitrogen) level

$18
$40

55% lower than market

Cell examination of specimen

$421
$187

125% higher than market

$112

Cell examination of urine; computer-assisted technology

$460
$580

21% lower than market

Column chromatography/, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, or GC/MS, HPLC/MS), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen

$35
$112

69% lower than market

Chemical analysis using spectrophotometry (light)

$58
$99

42% lower than market

Cholesterol level

$15
$52

71% lower than market

$15

Clotting factor VIII (AHG) measurement

$61
$79

22% lower than market

Clotting factor VIII (VW factor) antigen

$78
$227

66% lower than market

Clotting factor VIII (VW factor) measurement

$78
$223

65% lower than market

Russell viper venom time (includes venom); diluted

$17
$44

62% lower than market

Clotting factor XIII (fibrin stabilizing) screening test

$41
$115

64% lower than market

Coagulation time; activated

$203
$216

6% lower than market

Collagen cross links test, (urine test to evaluate bone health)

$60
$74

19% lower than market

Complete blood cell count - automated test with out Differential

$22
$229

90% lower than market

$22

Complete blood cell count - automated differential WBC count

$179
$151

18% higher than market

$26

Blood test, comprehensive group of blood chemicals

$36
$543

93% lower than market

$36

Concentration of specimen for infectious agents

$35
$47

25% lower than market

Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria)

$13
$30

56% lower than market

Cortisol (hormone) measurement

$25
$52

52% lower than market

Cortisol Measurement

$56
$82

32% lower than market

Creatine kinase Level (cardiac enzyme) - Total

$54
$319

83% lower than market

$22

Creatine kinase level (cardiac enzyme) - Muscle/Brain

$300
$520

42% lower than market

$32

Creatine kinase (CK), (CPK); isoenzymes

$17
$17

3% lower than market

Creatinine level to test for kidney function or muscle injury

$18
$205

91% lower than market

$18

Creatinine clearance measurement to test for kidney function

$32
$298

89% lower than market

$32

Cryoglobulin (protein) measurement

$22
$31

29% lower than market

Culture for acid-fast bacilli

$282
$242

16% higher than market

$37

Cyanocobalamin (vitamin B-12) level

$51
$172

70% lower than market

$51

Cyclosporine level

$59
$155

62% lower than market

Dehydroepiandrosterone (DHEA) hormone level

$16
$62

75% lower than market

Detection Test for Hepatitis C Virus; Includes Reverse Transcription

$146
$127

15% higher than market

Detection test for Cytomegalovirus (CMV)

$115
$199

42% lower than market

Detection test for HIV-1 and HIV-2

$66
$146

55% lower than market

Detection test for HIV-1 virus, amplified probe technique

$250
$323

23% lower than market

Detection test for Hepatitis Be surface antigen

$12
$11

10% higher than market

Detection test for Hepatitis C virus; amplified probe technique

$70
$75

7% lower than market

Detection test for trichomonas vaginalis (genital parasite); direct probe technique

$20
$70

71% lower than market

Detection test for adenovirus enteric types 40/41

$41
$98

58% lower than market

Detection test for candida species (yeast); direct probe technique

$20
$70

71% lower than market

Detection test for clostridium difficile

$101
$188

46% lower than market

Detection test for cytomegalovirus, quantification

$146
$135

8% higher than market

Detection test for entamoeba histolytica dispar group (parasite)

$40
$140

71% lower than market

Detection test for gardnerella vaginalis (bacteria); direct probe technique

$20
$70

71% lower than market

Detection test for identification of organism

$41
$66

38% lower than market

Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reve

$850
$2,289

63% lower than market

Detection test for organism; quantification, each organism

$146
$189

23% lower than market

Digoxin level

$45
$202

78% lower than market

$45

Dihydroxyvitamin D, 1, 25 level

$21
$38

45% lower than market

Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)

