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Patient Price Information List

Disclaimer: Ohio County Hospital 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, Ohio County Hospital has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2020. Ohio County Hospital's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Baptist Health Madisonville

Madisonville

KY

Deaconess Midtown Hospital

Evansville

IN

Owensboro Health Muhlenberg Community Hospital

Greenville

KY

Owensboro Health Regional Hospital

Owensboro

KY

The Medical Center at Bowling Green

Bowling Green

KY

TriStar Greenview Regional Hospital

Bowling Green

KY

Twin Lakes Reg Med Ctr

Leitchfield

KY

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$800
$1,565

49% lower than market

Semi-Private Room

$800
$1,549

48% lower than market

Intensive Care Unit

$2,125
$3,449

38% 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

Emergency department visit, low to moderately severe problem [CPT 99282]

$300
$585

49% lower than market

Emergency department visit, moderately severe problem [CPT 99283]

$500
$939

47% lower than market

Emergency department visit, problem of high severity [CPT 99284]

$700
$1,338

48% lower than market

Emergency department visit, problem with significant threat to life or function [CPT 99285]

$900
$1,884

52% 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

Elec stim other than wound [HCPCS G0283]

$46
$145

68% lower than market

Walking training to 1 or more areas, each 15 minutes [CPT 97116]

$106
$119

11% lower than market

Evaluation of physical therapy, typically 30 minutes [CPT 97162]

$264
$315

16% lower than market

Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes [CPT 97112]

$152
$150

1% higher than market

Manual (physical) therapy techniques to 1 or more regions, each 15 minutes [CPT 97140]

$96
$155

38% lower than market

Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes [CPT 97110]

$118
$150

21% lower than market

Evaluation of physical therapy, typically 20 minutes [CPT 97161]

$264
$264

Approximately equal to market

OUTPATIENT CLINIC CHARGES

Description

Our Charge
Market Charge

Variance

Hospital outpt clinic visit [HCPCS G0463]

$68
$178

62% lower than market

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

Evaluation of occupational therapy, typically 30 minutes [CPT 97165]

$264
$267

1% lower than market

Self-care or home management training, each 15 minutes [CPT 97535]

$96
$120

20% 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

Initiation and management of continued pressured respiratory assistance by mask or breathing tube [CPT 94660]

$400
$416

4% lower than market

Heart rhythm tracing of 48-hour EKG [CPT 93225]

$250
$627

60% lower than market

Pulmonary rehab w exer [HCPCS G0424]

$307
$294

4% higher than market

Routine electrocardiogram (EKG) with tracing using at least 12 leads [CPT 93005]

$125
$331

62% lower than market

Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration [CPT 94060]

$400
$748

47% lower than market

Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring [CPT 93017]

$700
$1,291

46% lower than market

OUTPATIENT SPEECH THERAPY CHARGES

Description

Our Charge
Market Charge

Variance

Treatment of speech, language, voice, communication, and/or hearing processing disorder [CPT 92507]

$178
$294

39% lower than market

Evaluation of swallowing function [CPT 92610]

$240
$460

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

Acute hepatitis panel [CPT 80074]

$152
$325

53% lower than market

Ammonia level [CPT 82140]

$70
$235

70% lower than market

Amylase (enzyme) level [CPT 82150]

$33
$125

74% lower than market

Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) [CPT 86618]

$37
$107

65% lower than market

Analysis for antibody to Rickettsia (bacteria) [CPT 86757]

$63
$150

58% lower than market

Analysis of substance using immunoassay technique, multiple step method [CPT 83516]

$65
$109

41% lower than market

Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid [CPT 86665]

$96
$134

28% lower than market

Blood gases measurement [CPT 82803]

$260
$266

2% lower than market

Bacterial blood culture [CPT 87040]

$161
$231

30% lower than market

Bacterial culture for aerobic isolates [CPT 87077]

$58
$62

7% lower than market

Bacterial culture, any other source except urine, blood or stool, aerobic [CPT 87070]

$47
$160

71% lower than market

Bacterial culture and colony count for anaerobic bacteria [CPT 87073]

$32
$73

56% lower than market

Bacterial colony count, urine [CPT 87086]

