Our patient price estimator tool will be activated by January 1, 2021 or sooner.
Patient Price Information List
Disclaimer: Salina Surgical 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.
Salina Surgical Hospital Patient Information Price List
LOCAL MARKET HOSPITALS
In order to present a meaningful comparison, Salina Surgical Hospital has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2022. Salina Surgical Hospital's charges are displayed and compared with the local market charge, consisting of the following hospitals:
Manhattan Surgical Center
Manhattan
KS
McPherson Hospital
McPherson
KS
Memorial Health System
Abilene
KS
Salina Regional Health Center
Salina
KS
Summit Surgical
Hutchinson
KS
Salina Surgical Hospital Patient Information Price List
INPATIENT ROOM AND BOARD DAILY CHARGES
INPATIENT ROOM AND BOARD DAILY CHARGES
Description
Variance
Private Room
Private Room
40% lower than market
Salina Surgical Hospital Patient Information Price List
CMS SHOPPABLE SERVICE
CMS SHOPPABLE SERVICE
Description
Variance
Breast cyst removal, male or female (1 or more cysts) [HCPCS 19120]
Breast cyst removal, male or female (1 or more cysts) [HCPCS 19120]
10% lower than market
Cataract removal involving removal of the front part of the capsule and the central part of the lens with lens prosthesis insertion [HCPCS 66984]
Cataract removal involving removal of the front part of the capsule and the central part of the lens with lens prosthesis insertion [HCPCS 66984]
38% lower than market
Colon (large bowel) examination and biopsy with endoscope [HCPCS 45380]
Colon (large bowel) examination and biopsy with endoscope [HCPCS 45380]
A flexible colonoscopy is performed with single or multiple biopsies. The colonoscope is inserted into the rectum and advanced through the colon to the cecum or a point within the terminal ileum, using air insufflation to separate the mucosal folds for better visualization. Mucosal surfaces of the colon are inspected and any abnormalities are noted. The endoscope is then withdrawn and mucosal surfaces are again inspected for ulcerations, varices, bleeding sites, lesions, strictures, or other abnormalities. Any suspect site(s) to be biopsied is identified and biopsy forceps are placed through the biopsy channel in the endoscope. The forceps are opened, the tissue is spiked, and the forceps are closed. The biopsied tissue is then removed through the endoscope. One or more tissue samples may be obtained and are sent for separately reportable laboratory analysis.
41% lower than market
Colon (large bowel) examination and polyps or tumors removal by snare technique with endoscope [HCPCS 45385]
Colon (large bowel) examination and polyps or tumors removal by snare technique with endoscope [HCPCS 45385]
A flexible colonoscopy is performed with removal of tumors, polyps, or other lesions by hot biopsy forceps or snare technique. The colonoscope is inserted into the rectum and advanced through the colon to the cecum or a point within the terminal ileum, using air insufflation to separate the mucosal folds for better visualization. Mucosal surfaces of the colon are inspected and any abnormalities are noted. The tumor, polyp, or other lesion is identified. Hot biopsy method uses insulated monopolar forceps to remove and electrocoagulate (cauterize) tissue simultaneously. Hot biopsy forceps are used primarily for removal of small polyps and treatment of vascular ectasias. A wire snare loop is placed around the lesion. The loop is heated to shave off and cauterize the lesion. Lesions may be removed en bloc with one placement of the snare or in a piecemeal fashion which requires multiple applications of the snare. The endoscope is withdrawn and mucosal surfaces are again inspected for ulcerations, bleeding sites, lesions, strictures, or other abnormalities.
39% lower than market
Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]
Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]
A flexible colonoscopy is performed with or without collection of specimens by brushing or washing. The colonoscope is inserted into the rectum and advanced through the colon to the cecum or a point within the terminal ileum, using air insufflation to separate the mucosal folds for better visualization. Mucosal surfaces of the colon are inspected and any abnormalities are noted. The endoscope is then withdrawn as mucosal surfaces are again inspected for ulcerations, varices, bleeding sites, lesions, strictures, or other abnormalities. Cytology (cell) samples may be obtained using a brush introduced through the endoscope. Alternatively, sterile water may be introduced to wash the mucosal lining and the fluid aspirated to obtain cell samples. Cytology samples are sent for separately reportable laboratory analysis.