$24
$378

94% lower than market

$24

Electron microscopy for diagnosis

$417
$541

23% lower than market

Enzyme activity measurement

$130
$279

53% lower than market

Estradiol (hormone) level

$95
$93

2% higher than market

$95

Estrogen analysis; fractionated

$20
$90

78% lower than market

Estrone (hormone) level

$28
$38

27% lower than market

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral); agar dilution method

$17
$57

70% lower than market

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral); disk method

$23
$92

75% lower than market

Ferritin (blood protein) level

$46
$174

74% lower than market

$46

Fibrinogen (factor 1) activity measurement

$268
$360

25% lower than market

Folic acid level

$50
$175

71% lower than market

$50

Folic acid level

$130
$119

10% higher than market

Fungal culture (mold or yeast)

$364
$99

267% higher than market

$29

Fungal culture, yeast

$35
$69

49% lower than market

G6PD (enzyme) level

$14
$40

65% lower than market

Gabapentin level

$18
$38

53% lower than market

Gastrin (GI tract hormone) level

$10
$14

26% lower than market

Gene analysis (Janus kinase 2) variant

$312
$278

12% higher than market

Gene analysis (coagulation factor V) Leiden variant

$208
$210

1% lower than market

Gene analysis (hemochromatosis) common variants

$75
$126

40% lower than market

Gene analysis (prothrombin, coagulation factor II) A variant

$168
$169

Approximately equal to market

Glucose Level on Body Fluid

$167
$242

31% lower than market

Glutamyltransferase (liver enzyme) level

$25
$257

90% lower than market

$25

Glycated protein level

$11
$35

69% lower than market

Gonadotropin (reproductive hormone) analysis

$300
$369

19% lower than market

$26

Gonadotropin, chorionic (reproductive hormone) level

$422
$664

36% lower than market

Gonadotropin, follicle stimulating (reproductive hormone) level

$63
$79

20% lower than market

$63

Gonadotropin, luteinizing (reproductive hormone) level

$63
$64

2% lower than market

$63

HDL cholesterol level

$28
$119

77% lower than market

Haptoglobin (serum protein) level

$43
$76

44% lower than market

Heavy metal level

$45
$99

55% lower than market

Hemoglobin A1C level

$33
$125

74% lower than market

$33

Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F)

$44
$92

52% lower than market

Hepatitis B Antibody Measurement

$41
$88

53% lower than market

Hepatitis B surface antibody measurement

$199
$61

229% higher than market

$37

Hepatitis B core antibody (IgM) measurement

$40
$65

38% lower than market

$40

Hepatitis Be antibody measurement

$14
$14

2% lower than market

Hepatitis C Antibody Measurement

$49
$77

36% lower than market

Homocysteine (amino acid) level

$57
$77

26% lower than market

Hydroxyindolacetic acid (product of metabolism) level

$16
$17

5% lower than market

Hydroxyprogesterone, 17-D (synthetic hormone) level

$14
$27

48% lower than market

IgE (immune system protein) level

$56
$174

68% lower than market

Immunologic analysis for detection of tumor antigen (CA 125)

$69
$101

32% lower than market

$69

Immunologic analysis for detection of organism; qualitative or semiquantitative; multiple-step method

$41
$97

58% lower than market

Immunologic analysis technique on body fluid; Immunofixation electrophoresis

$100
$132

24% lower than market

Immunofixation electrophoresis; serum

$76
$140

46% lower than market

Infection agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types

$101
$164

38% lower than market

Infusion, albumin (human), 5%, 250 ml

$509
$502

1% higher than market

Insulin Measurement; Total

$39
$55

30% lower than market

Ionized Calcium

$47
$130

64% lower than market

Iron level

$22
$96

77% lower than market

$22

Islet cell (pancreas) antibody measurement

$45
$120

62% lower than market

LDL cholesterol level

$33
$50

34% lower than market

Lactate dehydrogenase (enzyme) level

$21
$184

89% lower than market

$21

Lactic acid level

$230
$160

44% higher than market

$36

Lamotrigine level

$9
$26

65% lower than market

Lipase (fat enzyme) level

$199
$343

42% lower than market

$23

Blood test, lipids (cholesterol and triglycerides)