$42
$54

22% lower than market

Blood glucose (sugar) test performed by hand-held instrument [CPT 82962]

$17
$17

1% higher than market

Blood group typing (ABO) [CPT 86900]

$35
$66

47% lower than market

Blood typing for Rh (D) antigen [CPT 86901]

$70
$78

10% lower than market

Blood unit compatibility test, immediate spin technique [CPT 86920]

$150
$226

34% lower than market

Blood creatinine level [CPT 82565]

$25
$84

70% lower than market

Blood potassium level [CPT 84132]

$18
$75

76% lower than market

Blood test, basic group of blood chemicals (Calcium, total) [CPT 80048]

$29
$195

85% lower than market

Blood test, clotting time [CPT 85610]

$26
$63

59% lower than market

Blood test, comprehensive group of blood chemicals [CPT 80053]

$35
$174

80% lower than market

Blood test, lipids (cholesterol and triglycerides) [CPT 80061]

$75
$169

56% lower than market

Blood test, thyroid stimulating hormone (TSH) [CPT 84443]

$77
$223

65% lower than market

Coagulation function measurement, D-dimer; quantitative [CPT 85379]

$60
$110

45% lower than market

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count [CPT 85025]

$85
$46

85% higher than market

Complete blood cell count (red cells, white blood cell, platelets), automated test [CPT 85027]

$83
$85

2% lower than market

Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen [CPT 87635]

$240
$131

83% higher than market

Measure of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody [CPT 86769]

$75
$95

21% lower than market

Creatine kinase (cardiac enzyme) level, total [CPT 82550]

$30
$100

70% lower than market

Creatine kinase (cardiac enzyme) level, MB fraction only [CPT 82553]

$106
$135

22% lower than market

Creatinine level to test for kidney function or muscle injury [CPT 82570]

$16
$56

72% lower than market

Cyanocobalamin (vitamin B-12) level [CPT 82607]

$72
$150

52% lower than market

Detection test by immunoassay technique for bacteria toxin (shiga-like toxin) [CPT 87427]

$38
$172

78% lower than market

Detection test by immunoassay technique for clostridium difficile toxins (stool pathogen) [CPT 87324]

$57
$206

72% lower than market

Detection test by nucleic acid for multiple types influenza virus [CPT 87502]

$240
$378

36% lower than market

Detection test by nucleic acid for organism, quantification [CPT 87799]

$400
$424

6% lower than market

Digoxin level, total [CPT 80162]

$65
$154

58% lower than market

Testing for presence of drug, by chemistry analyzers [CPT 80307]

$121
$277

56% lower than market

Ferritin (blood protein) level [CPT 82728]

$67
$167

60% lower than market

Folic acid level, serum [CPT 82746]

$75
$145

48% lower than market

Hemoglobin A1C level [CPT 83036]

$48
$101

53% lower than market

Blood count, hemoglobin [CPT 85018]

$16
$39

59% lower than market

Hepatitis B core antibody measurement [CPT 86704]

$44
$94

53% lower than market

Hepatitis B surface antibody measurement [CPT 86706]

$40
$199

80% lower than market

Special stained specimen slides to examine tissue, each multiplex procedure [CPT 88344]

$195
$412

53% lower than market

Detection test by immunoassay technique for Strep (Streptococcus, group A) [CPT 87430]

$50
$157

68% lower than market

Detection test by nucleic acid for Strep (Streptococcus, group A), amplified probe technique [CPT 87651]

$117
$136

14% lower than market

Iron binding capacity [CPT 83550]

$40
$121

67% lower than market

Iron level [CPT 83540]

$29
$94

69% lower than market

Kidney function blood test panel [CPT 80069]

$33
$232

86% lower than market

Lactate dehydrogenase (enzyme) level [CPT 83615]

$27
$109

75% lower than market

Levetiracetam level [CPT 80177]

$74
$223

67% lower than market

Lipase (fat enzyme) level [CPT 83690]

$33
$138

76% lower than market

Liver function blood test panel [CPT 80076]

$38
$111

66% lower than market

Magnesium level [CPT 83735]

$32
$85

62% lower than market

Measurement C-reactive protein for detection of infection or inflammation [CPT 86140]

$44
$94

53% lower than market

Measurement of Hepatitis A antibody [CPT 86708]