59% lower than market
Esophagus, stomach, and/or upper small bowel examination and biopsy with endoscope [HCPCS 43239]
Esophagus, stomach, and/or upper small bowel examination and biopsy with endoscope [HCPCS 43239]
An upper gastrointestinal (UGI) endoscopic examination, also referred to as an esophagogastroduodenoscopy (EGD), is performed on the esophagus, stomach, duodenum and/or jejunum with biopsy(s). The mouth and throat are numbed using an anesthetic spray. A hollow mouthpiece is placed in the mouth. The flexible fiberoptic endoscope is then inserted and advanced as it is swallowed by the patient. Once the endoscope has been advanced beyond the cricopharyngeal region, it is guided using direct visualization. The esophagus is inspected and any abnormalities are noted. The endoscope is then advanced beyond the gastroesophageal junction into the stomach and the stomach is insufflated with air. The cardia, fundus, greater and lesser curvature, and antrum are inspected and any abnormalities are noted. The tip of the endoscope is then advanced through the pylorus and into the duodenum and/or jejunum where mucosal surfaces are inspected for any abnormalities. Single or multiple samples of suspect tissue are taken through the scope. The endoscope is withdrawn and mucosal surfaces are again inspected for ulcerations, varices, bleeding sites, lesions, strictures, or other abnormalities.
37% lower than market
Esophagus, stomach, and/or upper small bowel examination with endoscope for diagnosis [HCPCS 43235]
Esophagus, stomach, and/or upper small bowel examination with endoscope for diagnosis [HCPCS 43235]
A diagnostic upper gastrointestinal (UGI) endoscopic examination is performed of the esophagus, stomach, duodenum and/or jejunum with or without collection of specimens by brushing or washing. This procedure may also be referred to as an esophagogastroduodenoscopy (EGD). The mouth and throat are numbed using an anesthetic spray. A hollow mouthpiece is placed in the mouth. The flexible fiberoptic endoscope is then inserted and advanced as it is swallowed by the patient. Once the endoscope has been advanced beyond the cricopharyngeal region, it is guided using direct visualization. The esophagus is inspected and any abnormalities are noted. The endoscope is then advanced beyond the gastroesophageal junction into the stomach and the stomach is insufflated with air. The cardia, fundus, greater and lesser curvature, and antrum of the stomach are inspected and any abnormalities are noted. The tip of the endoscope is then advanced through the pylorus and into the duodenum and/or jejunum. Mucosal surfaces of the duodenum and/or jejunum are inspected and any abnormalities are noted. The endoscope is then withdrawn and mucosal surfaces are again inspected for ulcerations, varices, bleeding sites, lesions, strictures, or other abnormalities. Cytology samples may be obtained by cell brushing or washing.
33% lower than market
Gallbladder removal with an endoscope [HCPCS 47562]
Gallbladder removal with an endoscope [HCPCS 47562]
The gallbladder is removed by laparoscopic technique. A small portal incision is made at the navel and a trocar is inserted. The scope and video camera are then inserted at this site. The abdomen is inflated with carbon dioxide. Two to three additional abdominal portal incisions are made and trocars are inserted for placing surgical instruments. The gallbladder is identified. If the gallbladder is distended, a needle may be used to drain bile from the gallbladder. Grasper clamps are applied. The Hartmann's pouch is identified and retracted, exposing the triangle of Calot. The cystic artery and cystic duct are identified. The cystic duct is dissected free and transected. The cystic artery is dissected free, ligated, and doubly divided. Electrocautery is used to dissect the gallbladder off the liver bed. The gallbladder is placed in an extraction sac and removed from the abdomen through one of the small incisions.