$46
$434

89% lower than market

$46

Lipoprotein measurement; nuclear resonance spectroscopy

$34
$38

12% lower than market

Liver enzyme (SGOT), level

$18
$258

93% lower than market

$18

Liver enzyme (SGPT), level

$18
$263

93% lower than market

$18

Liver function blood test panel

$236
$539

56% lower than market

$28

Magnesium Level

$89
$165

46% lower than market

Measurement C-reactive protein

$18
$78

77% lower than market

Measurement high sensitivity C-reactive protein

$44
$181

76% lower than market

Measurement of Complement (Immune System Proteins)

$41
$101

59% lower than market

Measurement of Hepatitis A antibody

$42
$60

31% lower than market

Measurement of Hepatitis A antibody (IgM)

$38
$59

35% lower than market

$38

Measurement of antibody (IgE) to allergic substance

$18
$25

28% lower than market

Measurement of antibody for assessment of autoimmune disorder

$38
$45

15% lower than market

Measurement of complement (immune system proteins)

$7
$13

46% lower than market

Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified

$75
$68

11% higher than market

Metanephrines level

$30
$42

28% lower than market

Microscopic genetic analysis of tumor; using computer-assisted technology

$120
$295

59% lower than market

Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure

$260
$386

33% lower than market

Natriuretic peptide (heart and blood vessel protein) level

$324
$380

15% lower than market

$116

Nephelometry, test method using light

$38
$33

13% higher than market

Nucleotidase 5' (enzyme) level

$14
$65

78% lower than market

Organic acid level

$15
$22

32% lower than market

Oxalate level

$16
$29

44% lower than market

Oxcarbazepine level

$18
$41

56% lower than market

PSA (prostate specific antigen) measurement

$63
$177

64% lower than market

$63

Partial Thromblostatin Time, Activated

$182
$291

37% lower than market

Pathology examination of tissue using a microscope, moderately low complexity

$533
$385

39% higher than market

$112

Pathology examination of tissue during surgery

$353
$345

2% higher than market

Pathology examination of tissue using a microscope

$349
$369

5% lower than market

$80

Pathology examination of tissue using a microscope, limited examination

$189
$214

12% lower than market

Phenobarbital level

$39
$281

86% lower than market

$39

Phenytoin level

$45
$367

88% lower than market

$45

Phosphatase (enzyme) level

$18
$62

71% lower than market

$18

Phosphatase, alkaline; isoenzymes

$16
$33

51% lower than market

Phosphate level

$16
$137

88% lower than market

$16

Phospholipid antibody (autoimmune antibody) measurement

$18
$70

74% lower than market

Platelet count, automated test

$124
$95

30% higher than market

$15

Prealbumin (protein) level

$50
$161

69% lower than market

$50

Pregnenolone (reproductive hormone) level

$28
$73

62% lower than market

Primidone level

$14
$17

19% lower than market

Progesterone (reproductive hormone) level

$71
$93

24% lower than market

Prolactin (milk producing hormone) level

$66
$90

27% lower than market

$66

Protein C antigen (clotting inhibitor) measurement

$67
$102

35% lower than market

Protein Measurement, Serum

$37
$50

26% lower than market

Protein measurement, body fluid

$61
$77

21% lower than market

Blood test, clotting time

$152
$206

26% lower than market

$13

Qualitative or semiquantitative detection test for helicobacter pylori in stool, multiple-step metho