$44
$105

58% lower than market

Measurement of antibody (IgE) to allergic substance, crude allergen extract, each [CPT 86003]

$22
$33

34% lower than market

Microbial toxin or antitoxin assay [CPT 87230]

$48
$90

47% lower than market

Natriuretic peptide (heart and blood vessel protein) level [CPT 83880]

$152
$207

26% lower than market

Obstetric blood test panel [CPT 80055]

$185
$554

67% lower than market

PSA (prostate specific antigen) measurement, total [CPT 84153]

$85
$174

51% lower than market

PSA (prostate specific antigen) measurement, free [CPT 84154]

$86
$167

48% lower than market

Parathormone (parathyroid hormone) level [CPT 83970]

$116
$251

54% lower than market

Coagulation assessment blood test, plasma or whole blood [CPT 85730]

$30
$103

71% lower than market

Phosphate level [CPT 84100]

$24
$76

69% lower than market

Psa screening [HCPCS G0103]

$85
$175

51% lower than market

Rbc leukocytes reduced [HCPCS P9016]

$600
$695

14% lower than market

Red blood cell sedimentation rate, to detect inflammation, non-automated [CPT 85651]

$25
$94

73% lower than market

Rheumatoid factor analysis [CPT 86430]

$32
$42

24% lower than market

Smear for parasites [CPT 87177]

$35
$138

75% lower than market

Special Gram or Giemsa stain for microorganism [CPT 87205]

$33
$66

50% lower than market

Special stain for parasites [CPT 87209]

$35
$143

75% lower than market

Stool analysis for blood, by peroxidase activity [CPT 82272]

$15
$78

81% lower than market

Stool culture [CPT 87045]

$31
$146

79% lower than market

Stool culture, additional pathogens [CPT 87046]

$31
$54

43% lower than market

Strep test by immunoassay for Streptococcus [CPT 87880]

$39
$82

52% lower than market

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution [CPT 87186]

$85
$116

27% lower than market

Tacrolimus level [CPT 80197]

$113
$331

66% lower than market

Detection test by immunoassay for influenza virus [CPT 87804]

$35
$118

70% lower than market

Testosterone (hormone) level, total [CPT 84403]

$57
$221

74% lower than market

Thyroid hormone evaluation [CPT 84479]

$47
$100

53% lower than market

Thyroxine (thyroid chemical), free [CPT 84439]

$75
$155

51% lower than market

Thyroxine (thyroid chemical), total [CPT 84436]

$48
$102

53% lower than market

Special stained specimen slides to examine tissue, initial procedure [CPT 88342]

$125
$371

66% lower than market

Total protein level, urine [CPT 84156]

$12
$43

72% lower than market

Troponin (protein) analysis, quantitative [CPT 84484]

$85
$190

55% lower than market

Manual urinalysis test with examination using microscope, automated [CPT 81001]

$28
$85

67% lower than market

Automated urinalysis test [CPT 81003]

$23
$52

56% lower than market

Urine microalbumin (protein) level [CPT 82043]

$29
$96

70% lower than market

Valproic acid level, total [CPT 80164]

$59
$222

73% lower than market

Vitamin D-3 level [CPT 82306]

$140
$192

27% lower than market

OUTPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Injection of incremental dosages of allergen, 2 or more injections [CPT 95117]

$40
$63

37% lower than market

Injection of incremental dosages of allergen [CPT 95115]

$38
$54

30% lower than market

Application of mechanical traction to 1 or more areas [CPT 97012]

$92
$161

43% lower than market

Air and bone conduction assessment of hearing loss and speech recognition [CPT 92557]

$205
$217

6% lower than market

Removal of tissue from wounds per session, first 20 sq cms or less [CPT 97597]

$214
$827

74% lower than market

Determination of lung volumes using gas dilution or washout [CPT 94727]

$150
$324

54% lower than market

Eardrum testing using ear probe [CPT 92567]

$48
$59

19% lower than market

Evaluation of defibrillator including connection, recording and disconnection [CPT 93289]

$51
$125

59% lower than market

Heart rhythm analysis, interpretation and report of 48-hour EKG [CPT 93226]

$350
$742

53% lower than market

Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle [CPT 96402]