51% lower than market
Groin hernia repair for patient 5 years of age or older (herniated tissue that is not trapped) [HCPCS 49505]
Groin hernia repair for patient 5 years of age or older (herniated tissue that is not trapped) [HCPCS 49505]
An initial inguinal hernia repair is performed on a patient who is five years or older. An inguinal hernia is a condition where structures protrude through a weakness in the abdominal wall in the groin area. Incarcerated hernia tissue cannot be pushed back into its normal position. Strangulated hernias are those in which circulation is compromised. An incision is made over the internal ring. The skin, fat, and subcutaneous fascia are incised down to the aponeurosis of the external oblique muscle. The external ring is identified and the external oblique aponeurosis is slit. The internal ring is opened and the inguinal canal is exposed. In males, the spermatic cord and its covering are mobilized and the covering is removed. The hernia sac is dissected free into the retroperitoneum, opened, and inspected for the presence of bowel or bladder wall. Any bowel or bladder content is reduced (pushed back into the abdominal cavity) and the hernia sac is transected and inverted into the abdominal cavity. A mesh plug may be placed to reinforce the repair. In women, the sac is inspected for the ovary. If the ovary is present, it is returned to the abdomen. The sac is then resected together with the round ligament. The internal ring is closed and the posterior wall of the inguinal canal is repaired.
35% lower than market
Knee cartilage removal with endoscope (one knee) [HCPCS 29881]
Knee cartilage removal with endoscope (one knee) [HCPCS 29881]
24% lower than market
Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]
Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]
A urinalysis is performed by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, and/or urobilinogen. Urinalysis can quickly screen for conditions that do not immediately produce symptoms such as diabetes mellitus, kidney disease, or urinary tract infection. A dip stick allows qualitative and semi-quantitative analysis using a paper or plastic stick with color strips for each agent being tested. The stick is dipped in the urine specimen and the color strips are then compared to a color chart to determine the presence or absence and/or a rough estimate of the concentration of each agent tested. Reagent tablets use an absorbent mat with a few drops of urine placed on the mat followed by a reagent tablet. A drop of distilled, deionized water is then placed on the tablet and the color change is observed. Bilirubin is a byproduct of the breakdown of red blood cells by the liver. Normally bilirubin is excreted through the bowel, but in patients with liver disease, bilirubin is filtered by the kidneys and excreted in the urine. Glucose is a sugar that is normally filtered by the glomerulus and excreted only in small quantities in the urine. Excess sugar in the urine (glycosuria) is indicative of diabetes mellitus. The peroxidase activity of erythrocytes is used to detect hemoglobin in the urine which may be indicative of hematuria, myoglobinuria, or hemoglobinuria. Ketones in the urine are the result of diabetic ketoacidosis or calorie deprivation (starvation). A leukocyte esterase test identifies the presence of white blood cells in the urine. The presence of nitrites in the urine is indicative of bacteria. The pH identifies the acid-base levels in the urine. The presence of excessive amounts of protein (proteinuria) may be indicative of nephrotic syndrome. Specific gravity measures urine density and is indicative of the kidneys' ability to concentrate and dilute urine. Following dip stick or reagent testing, the urine sample may be examined under a microscope. The urine sample is placed in a test tube and centrifuged. The sediment is resuspended. A drop of the resuspended sediment is then placed on a glass slide, cover-slipped, and examined under a microscope for crystals, casts, squamous cells, blood (white, red) cells, and bacteria.