$42
$116

64% lower than market

Quantitation of therapeutic drug

$71
$106

33% lower than market

Red blood count, automated test

$14
$161

91% lower than market

$14

Red blood cell sedimentation rate, to detect inflammation

$9
$118

92% lower than market

$9

Renin (kidney enzyme) level

$13
$30

57% lower than market

Rheumatoid factor analysis

$19
$37

48% lower than market

Rheumatoid factor level

$19
$51

63% lower than market

Screening test for antibody to noninfectious agent

$41
$66

38% lower than market

Screening test for compatible blood unit

$219
$218

1% higher than market

Selenium (vitamin) level

$14
$63

78% lower than market

Serotonin (hormone) level

$35
$33

6% higher than market

Sirolimus level

$47
$169

72% lower than market

Smear for Parasites

$30
$65

54% lower than market

Smear for infectious agents

$159
$265

40% lower than market

Somatomedin (growth factor) level

$10
$22

55% lower than market

Special Stain for Microorganism; Gram or Glemsa Stain

$117
$131

11% lower than market

Special stain for microorganism; special stain for parasites

$20
$45

56% lower than market

Stool Analysis for Blood

$124
$127

2% lower than market

Stool analysis for blood

$49
$88

44% lower than market

Stool calprotectin (protein) level

$90
$160

44% lower than market

Stool lactoferrin (immune system protein) analysis

$67
$107

37% lower than market

Surgical Pathology, High Complexity

$893
$883

1% higher than market

Pathology examination of tissue using a microscope, intermediate complexity

$654
$719

9% lower than market

$112

Pathology examination of tissue using a microscope, moderately high complexity

$748
$580

29% higher than market

$539

Syphilis Detection Test

$15
$53

72% lower than market

Tacrolimus Level

$47
$61

23% lower than market

Test for Influenza Virus

$133
$312

57% lower than market

Testosterone Level; Free

$30
$27

13% higher than market

Testosterone (hormone) level

$88
$64

38% higher than market

$88

Theophylline level

$48
$220

78% lower than market

Thyroglobulin (thyroid protein) antibody measurement

$54
$51

6% higher than market

Thyroglobulin (thyroid related hormone) level

$11
$54

80% lower than market

Thyroid hormone, T3 measurement - Total

$48
$132

64% lower than market

$48

Thyroid Hormone, T3 Measurement, Free

$54
$112

52% lower than market

Blood test, thyroid stimulating hormone (TSH)

$57
$393

85% lower than market

$57

Thyroid hormone, T3 measurement

$17
$48

65% lower than market

Thyroid stimulating immune globulins (thyroid related protein) level

$18
$35

48% lower than market

Thyroxine (thyroid chemical) measurement - Free Thyroxine

$31
$172

82% lower than market

$31

Thyroxine (thyroid chemical) measurement - Total

$23
$205

89% lower than market

$23

Tissue culture inoculation for virus isolation

$89
$142

37% lower than market

Topiramate level

$16
$34

53% lower than market

Total protein level, blood

$76
$54

41% higher than market

$13

Total Protein Level, Body Fluid

$207
$335

38% lower than market

Transferrin (iron binding protein) level

$43
$68

37% lower than market

Triglycerides level

$20
$141

86% lower than market

$20

Troponin (protein) analysis

$309
$466

34% lower than market

$34

Urea nitrogen level to assess kidney function

$54
$161

67% lower than market

$13

Uric acid level, blood

$15
$211

93% lower than market

$15

Uric acid level

$16
$77

79% lower than market

$16

Urinalysis, Automated Test

$117
$142

17% lower than market

Urine microalbumin (protein) level

$6
$106

94% lower than market

$6

Urine osmolality (concentration) measurement

$155
$92

68% higher than market

$23

Urine potassium level

$15
$128

88% lower than market

$15

Urine sodium level

$133
$145

9% lower than market

$17

Urine albumin (protein) level

$55
$77

28% lower than market

Urine calcium level

$21
$40

48% lower than market

$21

Urine phosphate level

$16
$27

41% lower than market

Valproic acid level

$46
$298

85% lower than market

$46

Vancomycin (antibiotic) level

$46
$323

86% lower than market

$46

Vitamin A level

$9
$32

72% lower than market

Vitamin B-2 (riboflavin) level

$95
$137

30% lower than market

Vitamin D-3 Level

$101
$114

11% lower than market

Vitamin E level

$10
$30

66% lower than market

Vitamin K level

$52
$120

57% lower than market

Zonisamide level

$50
$62

19% lower than market

OUTPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Cash Price

Administration of vaccine

$44
$190

77% lower than market

Audiology exam - hearing test

$356
$467

24% lower than market

$232

Application of mechanical traction to 1 or more areas

$137
$220

38% lower than market

Application of medication through skin using electrical current, each 15 minutes

$121
$116

4% higher than market

Application of on-body injector (includes cannula insertion) for timed subcutaneous injection