$154
$798

81% lower than market

Hydration infusion into a vein [CPT 96361]

$75
$151

50% lower than market

Hydration infusion into a vein 31 minutes to 1 hour [CPT 96360]

$400
$581

31% lower than market

Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour [CPT 96367]

$115
$328

65% lower than market

Infusion into a vein for therapy, prevention, or diagnosis [CPT 96366]

$75
$180

58% lower than market

Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour [CPT 96365]

$400
$682

41% lower than market

Injection beneath the skin or into muscle for therapy, diagnosis, or prevention [CPT 96372]

$150
$176

15% lower than market

Injection of drug or substance into a vein for therapy, diagnosis, or prevention, in a facility [CPT 96376]

$200
$215

7% lower than market

Irrigation of implanted venous access drug delivery device [CPT 96523]

$152
$174

13% lower than market

Measurement and recording of brain wave (EEG) activity, awake and drowsy [CPT 95816]

$500
$1,182

58% lower than market

Moderate sedation services by physician also performing a procedure, additional 15 minutes [CPT 99153]

$125
$234

47% lower than market

Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes [CPT 99152]

$125
$570

78% lower than market

Needle measurement and recording of electrical activity of muscles of arm or leg complete study [CPT 95886]

$300
$421

29% lower than market

Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session [CPT 93798]

$207
$264

21% lower than market

Pneumococcal vaccine for injection into muscle [CPT 90670]

$129
$485

73% lower than market

Sleep monitoring of patient (6 years or older) in sleep lab [CPT 95810]

$4,200
$4,343

3% lower than market

Therapeutic removal of whole blood to correct blood level imbalance [CPT 99195]

$65
$244

73% lower than market

Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older [CPT 90732]

$326
$374

13% lower than market

Vaccine for influenza for injection into muscle, split virus, preservation free [CPT 90662]

$113
$197

43% lower than market

Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older [CPT 90714]

$81
$165

51% lower than market

Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes [CPT 97113]

$84
$336

75% lower than market

OUTPATIENT OBSERVATION CHARGES

Description

Our Charge
Market Charge

Variance

Hospital observation per hr [HCPCS G0378]

$63
$73

13% lower than market

OUTPATIENT OTHER CHARGES

Description

Our Charge
Market Charge

Variance

Injections of upper or middle spine facet joint using imaging guidance, single level [CPT 64490]

$2,030
$2,218

8% lower than market

Destruction of peripheral nerve or branch [CPT 64640]

$2,030
$1,853

10% higher than market

Destruction of upper or middle spinal facet joint nerves using imaging guidance [CPT 64633]

$4,298
$5,106

16% lower than market

Destruction of upper or middle spinal facet joint nerves with imaging guidance [CPT 64634]

$1,795
$2,623

32% lower than market

Tomosynthesis, mammo [HCPCS G0279]

$50
$116

57% lower than market

Direct refer hospital observ [HCPCS G0379]

$112
$304

63% lower than market

Drug test def 22+ classes [HCPCS G0483]

$370
$495

25% lower than market

Injection of substance into spinal canal of lower back or sacrum using imaging guidance [CPT 62323]

$1,562
$2,227

30% lower than market

Injection of anesthetic agent and/or steroid into other peripheral nerve or branch [CPT 64450]

$1,562
$2,493

37% lower than market

Injections of upper or middle spine facet joint using imaging guidance, second level [CPT 64491]

$514
$842

39% lower than market

Injections of upper or middle spine facet joint using imaging guidance, third and any additional level(s) [CPT 64492]

$514
$830

38% lower than market

Inj pantoprazole sodium, via [HCPCS C9113]

$24
$91

74% lower than market

Tc99m maa [HCPCS A9540]

$400
$919

56% lower than market

Tc99m mebrofenin [HCPCS A9537]

$120
$369

68% lower than market

Tc99m oxidronate [HCPCS A9561]

$170
$289

41% lower than market

Oth resp proc, indiv [HCPCS G0238]

$95
$163

42% lower than market

Therapeutic procd strg endur [HCPCS G0237]

$100
$98

2% higher than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION CHARGES

Description

Our Charge
Market Charge

Variance

Administration of 1 vaccine [CPT 90471]

