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Patient Price Information List

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

Hospital Name
Location

Carlinville Area Hospital

Carlinville

IL

Decatur Memorial Hospital

Decatur

IL

Fayette County Hospital

Vandalia

IL

HSHS Good Shepherd Hospital

Shelbyville

IL

HSHS Saint John's Hospital

Springfield

IL

HSHS Saint Mary's Hospital

Decatur

IL

Hillsboro Area Hospital

Hillsboro

IL

Kirby Medical Center

Monticello

IL

Memorial Medical Center

Springfield

IL

Taylorville Memorial Hospital

Taylorville

IL

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$1,497
$1,700

12% lower than market

Semi-Private Room

$1,092
$1,308

16% 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 - Level 1

$397
$325

22% higher than market

Emergency Department Visit - Level 2

$321
$436

26% lower than market

Emergency Department Visit - Level 3

$452
$677

33% lower than market

Emergency Department Visit - Level 4

$706
$918

23% lower than market

Emergency Department Visit - Level 5

$1,146
$1,680

32% lower than market

Emergency Critical Care, Each Additional 30 Minutes

$604
$800

25% lower than market

Emergency Critical Care, First 30 Minutes

$1,862
$2,436

24% lower than market

Subsequent hospital inpatient care, typically 25 minutes per day

$175
$170

3% higher 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

Application of Electrical Stimulation - 15 Minutes

$121
$184

34% lower than market

Electric Stimulation for Therapy

$96
$202

52% lower than market

Gait Training - 15 Minutes

$124
$149

17% lower than market

PT Evaluation - Moderate Complexity

$310
$421

26% lower than market

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

$115
$162

29% lower than market

Physical Therapy 1 or More Regions (15 min)

$161
$168

4% lower than market

Physical Therapy Exercise, 15 Minutes

$129
$172

25% lower than market

Physical Therapy, complex evaluation

$310
$516

40% lower than market

Physical Therapy, re-evaluation

$197
$190

4% higher than market

Physical Therapy, standard evaluation - 20 minutes

$310
$340

9% 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

Occupational Therapy Evaluation - Moderate Complexity

$310
$400

22% lower than market

Occupational Therapy, complex evaluation

$310
$461

33% lower than market

Occupational Therapy, re-evaluation

$197
$225

12% lower than market

Occupational Therapy, standard evaluation - 30 minutes

$310
$340

9% lower than market

Self Care - Home Management Training - 15 Minutes

$117
$159

26% lower than market

Therapeutic Activities Involving Functional Activities (15 min)

$115
$157

27% 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

Aerosol Treatment

$147
$312

53% lower than market

Holter Testing - 48-Hour EKG

$846
$875

3% lower than market

Routine EKG - Minimum 12 Leads

$292
$340

14% lower than market

Spirometry - breathing test

$274
$339

19% lower than market

Spirometry - medicated breathing procedure

$547
$659

17% lower than market

Stress Test with EKG tracing

$1,049
$1,347

22% lower than market

OUTPATIENT SPEECH THERAPY CHARGES

Description

Our Charge
Market Charge

Variance

Evaluation of Speech Sound Production

$401
$476

16% lower than market

Evaluation of Speech Sound Production and Language Comprehenson

$401
$585

31% lower than market

Speech Therapy

$333
$384

13% lower than market

Swallow Treatment

$283
$336

16% 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

Blood test, basic group of blood chemicals

$175
$196

11% lower than market

Blood test, clotting time

$68
$92

27% lower than market

Blood test, comprehensive group of blood chemicals

$270
$232

16% higher than market

Blood test, lipids (cholesterol and triglycerides)

$235
$209

13% higher than market

Blood test, thyroid stimulating hormone (TSH)

$181
$223

19% lower than market

Complete blood cell count - automated differential WBC count

$140
$119

18% higher than market

Complete blood cell count - automated test with out Differential

$105
$100

5% higher than market

COVID-19 amplified probe technique test

$171
$145

18% higher than market

COVID-19 antibody test

$167
$167

Approximately equal to market

Kidney Function Blood Test Panel

$201
$273

26% lower than market

Liver function blood test panel

$181
$220

17% lower than market

PSA (prostate specific antigen) measurement

$150
$203

26% lower than market

PSA Measurement; Free

$65
$154

58% lower than market

Coagulation assessment blood test

$66
$140

53% lower than market

Urinalysis with Examination, using Microscope

$92
$105

13% lower than market

Urinalysis, Automated Test

$8
$65

88% lower than market

OUTPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Application of blood vessel compression or decompression device to 1 or more areas