$139
$221

37% lower than market

Application of whirlpool therapy to 1 or more areas

$127
$170

25% lower than market

Attempt to Restart Heart and Lungs

$1,081
$1,254

14% lower than market

Balloon dilation of narrowed or blocked major coronary artery or branch (accessed through the skin)

$16,422
$23,721

31% lower than market

Catheter insertion of stents in major coronary artery or branch, accessed through the skin

$23,476
$44,354

47% lower than market

Demonstration and/or evaluation of manual maneuvers to chest wall to assist movement of lung secreti

$180
$254

29% lower than market

Determination of lung volumes using gas dilution or washout

$295
$590

50% lower than market

Eardrum testing using ear probe

$171
$149

15% higher than market

Evaluation and insertion of catheters for creation of complete heart block

$29,686
$60,055

51% lower than market

Evaluation and insertion of catheters for recording, pacing, and attempted induction of abnormal hea

$29,686
$61,311

52% lower than market

Evaluation and insertion of catheters for recording, pacing, and treatment of abnormal heart rhythm

$29,686
$68,436

57% lower than market

Evaluation of heart function using tilt table

$2,956
$2,640

12% higher than market

External shock to heart to regulate heart beat

$1,501
$1,860

19% lower than market

Fluoroscopic and video recorded motion evaluation of swallowing function

$601
$709

15% lower than market

Haemophilus influenza type B vaccine (HiB), 4 dose schedule

$139
$391

65% lower than market

Hearing assessment of abnormal sounds

$289
$447

35% lower than market

Heart rhythm analysis, interpretation and report of 48-hour EKG

$777
$1,015

23% lower than market

$179

Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle

$139
$593

77% lower than market

Infusion (Additional) for Therapy, Diagnosis or Prevention

$139
$229

39% lower than market

Infusion into a Vein for Therapy, Diagnosis, or Prevention

$94
$208

55% lower than market

Infusion of Drug or Substance into Vein for Therapy or Diagnosis

$577
$767

25% lower than market

Infusion of chemotherapy into a vein

$139
$256

46% lower than market

Infusion of chemotherapy into a vein using push technique

$548
$651

16% lower than market

Infusion of different chemotherapy drug or substance into a vein

$139
$413

66% lower than market

Infusion of different chemotherapy drug or substance into a vein up to 1 hour

$139
$274

49% lower than market

Inhaled pneumonia treatment

$409
$571

28% lower than market

Injection Beneath the Skin for Therapy, Diagnosis, or Prevention

$166
$385

57% lower than market

Injection for X-ray imaging of aorta above heart valve

$3,416
$3,127

9% higher than market

Injection of Same Drug into Vein for Therapy or Diagnosis

$240
$227

6% higher than market

Insertion of catheter for diagnostic evaluation of right heart structures

$7,113
$14,878

52% lower than market

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography

$9,487
$14,527

35% lower than market

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography; with bypass graft angiography

$13,140
$11,835

11% higher than market

Catheter placement in left coronary artery(s) for coronary angiography

$15,336
$22,530

32% lower than market

Catheter placement in left coronary artery(s) for coronary angiography; in bypass graft(s)

$18,988
$22,124

14% lower than market

Catheter placement in left and right coronary artery(s) for coronary angiography

$18,245
$23,034

21% lower than market

Catheter placement in left and right coronary artery(s) for coronary angiography; with bypass graft angiography

$21,897
$26,414

17% lower than market

Left heart catheterization by transseptal puncture through intact septum

$7,978
$19,378

59% lower than market

Insertion of catheters for 3D mapping of electrical impulses to heart muscles

$7,740
$10,317

25% lower than market

Insertion of catheters for recording, pacing, and attempted induction of abnormal rhythm in right up