$50
$95

47% lower than market

Admin influenza virus vac [HCPCS G0008]

$55
$83

34% lower than market

Admin pneumococcal vaccine [HCPCS G0009]

$53
$126

58% lower than market

Injection of drug or substance into a vein for therapy, diagnosis, or prevention [CPT 96374]

$300
$363

17% lower than market

Injection of different drug or substance into a vein for therapy, diagnosis, or prevention [CPT 96375]

$200
$241

17% lower than market

Diphenhydramine hcl injectio [HCPCS J1200]

$10
$40

75% lower than market

Fentanyl citrate injection [HCPCS J3010]

$27
$50

46% lower than market

Furosemide injection [HCPCS J1940]

$12
$34

65% lower than market

Hydralazine hcl injection [HCPCS J0360]

$87
$124

30% lower than market

Ketorolac tromethamine inj [HCPCS J1885]

$22
$35

36% lower than market

Inj midazolam hydrochloride [HCPCS J2250]

$17
$30

44% lower than market

Vancomycin hcl injection [HCPCS J3370]

$52
$52

Approximately equal to market

Garamycin gentamicin inj [HCPCS J1580]

$26
$40

34% lower than market

Hydrocortisone sodium succ i [HCPCS J1720]

$84
$104

19% lower than market

Insulin injection [HCPCS J1815]

$6
$6

5% lower than market

Meperidine hydrochl /100 mg [HCPCS J2175]

$32
$65

51% lower than market

Methylprednisolone 40 mg inj [HCPCS J1030]

$39
$64

39% lower than market

Methylprednisolone 80 mg inj [HCPCS J1040]

$69
$140

51% lower than market

Methylprednisolone injection [HCPCS J2920]

$20
$66

70% lower than market

Injection,onabotulinumtoxina [HCPCS J0585]

$18
$27

33% lower than market

Orphenadrine injection [HCPCS J2360]

$51
$85

40% lower than market

Leuprolide acetate suspnsion [HCPCS J9217]

$1,526
$6,859

78% lower than market

Vaccine for tetanus, diphtheria toxoids and acellular pertussis (whooping cough) for injection into muscle, patient 7 years or older [CPT 90715]

$162
$245

34% lower than market

OUTPATIENT RESPIRATORY THERAPY CHARGES

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

Description

Our Charge
Market Charge

Variance

Arterial puncture withdrawal of blood for diagnosis [CPT 36600]

$114
$141

19% lower than market

Measurement of lung diffusing capacity [CPT 94729]

$200
$327

39% lower than market

Respiratory inhaled pressure or nonpressure treatment to relieve airway obstruction or for sputum specimen [CPT 94640]

$180
$201

10% lower than market

OUTPATIENT SURGICAL SERVICES CHARGES

Description

Our Charge
Market Charge

Variance

Aspiration and/or injection of medium joint or joint capsule [CPT 20605]

$619
$1,123

45% lower than market

Aspiration and/or injection of large joint or joint capsule [CPT 20610]

$619
$1,102

44% lower than market

Aspiration and/or injection of small joint or joint capsule [CPT 20600]

$619
$1,731

64% lower than market

Biopsy of the large bowel using an endoscope (colonoscopy) [CPT 45380]

$2,000
$2,339

14% lower than market

Biopsy of prostate gland [CPT 55700]

$2,767
$4,093

32% lower than market

Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope [CPT 43239]

$2,000
$2,759

28% lower than market

Colorectal scrn; hi risk ind [HCPCS G0105]

$2,000
$3,146

36% lower than market

Diagnostic examination of the colon (large bowel) using an endoscope(colonoscopy); high risk [CPT 45378]

$2,000
$2,815

29% lower than market

Colon ca scrn not hi rsk ind [HCPCS G0121]

$2,600
$3,252

20% lower than market

Destruction of lower or sacral spinal facet joint nerves using imaging guidance [CPT 64635]

$4,298
$5,171

17% lower than market

Destruction of lower or sacral spinal facet joint nerves with imaging guidance [CPT 64636]

$1,795
$2,116

15% lower than market

Destruction of up to 14 skin growths [CPT 17110]

$240
$256

6% lower than market

Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope [CPT 43235]