$121
$142

15% lower than market

Application of mechanical traction to 1 or more areas

$159
$205

22% lower than market

Application of whirlpool therapy to 1 or more areas

$169
$169

Approximately equal to market

Assessment of expressive and receptive speech with interpretation and report per hour

$401
$372

8% higher than market

Behavioral and qualitative analysis of voice and resonance

$401
$563

29% lower than market

Community or work reintegration training, each 15 minutes

$121
$122

1% lower than market

Debridement, open wound; first 20 cm2 or less

$301
$530

43% lower than market

Debridement, open wound; each additional 20cm2 or part thereof

$247
$698

65% lower than market

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

$176
$191

8% lower than market

Determination of lung volumes using gas dilution or washout

$400
$376

6% higher than market

External shock to heart to regulate heart beat

$887
$1,868

53% lower than market

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

$803
$727

11% higher than market

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

$246
$248

1% lower than market

Hydration Infusion into a Vein

$146
$189

23% lower than market

Hydration Infusion into a Vein - 31 Minutes to 1 Hour

$315
$431

27% lower than market

Infusion (Additional) for Therapy, Diagnosis or Prevention

$228
$230

1% lower than market

Infusion into a Vein for Therapy, Diagnosis, or Prevention

$228
$225

1% higher than market

Infusion of Drug or Substance into Vein for Therapy or Diagnosis

$359
$447

20% lower than market

Infusion of chemotherapy into a vein using push technique

$372
$357

4% higher than market

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

$271
$342

21% lower than market

Inhaled pneumonia treatment

$297
$429

31% lower than market

Injection Beneath the Skin for Therapy, Diagnosis, or Prevention

$187
$182

3% higher than market

Irrigation of implanted venous access drug delivery device

$196
$177

11% higher than market

Manual maneuvers to chest wall to assist movement of lung secretions

$101
$111

9% lower than market

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

$908
$1,003

9% lower than market

Measurement of exhaled carbon dioxide gas

$308
$347

11% lower than market

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

$29
$67

56% lower than market

Medical nutrition therapy, assessment and intervention, each 15 minutes

$29
$88

67% lower than market

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

$210
$829

75% lower than market

Multiple measurements and graphic recordings of the amount and speed of breathed air, before and fol

$1,336
$1,384

3% lower than market

Multiple measurements of oxygen saturation in blood using ear or finger device

$143
$229

38% lower than market

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

$246
$272

9% 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

$114
$150

24% lower than market

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

$207
$318

35% lower than market

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

$281
$380

26% lower than market

Repositioning maneuvers for treatment of vertigo, per day

$178
$167

7% higher than market

Respiratory flow testing, volume loop

$201
$377

47% lower than market

Respiratory inhaled aerosol treatment to relieve airway obstruction

$149
$197

24% lower than market

Respiratory inhaled aerosol treatment to relieve airway obstruction, first hour

$149
$261

43% lower than market

Temporary pacemaker to regulate heart beat

$1,020
$1,523

33% lower than market

Therapeutic massage to 1 or more areas, each 15 minutes

$114
$199

43% lower than market

Therapeutic procedures in a group setting

$75
$111

33% lower than market

Therapeutic removal of whole blood to correct blood level imbalance

$378
$436

13% lower than market

Tracing of electrical activity of the heart using 1-3 leads

$176
$243

28% lower than market

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

$117
$163

28% lower than market

Training in use of prosthesis for arms and/or legs each 15 minutes

$114
$302

62% lower than market

Measurement of largest amount of air exhaled from lungs

$82
$134

39% lower than market

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

$228
$207

10% higher than market

Ventilation assist and management; hospital inpatient/observation, initial day

$1,308
$1,617

19% lower than market

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

$107
$182

41% lower than market

Wheelchair management, each 15 minutes

$74
$145

49% lower than market

OUTPATIENT OBSERVATION CHARGES

Description

Our Charge
Market Charge

Variance

Hospital Observation per Hour

$44
$83

47% lower than market

Hospital observation care discharge

$190
$228

17% lower than market

Hospital observation care typically 30 minutes

$259
$241

7% higher than market

Hospital observation care typically 50 minutes

$346
$349

1% lower than market

Hospital observation care typically 70 minutes per day

$472
$451

5% higher 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

$66
$166

61% lower than market

CO Diffusion Capacity

$251
$398

37% lower than market

Pulse Oximetry

$105
$106

1% lower than market

OUTPATIENT SURGICAL SERVICES CHARGES

Description

Our Charge
Market Charge

Variance

Application of Short Arm Splint

$265
$442

40% lower than market

Application of Short Leg Splint (Calf to Foot)