76% lower than market
Lab analysis of urine specimen by dipstick without microscope (non-automated) [HCPCS 81002]
Lab analysis of urine specimen by dipstick without microscope (non-automated) [HCPCS 81002]
A urinalysis is performed by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, and/or urobilinogen. Urinalysis can quickly screen for conditions that do not immediately produce symptoms such as diabetes mellitus, kidney disease, or urinary tract infection. A dip stick allows qualitative and semi-quantitative analysis using a paper or plastic stick with color strips for each agent being tested. The stick is dipped in the urine specimen and the color strips are then compared to a color chart to determine the presence or absence and/or a rough estimate of the concentration of each agent tested. Reagent tablets use an absorbent mat with a few drops of urine placed on the mat followed by a reagent tablet. A drop of distilled, deionized water is then placed on the tablet and the color change is observed. Bilirubin is a byproduct of the breakdown of red blood cells by the liver. Normally bilirubin is excreted through the bowel, but in patients with liver disease, bilirubin is filtered by the kidneys and excreted in the urine. Glucose is a sugar that is normally filtered by the glomerulus and excreted only in small quantities in the urine. Excess sugar in the urine (glycosuria) is indicative of diabetes mellitus. The peroxidase activity of erythrocytes is used to detect hemoglobin in the urine which may be indicative of hematuria, myoglobinuria, or hemoglobinuria. Ketones in the urine are the result of diabetic ketoacidosis or calorie deprivation (starvation). A leukocyte esterase test identifies the presence of white blood cells in the urine. The presence of nitrites in the urine is indicative of bacteria. The pH identifies the acid-base levels in the urine. The presence of excessive amounts of protein (proteinuria) may be indicative of nephrotic syndrome. Specific gravity measures urine density and is indicative of the kidneys' ability to concentrate and dilute urine. Following dip stick or reagent testing, the urine sample may be examined under a microscope. The urine sample is placed in a test tube and centrifuged. The sediment is resuspended. A drop of the resuspended sediment is then placed on a glass slide, cover-slipped, and examined under a microscope for crystals, casts, squamous cells, blood (white, red) cells, and bacteria.
2% lower than market
Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]
Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]
Prothrombin time (PT) measures how long it takes for blood to clot. Prothrombin, also called factor II, is one of the clotting factors made by the liver and adequate levels of vitamin K are needed for the liver to produce sufficient prothrombin. Prothrombin time is used to help identify the cause of abnormal bleeding or bruising; to check whether blood thinning medication, such as warfarin (Coumadin), is working; to check for low levels of blood clotting factors I, II, V, VII, and X; to check for low levels of vitamin K; to check liver function, to see how quickly the body is using up its clotting factors. The test is performed using electromagnetic mechanical clot detection. If prothrombin time is elevated and the patient is not on a blood thinning medication, a second prothrombin time using substitution plasma fractions, also referred to as a prothrombin time mixing study, may be performed. This is performed by mixing patient plasma with normal plasma using a 1:1 mix. The mixture is incubated and the clotting time is again measured. If the result does not correct, it may be indicative that the patient has an inhibitor, such as lupus anticoagulant. If the result does correct, the patient may have a coagulation factor deficiency.
49% higher than market
Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]
Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]
A blood test is performed to determine levels of thyroid stimulating hormone (TSH). TSH is produced in the pituitary and helps to regulate two other thyroid hormones, triiodothyronine (T3) and thyroxin (T4), which in turn help regulate the body's metabolic processes. TSH levels are tested to determine whether the thyroid is functioning properly. Patients with symptoms of weight gain, tiredness, dry skin, constipation, or menstrual irregularities may have an underactive thyroid (hypothyroidism). Patients with symptoms of weight loss, rapid heart rate, nervousness, diarrhea, feeling of being too hot, or menstrual irregularities may have an overactive thyroid (hypothyroidism). TSH levels are also periodically tested in individuals on thyroid medications. The test is performed by electrochemiluminescent immunoassay.
82% lower than market
Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test [HCPCS 85027]
Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test [HCPCS 85027]
An automated complete blood count (CBC) is performed with or without automated differential white blood cell (WBC) count. A CBC is used as a screening test to evaluate overall health and symptoms such as fatigue, bruising, bleeding, and inflammation, or to help diagnose infection. A CBC includes measurement of hemoglobin (Hgb) and hematocrit (Hct), red blood cell (RBC) count, white blood cell (WBC) count with or without differential, and platelet count. Hgb measures the amount of oxygen-carrying protein in the blood. Hct refers to the volume of red blood cells (erythrocytes) in a given volume of blood and is usually expressed as a percentage of total blood volume. RBC count is the number of red blood cells (erythrocytes) in a specific volume of blood. WBC count is the number of white blood cells (leukocytes) in a specific volume of blood. There are five types of WBCs: neutrophils, eosinophils, basophils, monocytes, and lymphocytes. If a differential is performed, each of the five types is counted separately. Platelet count is the number of platelets (thrombocytes) in the blood. Platelets are responsible for blood clotting. The CBC is performed with an automated blood cell counting instrument that can also be programmed to provide an automated WBC differential count.