$2,000
$2,826

29% lower than market

Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope [CPT 52000]

$2,767
$5,212

47% lower than market

Removal of cataract with insertion of lens, simple [CPT 66984]

$2,767
$5,442

49% lower than market

Removal of gallbladder using an endoscope [CPT 47562]

$4,462
$9,594

53% lower than market

Insertion of needle or catheter into a vein [CPT 36000]

$100
$100

Approximately equal to market

Inj for sacroiliac jt anesth [HCPCS G0260]

$1,836
$3,588

49% lower than market

Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance, single level [CPT 64483]

$2,030
$2,225

9% lower than market

Injection of substance into spinal canal of lower back or sacrum [CPT 62322]

$1,562
$9,702

84% lower than market

Injections of tendon sheath, ligament, or muscle membrane [CPT 20550]

$654
$1,024

36% lower than market

Injections of trigger points in 3 or more muscles [CPT 20553]

$654
$1,046

37% lower than market

Insertion of needle into vein for collection of blood sample [CPT 36415]

$7
$22

68% lower than market

Insertion of stent in urinary duct (ureter) using an endoscope [CPT 52332]

$3,542
$7,573

53% lower than market

Injections of lower or sacral spine facet joint using imaging guidance, single level [CPT 64493]

$2,030
$2,887

30% lower than market

Removal of impacted ear wax by washing [CPT 69209]

$275
$527

48% lower than market

Removal of polyps or growths in large bowel using an endoscope (colonoscopy) using a mechanical snare [CPT 45385]

$3,800
$2,469

54% higher than market

Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs [CPT 12002]

$255
$719

65% lower than market

Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs [CPT 12001]

$244
$719

66% lower than market

Transfusion of blood or blood products [CPT 36430]

$582
$1,247

53% lower than market

Ultrasound measurement of bladder capacity after voiding [CPT 51798]

$115
$245

53% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL CHARGES

The following charges reflect our most common x-ray and radiological procedures. For all exams requiring contrast, the contrast will be charged separately.

Description

Our Charge
Market Charge

Variance

Ultrasound of one breast, complete [CPT 76641]

$700
$739

5% lower than market

CT scan of abdomen and pelvis with contrast [CPT 74177]

$1,100
$4,485

75% lower than market

CT scan of abdomen and pelvis before and after contrast [CPT 74178]

$1,100
$5,386

80% lower than market

CT scan of abdomen and pelvis [CPT 74176]

$1,100
$3,553

69% lower than market

CT scan of blood vessels in chest with contrast [CPT 71275]

$1,100
$2,748

60% lower than market

CT scan of blood vessel of head with contrast [CPT 70496]

$1,100
$2,512

56% lower than market

CT scan of neck blood vessels with contrast [CPT 70498]

$1,100
$2,538

57% lower than market

Diagnostic CT scan of chest with contrast [CPT 71260]

$1,100
$2,552

57% lower than market

Diagnostic CT scan of chest [CPT 71250]

$1,100
$2,149

49% lower than market

CT scan of face [CPT 70486]

$1,100
$2,177

49% lower than market

CT scan head or brain before and after contrast [CPT 70470]

$1,100
$2,575

57% lower than market

CT scan head or brain [CPT 70450]

$1,100
$2,088

47% lower than market

CT scan leg [CPT 73700]

$1,100
$2,183

50% lower than market

CT scan of neck with contrast [CPT 70491]

$1,100
$2,582

57% lower than market

CT scan pelvis with contrast [CPT 72193]

$1,100
$2,770

60% lower than market

CT scan pelvis [CPT 72192]

$1,100
$2,101

48% lower than market

CT scan of upper spine [CPT 72125]

$1,100
$2,452

55% lower than market

CT scan of lower spine [CPT 72131]

$1,100
$2,381

54% lower than market

CT scan of middle spine [CPT 72128]

$1,100
$2,391

54% lower than market

X-ray of chest, 2 views [CPT 71046]

$200
$351

43% lower than market

X-ray of chest, 1 view [CPT 71045]

$200
$278

28% lower than market

Diagnostic mammography of both breasts [CPT 77066]

$400
$414

3% lower than market

Diagnostic mammography of one breast [CPT 77065]