$301
$419

28% lower than market

Application of long arm splint (shoulder to hand)

$235
$384

39% lower than market

Application of long leg splint (thigh to ankle or toes)

$235
$529

56% lower than market

Application of non-moveable, hinged finger splint

$235
$309

24% lower than market

Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting

$1,034
$1,817

43% lower than market

Arthrocentesis, aspiration and/or injection, major joint or bursa with ultrasound guidance

$1,034
$1,376

25% lower than market

Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting

$1,034
$1,258

18% lower than market

Arthrodesis, great toe; metatarsophalangeal joint

$2,801
$10,490

73% lower than market

Aspiration and/or injection: intermediate joint/bursa

$386
$874

56% lower than market

Aspiration and/or injection: large joint/bursa

$1,002
$1,275

21% lower than market

Avulsion of nail plate, partial or complete, simple; single

$263
$279

6% lower than market

Biopsy of Large Bowel, Using an Endoscope

$1,845
$3,810

52% lower than market

Biopsy of breast accessed throught the skin with ultrasound guidance; first lesion

$3,100
$3,355

8% lower than market

Biopsy of prostate gland

$5,470
$6,334

14% lower than market

Closed treatment of broken ankle; trimalleolar ankle fracture

$368
$537

32% lower than market

Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each

$368
$955

62% lower than market

Closed treatment of shoulder dislocation with manipulation

$368
$686

46% lower than market

Closed treatment of upper arm fracture; humeral shaft fracture

$368
$1,021

64% lower than market

Collection of blood specimen from a completely implantable venous access device

$101
$192

47% lower than market

Collection of blood specimen from central or peripheral venous catheter

$101
$211

52% lower than market

Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps

$1,957
$4,779

59% lower than market

Colorectal Cancer Screening; Colonoscopy on Non-High Risk Patient

$1,511
$3,345

55% lower than market

Complex control of nose bleed

$269
$452

40% lower than market

Control Nose Bleed - Simple Case

$269
$514

48% lower than market

Control of nose bleed and insertion of packing

$269
$671

60% lower than market

Correction of deformity of first long bone at toe joint

$5,442
$6,156

12% lower than market

Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with resection of proximal phalanx base, when performed, any method

$8,980
$8,375

7% higher than market

Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope

$1,271
$4,789

73% lower than market

Drainage of Abscess

$448
$503

11% lower than market

Drainage of blood or fluid accumulation

$2,100
$4,670

55% lower than market

Drainage of fluid from abdominal cavity using imaging guidance

$1,971
$2,074

5% lower than market

Drainage of multiple abscess

$448
$744

40% lower than market

Dressing change and/or removal of burn tissue (5% to 10% total body surface)

$333
$447

25% lower than market

Dressing change and/or removal of burn tissue (greater than 10% total body surface)

$333
$523

36% lower than market

Dressing change and/or removal of burn tissue (less than 5% total body surface)

$333
$359

7% lower than market

Removal of cataract with insertion of lens

$4,968
$6,079

18% lower than market

Gallbladder Removal Using an Endoscope

$8,820
$14,972

41% lower than market

Incision and drainage of pilonidal cyst; simple

$1,050
$2,100

50% lower than market

Incision and removal of foreign body, subcutaneous tissues; simple

$525
$1,808

71% lower than market

Injection procedure for X-ray imaging of the bladder or during voiding

$201
$302

33% lower than market

Injections of large bowel using an endoscope

$1,790
$2,289

22% lower than market

Injections of tendon attachment to bone

$791
$2,869

72% lower than market

Injections of tendon sheath, ligament, or muscle membrane

$791
$1,043

24% lower than market

Insertion of Breathing Tube Using an Endoscope

$263
$985

73% lower than market

Insertion of Central Venous Catheter

$2,583
$5,722

55% lower than market

Insertion of Central Venous Catheter for Infusion

$2,528
$1,985

27% higher than market

Insertion of Indwelling Bladder Catheter

$304
$370

18% lower than market

Insertion of Needle into Vein to Collect Blood

$21
$30

31% lower than market

Insertion of catheter for suction of secretions

$276
$293

6% lower than market

Insertion of lens prosthesis

$3,577
$8,490

58% lower than market

Insertion of nasal or oral stomach tube using fluoroscopic guidance

$699
$933

25% lower than market

Insertion of needle for infusion into bone

$372
$478

22% lower than market

Insertion of temporary bladder catheter

$289
$260

11% higher than market

Needle biopsy or removal of lymph nodes

$3,357
$3,505

4% lower than market

Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance

$1,824
$2,408

24% lower than market

Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance

$1,824
$3,261

44% lower than market

Removal (less than 3 centimeters) tissue growth beneath the skin of back or flank