$12,745
$18,912

33% lower than market

Irrigation of implanted venous access drug delivery device

$258
$236

9% higher than market

Meningitis vaccine

$340
$1,284

74% lower than market

Manual maneuvers to chest wall to assist movement of lung secretions

$122
$206

41% lower than market

Measurement and recording of brain wave (EEG) activity, awake and asleep

$2,064
$2,092

1% lower than market

Measurement of esophageal swallowing movement

$859
$2,707

68% lower than market

Measurement of largest amount of air breathed in an out of lungs over one minute

$98
$207

53% lower than market

Medical nutrition therapy re-assessment and intervention, each 15 minutes

$69
$76

9% lower than market

Medical nutrition therapy, assessment and intervention, each 15 minutes

$69
$78

11% lower than market

Moderate sedation services - each additional 15 minutes intraservice time

$259
$240

8% higher than market

Moderate sedation services - initial 15 minutes, patient age 5 or older

$259
$727

64% lower than market

Monitoring and recording of gastroesophageal reflux with pH electrode insertion including analysis a

$2,067
$3,244

36% lower than market

Negative pressure wound therapy; surface area less than or equal to 50 square centimeters

$726
$1,748

58% lower than market

Negative pressure wound therapy, surface area less than or equal to 50 square centimeters, per sessi

$546
$531

3% higher than market

Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle

$337
$415

19% lower than market

Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes

$117
$265

56% lower than market

Overnight measurement of oxygen saturation in blood using ear or finger device

$219
$498

56% lower than market

Polio vaccine (IPV)

$135
$551

75% lower than market

PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH

$9,081
$17,339

48% lower than market

Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session

$179
$260

31% lower than market

Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive

$1,136
$2,444

54% lower than market

Programmed heart rhythm stimulation after drug infusion into a vein

$7,463
$11,657

36% lower than market

Prolonged chemotherapy infusion into a vein by portable or implanted pump more than 8 hours

$953
$1,349

29% lower than market

Removal of blood clot in heart artery, accessed through the skin

$2,282
$4,212

46% lower than market

Removal of devitalized tissue from wound(s), non-selective debridement without anesthesia

$218
$517

58% lower than market

Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound

$234
$802

71% lower than market

Sleep Monitoring with CPAP

$5,333
$4,830

10% higher than market

$1535

Sleep monitoring of patient (6 years or older) in sleep lab

$5,122
$4,431

16% higher than market

$1535

Therapeutic procedures in a group setting

$137
$152

10% lower than market

Therapeutic removal of whole blood to correct blood level imbalance

$258
$399

35% lower than market

Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk each 15 minu

$111
$287

61% lower than market

Vaccine for Hepatitis A injection into muscle, adult dosage

$496
$796

38% lower than market

Vaccine for Hepatitis B adult dosage (3 dose schedule) injection into muscle

$427
$713

40% lower than market

Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older

$265
$279

5% lower than market

Vein Infusion for Therapy, Prevention or Diagnosis, Concurrent with Another Infusion

$63
$180

65% lower than market

Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes

$111
$190

42% lower than market

Wheelchair management, each 15 minutes

$111
$139

20% lower than market

OUTPATIENT OTHER CHARGES

Description

Our Charge
Market Charge

Variance

Cash Price

Adhesion barrier

$2,072
$3,565

42% lower than market

Administration of hepatitis b vaccine

$168
$190

12% lower than market

Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)

$1,169
$3,073

62% lower than market

Biopsy and/or destruction of growth of urinary duct (ureter) or kidney using an endoscope

$5,701
$22,507

75% lower than market

Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)

$553
$1,001

45% lower than market

Catheter, electrophysiology, diagnostic/ablation, 3d or vector mapping

$12,676
$11,456

11% higher than market

Catheter, electrophysiology, diagnostic/ablation, other than 3d or vector mapping, other than cool-tip

$7,362
$7,644

4% lower than market

Catheter, guiding (may include infusion/perfusion capability)

$527
$676

22% lower than market

Catheter, hemodialysis/peritoneal, long-term

$2,220
$2,759

20% lower than market

Catheter, ureteral

$81