$300
$299

Approximately equal to market

Fluoroscopic guidance for insertion of needle [CPT 77002]

$301
$754

60% lower than market

Complete X-ray study of abdomen with single X-ray of chest [CPT 74022]

$200
$653

69% lower than market

X-ray of abdomen, 2 views [CPT 74019]

$200
$449

55% lower than market

X-ray of abdomen, 1 view [CPT 74018]

$200
$401

50% lower than market

Imaging of liver and bile duct system with use of drugs [CPT 78227]

$1,375
$1,916

28% lower than market

MRI scan of arm joint [CPT 73221]

$1,500
$2,701

44% lower than market

MRI scan of brain before and after contrast [CPT 70553]

$1,500
$3,366

55% lower than market

MRI scan brain [CPT 70551]

$1,500
$2,936

49% lower than market

MRI scan of leg joint [CPT 73721]

$1,500
$2,795

46% lower than market

MRI scan of upper spinal canal [CPT 72141]

$1,500
$2,875

48% lower than market

MRI scan of lower spinal canal [CPT 72148]

$1,500
$2,924

49% lower than market

Nuclear medicine study of vessels of heart using drugs or exercise multiple studies [CPT 78452]

$2,850
$5,664

50% lower than market

Nuclear medicine study of lung ventilation and blood circulation in the lungs [CPT 78582]

$1,500
$2,241

33% lower than market

Screening mammography of both breasts [CPT 77067]

$326
$362

10% lower than market

Screening digital tomography of both breasts [CPT 77063]

$60
$116

48% lower than market

Stomach emptying study [CPT 78264]

$1,300
$2,240

42% lower than market

Ultrasound of abdomen, complete [CPT 76700]

$1,000
$1,364

27% lower than market

Ultrasound of abdomen, limited [CPT 76705]

$650
$914

29% lower than market

Ultrasound behind abdominal cavity [CPT 76770]

$900
$1,452

38% lower than market

Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck [CPT 93880]

$1,000
$1,556

36% lower than market

Ultrasound of head and neck [CPT 76536]

$700
$949

26% lower than market

Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function [CPT 93306]

$2,100
$2,408

13% lower than market

Partial ultrasound of joint or other non-blood vessel structure of arm or leg [CPT 76882]

$400
$639

37% lower than market

Ultrasound of pelvis, complete, not pregnancy related [CPT 76856]

$1,000
$1,232

19% lower than market

Ultrasound pelvis through vagina [CPT 76830]

$600
$1,002

40% lower than market

Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus [CPT 76805]

$900
$711

27% higher than market

Ultrasound of scrotum [CPT 76870]

$800
$884

9% lower than market

Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers [CPT 93970]

$1,200
$1,559

23% lower than market

Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers [CPT 93971]

$1,000
$1,174

15% lower than market

Ultrasound of pelvis, limited, not pregnancy related [CPT 76857]

$700
$952

26% lower than market

Ultrasound of pelvic region through rectum [CPT 76872]

$375
$916

59% lower than market

Ultrasound scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow [CPT 93975]

$900
$1,457

38% lower than market

Ultrasound evaluation of abdominal aorta to detect bulging (aneurysm) [CPT 76706]

$500
$615

19% lower than market

Bone and/or joint imaging, whole body [CPT 78306]

$1,850
$2,603

29% lower than market

X-ray of ankle, minimum of 3 views [CPT 73610]

$300
$452

34% lower than market

X-ray of both hips with pelvis, 2 views [CPT 73521]

$200
$541

63% lower than market

X-ray of elbow, 2 views [CPT 73070]

$300
$292

3% higher than market

X-ray of elbow, minimum of 3 views [CPT 73080]

$300
$451

33% lower than market

X-ray of femur, minimum 2 views [CPT 73552]

$200
$439

54% lower than market

X-ray of fingers, minimum of 2 views [CPT 73140]

$200
$383

48% lower than market

X-ray of foot, 2 views [CPT 73620]

$300
$422

29% lower than market

X-ray of foot, minimum of 3 views [CPT 73630]

$300
$444

32% lower than market

X-ray of forearm, 2 views [CPT 73090]

$400
$419

5% lower than market

X-ray of hand, 2 views [CPT 73120]