36% lower than market
Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]
Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]
An automated complete blood count (CBC) is performed with or without automated differential white blood cell (WBC) count. A CBC is used as a screening test to evaluate overall health and symptoms such as fatigue, bruising, bleeding, and inflammation, or to help diagnose infection. A CBC includes measurement of hemoglobin (Hgb) and hematocrit (Hct), red blood cell (RBC) count, white blood cell (WBC) count with or without differential, and platelet count. Hgb measures the amount of oxygen-carrying protein in the blood. Hct refers to the volume of red blood cells (erythrocytes) in a given volume of blood and is usually expressed as a percentage of total blood volume. RBC count is the number of red blood cells (erythrocytes) in a specific volume of blood. WBC count is the number of white blood cells (leukocytes) in a specific volume of blood. There are five types of WBCs: neutrophils, eosinophils, basophils, monocytes, and lymphocytes. If a differential is performed, each of the five types is counted separately. Platelet count is the number of platelets (thrombocytes) in the blood. Platelets are responsible for blood clotting. The CBC is performed with an automated blood cell counting instrument that can also be programmed to provide an automated WBC differential count.
74% lower than market
Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 800
Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 800
A hepatic function panel is obtained to diagnose acute and chronic liver disease, inflammation, or scarring and to monitor hepatic function while taking certain medications. Tests in a hepatic function panel should include albumin (ALB), total and direct bilirubin, alkaline phosphatase (ALP), total protein (TP), alanine aminotransferase (ALT, SGPT), and aspartate aminotransferase (AST, SGOT). Albumin (ALB) is a protein made by the liver that helps to nourish tissue and transport hormones, vitamins, drugs, and calcium throughout the body. Bilirubin, a waste product from the breakdown of red blood cells, is removed by the liver in a conjugated state. Bilirubin is measured as total (all the bilirubin circulating in the blood) and direct (the conjugated amount only) to determine how well the liver is performing. Alkaline phosphatase (ALP) is an enzyme produced by the liver and other organs of the body. In the liver, cells along the bile duct produce ALP. Blockage of these ducts can cause elevated levels of ALP, whereas cirrhosis, cancer, and toxic drugs will decrease ALP levels. Circulating blood proteins include albumin (60% of total) and globulins (40% of total). By measuring total protein (TP) and albumin (ALB), the albumin/globulin (A/G) ratio can be determined and monitored. TP may decrease with malnutrition, congestive heart failure, hepatic disease, and renal disease and increase with inflammation and dehydration. Alanine aminotransferase (ALT, SGPT) is an enzyme produced primarily in the liver and kidneys. In healthy individuals ALT is normally low. ALT is released when the liver is damaged, especially with exposure to toxic substances such as drugs and alcohol. Aspartate aminotransferase (AST, SGOT) is an enzyme produced by the liver, heart, kidneys, and muscles. In healthy individuals AST is normally low. An AST/ALT ratio is often performed to determine if elevated levels are due to liver injury or damage to the heart or skeletal muscles. A specimen is obtained by separately reportable venipuncture. Serum/plasma is tested using quantitative enzymatic method or quantitative spectrophotometry.
84% lower than market
Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]
Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]
A comprehensive metabolic panel is obtained that includes albumin, bilirubin, total calcium, carbon dioxide, chloride, creatinine, glucose, alkaline phosphatase, potassium, total protein, sodium, alanine amino transferase (ALT) (SGPT), aspartate amino transferase (AST) (SGOT), and urea nitrogen (BUN). This test is used to evaluate electrolytes and fluid balance as well as liver and kidney function. It is also used to help rule out conditions such as diabetes. Tests related to electrolytes and fluid balance include: carbon dioxide, chloride, potassium, and sodium. Tests specific to liver function include: albumin, bilirubin, alkaline phosphatase, ALT, AST, and total protein. Tests specific to kidney function include: BUN and creatinine. Calcium is needed to support metabolic processes such as heart function, muscle contraction, nerve function, and blood clotting. Glucose is the main source of energy for the body and is regulated by insulin. Glucose measurement determines whether the glucose/insulin metabolic process is functioning properly.