$2,717
$3,115

13% lower than market

Removal of (2 centimeters or greater) muscle growth of face and scalp

$2,853
$9,686

71% lower than market

Colonoscopy with removal of polyp(s)

$2,124
$3,123

32% lower than market

Removal of fluid from between lung and chest cavity, open procedure

$1,890
$3,160

40% lower than market

Removal of fluid from chest cavity

$623
$1,654

62% lower than market

Removal of fluid from chest cavity with imaging guidance

$1,824
$2,431

25% lower than market

Removal of foreign body from ear canal

$263
$256

3% higher than market

Removal of foreign body in nose

$269
$301

11% lower than market

Removal of gallbladder with X-ray study of bile ducts using endoscope

$8,400
$14,561

42% lower than market

Removal of growth (2.1 to 3.0 centimeters) of face, ears, eyelids, nose, lips, or mouth

$625
$1,670

63% lower than market

Removal of hemorrhoid by rubber banding

$831
$2,464

66% lower than market

Removal of internal and external hemorrhoids

$1,734
$3,511

51% lower than market

Removal of malignant growth (over 4.0 centimeters) of the trunk, arms, or legs

$2,717
$2,933

7% lower than market

Removal of peripheral venous catheter for infusion

$1,123
$2,983

62% lower than market

Removal of testis (testicle)

$5,381
$6,197

13% lower than market

Repair of Wound (2.6 to 7.5 centimeters)

$295
$537

45% lower than market

Repair of Wound (7.6 to 12.5 cm)

$295
$591

50% lower than market

Repair of wound (12.6 to 20.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/

$428
$602

29% lower than market

Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth

$428
$1,423

70% lower than market

Repair of wound (2.5 centimeters or less) of neck, hands, feet, and/or genitals

$428
$1,120

62% lower than market

Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs

$428
$1,423

70% lower than market

Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth

$428
$1,547

72% lower than market

Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs

$428
$1,720

75% lower than market

Repair of wound (20.1 to 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/

$428
$610

30% lower than market

Repair of wound (5.1 to 7.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth

$428
$1,646

74% lower than market

Repair of wound (5.1 to 7.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membr

$295
$600

51% lower than market

Repair of wound (7.6 to 12.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth

$428
$1,819

76% lower than market

Repair of wound (7.6 to 12.5 centimeters) of neck, hands, feet, and/or genitals

$525
$707

26% lower than market

Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs

$428
$1,327

68% lower than market

Replacement of peripheral venous catheter, without subcutaneous port

$2,357
$2,864

18% lower than market

Simple wound repair of face, including ears; 2.5 cm or less

$295
$441

33% lower than market

Simple wound repair of face, including ears; 2.6 cm to 5.0 cm

$295
$532

45% lower than market

Simple wound repair of scalp, neck, external genitalia; 2.5 cm or less

$295
$500

41% lower than market

Spinal tap for diagnosis

$349
$1,254

72% lower than market

Strapping of ankle and/or foot

$235
$295

21% lower than market

Strapping of knee

$235
$468

50% lower than market

Strapping of shoulder

$235
$337

30% lower than market

Strapping, Unna boot

$235
$411

43% lower than market

Transfusion of Blood or Blood Products

$863
$1,231

30% lower than market

Treatment of hip dislocation

$2,080
$1,707

22% higher than market

Upper arm and elbow procedure

$368
$642

43% 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

Bone Density Scan (DEXA Scan)