$300
$447

33% lower than market

X-ray of hand, minimum of 3 views [CPT 73130]

$300
$445

33% lower than market

X-ray of hip with pelvis, 1 view [CPT 73501]

$200
$316

37% lower than market

X-ray of hip with pelvis, 2-3 views [CPT 73502]

$200
$424

53% lower than market

X-ray of knee, 1 or 2 views [CPT 73560]

$400
$389

3% higher than market

X-ray of knee, 3 views [CPT 73562]

$400
$465

14% lower than market

X-ray of knee, 4 or more views [CPT 73564]

$500
$541

8% lower than market

X-ray of lower leg, 2 views [CPT 73590]

$300
$436

31% lower than market

X-ray of lower and sacral spine, 2 or 3 views [CPT 72100]

$200
$381

48% lower than market

X-ray of lower and sacral spine, minimum of 4 views [CPT 72110]

$200
$769

74% lower than market

X-ray of middle spine, 2 views [CPT 72070]

$200
$479

58% lower than market

X-ray of spine of neck, 2 or 3 views [CPT 72040]

$200
$476

58% lower than market

X-ray of pelvis, 1 or 2 views [CPT 72170]

$200
$406

51% lower than market

X-ray of pelvis, minimum of 2 views [CPT 72220]

$200
$452

56% lower than market

X-ray of shoulder, minimum of 2 views [CPT 73030]

$400
$452

11% lower than market

X-ray of toes, minimum of 2 views [CPT 73660]

$200
$390

49% lower than market

X-ray of upper arm, minimum of 2 views [CPT 73060]

$350
$440

20% lower than market

X-ray of upper spine, 4 or 5 views [CPT 72050]

$200
$665

70% lower than market

X-ray of wrist, 2 views [CPT 73100]

$300
$389

23% lower than market

X-ray of wrist, minimum of 3 views [CPT 73110]

$300
$456

34% lower than market

X-ray of middle spine, 3 views [CPT 72072]

$200
$606

67% lower than market

X-ray of ribs on one side of body including the chest, minimum of 3 views [CPT 71101]

$300
$541

45% lower than market

INPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Anemia or other red blood cell disorders without complications

$10,537
$23,605

55% lower than market

Nutritional or Metabolic Disorders without major complications

$6,626
$20,881

68% lower than market

Stomach Disorder without complications

$7,748
$21,140

63% lower than market

INPATIENT ORTHOPEDIC SURGERY CHARGES

Description

Our Charge
Market Charge

Variance

Total Knee or Hip Replacement

$50,719
$64,846

22% lower than market

INPATIENT PULMONOLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Chronic Lung Disease with complications

$8,676
$23,189

63% lower than market

Chronic Lung Disease with major complications

$11,104
$26,013

57% lower than market

Chronic Lung Disease without complications

$7,264
$15,644

54% lower than market

Pneumonia with complications

$9,835
$22,831

57% lower than market

Pneumonia without complications

$10,155
$16,245

37% lower than market

INPATIENT UROLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Kidney & urinary Infection without complications

$6,015
$20,155

70% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Ohio County Hospital for your healthcare needs. We want to make understanding and paying your bill as easy as possible. Here are some ways you can help us as we work to make the billing process go smoothly.

• Please give us complete health insurance information.

In addition to your health insurance card, we may ask for a photo ID. If you have been seen at Ohio County Hospital, let us know if your personal information or insurance information has changed since your last visit.

• Please understand and follow the requirements of your health plan.

Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and Ohio County Hospital is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.

• Please respond promptly to any requests from your insurance provider.

You may receive multiple bills from your hospital visit, including your family doctor, specialists, physicians that read x-rays, providers that give anesthesia, or physicians that interpret blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from Ohio County Hospital indicating the bill is now your responsibility. All bills sent to you are due upon receipt.

Questions about Price and Billing Information

Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.

To ask questions or get more information about a bill for services you've received, please contact our Billing Department at 270-298-5431.

If you need more information about the price of a future service, please contact our Customer Service at 270-298-5431. A physician’s order or CPT code is strongly encouraged when you call to assist us in providing you with the most accurate estimate. You can obtain the CPT code from the ordering physician.