$591
$696

15% lower than market

CT Abdomen & Pelvis with Contrast

$4,772
$5,686

16% lower than market

CT Abdomen & Pelvis with and without Contrast

$6,645
$6,193

7% higher than market

CT Abdomen & Pelvis without Contrast

$4,138
$4,785

14% lower than market

CT Abdomen with and without Contrast

$3,323
$3,688

10% lower than market

CT Angiogram Chest with and without Contrast

$3,475
$3,730

7% lower than market

CT Chest with Contrast

$2,604
$3,027

14% lower than market

CT Chest without Contrast

$2,045
$2,453

17% lower than market

CT Face without Contrast

$2,045
$2,307

11% lower than market

CT Head Brain without Contrast

$2,413
$2,414

Approximately equal to market

CT Pelvis without Contrast

$2,045
$2,510

19% lower than market

CT Spine Cervical without Contrast

$2,303
$3,011

24% lower than market

CT Spine Lumbar without Contrast

$2,303
$2,642

13% lower than market

Chest X-Ray; 2 Views

$332
$424

22% lower than market

Chest X-Ray; Single View

$268
$374

29% lower than market

Diagnostic mammography, bilateral

$418
$512

18% lower than market

Diagnostic mammography, unilateral

$257
$377

32% lower than market

Imaging for Evaluation of Swalling Function

$444
$742

40% lower than market

Imaging of Abdomen; Single View

$332
$413

20% lower than market

Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries

$317
$696

54% lower than market

MRI Arm Joint without Contrast

$2,804
$3,414

18% lower than market

MRI Brain with and without Conrast

$3,984
$5,187

23% lower than market

MRI Brain without Contrast

$3,235
$3,708

13% lower than market

MRI Leg Joint without Contrast

$2,804
$3,419

18% lower than market

MRI Spine Lumbar without Contrast

$3,235
$3,976

19% lower than market

Myocardial Perfusion, Tomographic

$5,617
$5,122

10% higher than market

Physical Therapy, ultrasound therapy - 15 minutes

$117
$171

32% lower than market

Screening Mammography, Bilateral, with CAD

$356
$390

9% lower than market

Screening digital breast tomosynthesis, bilateral

$92
$163

44% lower than market

Ultrasound Abdomen - Complete

$933
$1,268

26% lower than market

Ultrasound Abdomen - Limited

$733
$936

22% lower than market

Ultrasound Behind Abdominal Cavity - Complete

$775
$1,088

29% lower than market

Ultrasound Behind Abdominal Cavity - Limited

$788
$906

13% lower than market

Ultrasound Blood Flow Outside the Brain

$1,068
$1,307

18% lower than market

Ultrasound Head Neck

$480
$811

41% lower than market

Ultrasound Heart

$1,936
$2,315

16% lower than market

Ultrasound Pelvis NonOB

$770
$996

23% lower than market

Ultrasound Pelvis through Vagina

$606
$863

30% lower than market

Ultrasound Pregnant Uterus > 14 Weeks Pregnant

$691
$1,610

57% lower than market

Ultrasound Veins of Both Arms or Legs

$1,154
$1,540

25% lower than market

Ultrasound Veins of One Arm or Leg

$782
$1,080

28% lower than market

Ultrasound of Arteries of Both Legs

$1,134
$1,473

23% lower than market

X-Ray Both Hips and Pelvis, 2 Views

$548
$663

17% lower than market

X-Ray Hip and Pelvis, 2 Views

$396
$503

21% lower than market

X-Ray Lower Sacral Spine, 2-3 Views

$421
$559

25% lower than market

X-Ray Lower Sacral Spine, 4 or More Views

$528
$807

35% lower than market

X-Ray Neck Spine, 2-3 Views

$492
$554

11% lower than market

X-Ray Pelvis, 1-2 Views

$332
$441

25% lower than market

X-Ray Upper Spine, 4-5 Views

$682
$721

5% lower than market

X-Ray of Middle Spine; 3 Views

$474
$598

21% lower than market

X-ray of eye

$295
$311

5% lower than market

INPATIENT CARDIOLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Abnormal or Irregular Heartbeat without complications

$11,247
$12,751

12% lower than market

Acute myocardial infarction, discharged alive with major complications

$27,730
$26,769

4% higher than market

Heart Failure with complications

$16,813
$17,754

5% lower than market

Heart failure & shock without complications

$10,565
$14,007

25% lower than market

INPATIENT GENERAL SURGERY CHARGES

Description

Our Charge
Market Charge

Variance

Non-extensive O.R. procedure unrelated to principal diagnosis without complications

$24,470
$27,889

12% lower than market

INPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Cellulitis with major complications

$27,210
$23,699

15% higher than market

INPATIENT ORTHOPEDICS CHARGES

Description

Our Charge
Market Charge

Variance

Fractures of hip & pelvis without major complications

$14,047
$12,492

12% higher than market

INPATIENT PULMONOLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Major chest trauma without complications

$6,386
$21,287

70% lower than market

Pneumonia with major complications

$26,569
$25,411

5% higher than market

Pneumonia without complications

$10,456
$16,533

37% lower than market

INPATIENT UROLOGY CHARGES

Description

Our Charge
Market Charge

Variance

Kidney & urinary Infection without complications

$10,984
$16,774

35% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Pana Community 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 Pana Community 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 Pana Community 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 Pana Community 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 217-562-2131.

If you need more information about the price of a future service, please contact our Customer Service at 217-562-2131. 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.