89% lower than market
Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]
Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]
Therapeutic exercise is the application of careful, graduated force to the body to increase strength, endurance, range of motion, and flexibility. Increased muscle strength is achieved by the deliberate overloading of a targeted muscle or muscle group and improved endurance is achieved by raising the intensity of the strengthening exercise to the targeted area(s) over a prolonged period of time. To maintain range of motion (ROM) and flexibility requires the careful movement and stretching of contractile and non-contractile tissue that may tighten with injury or neurological disease, causing weakness and/or spasticity. Therapeutic exercise can increase blood flow to the targeted area, reduce pain and inflammation, reduce the risk of blood clots from venous stasis, decrease muscle atrophy and improve coordination and motor control. Therapeutic exercise may be prescribed following acute illness or injury and for chronic conditions that affect physical activity or function.
19% higher than market
Prostate gland biopsy [HCPCS 55700]
Prostate gland biopsy [HCPCS 55700]
44% lower than market
Shoulder examination and shoulder bone shaving with endoscope [HCPCS 29826]
Shoulder examination and shoulder bone shaving with endoscope [HCPCS 29826]
9% lower than market
Total Knee or Hip Replacement
Total Knee or Hip Replacement
42% lower than market
Salina Surgical Hospital Patient Information Price List
OUTPATIENT MEDICINE
OUTPATIENT MEDICINE
Description
Variance
Esophageal swallowing movement measurement [HCPCS 91010]
Esophageal swallowing movement measurement [HCPCS 91010]
33% lower than market
Gastroesophageal reflux test with pH electrode insertion including recording, analysis and interpretation [HCPCS 91035]
Gastroesophageal reflux test with pH electrode insertion including recording, analysis and interpretation [HCPCS 91035]
62% higher than market
Salina Surgical Hospital Patient Information Price List
OUTPATIENT PHARMACY AND DRUG ADMINISTRATION
OUTPATIENT PHARMACY AND DRUG ADMINISTRATION
Description
Variance
Cefazolin sodium injection [HCPCS J0690]
Cefazolin sodium injection [HCPCS J0690]
Injection, cefazolin sodium, 500 mg
13% higher than market
Diphenhydramine hcl injectio [HCPCS J1200]
Diphenhydramine hcl injectio [HCPCS J1200]
Injection, diphenhydramine hcl, up to 50 mg
50% lower than market
Fentanyl citrate injection [HCPCS J3010]
Fentanyl citrate injection [HCPCS J3010]
Injection, fentanyl citrate, 0.1 mg
43% lower than market
Garamycin gentamicin inj [HCPCS J1580]
Garamycin gentamicin inj [HCPCS J1580]
74% lower than market
Inj midazolam hydrochloride [HCPCS J2250]
Inj midazolam hydrochloride [HCPCS J2250]
Injection, midazolam hydrochloride, per 1 mg
79% lower than market
Levofloxacin injection [HCPCS J1956]
Levofloxacin injection [HCPCS J1956]
Injection, levofloxacin, 250 mg
83% lower than market
Metoclopramide hcl injection [HCPCS J2765]
Metoclopramide hcl injection [HCPCS J2765]
Injection, metoclopramide hcl, up to 10 mg
63% lower than market
Neostigmine methylslfte inj [HCPCS J2710]
Neostigmine methylslfte inj [HCPCS J2710]
85% lower than market
Promethazine hcl injection [HCPCS J2550]
Promethazine hcl injection [HCPCS J2550]
Injection, promethazine hcl, up to 50 mg
74% lower than market
Vancomycin hcl injection [HCPCS J3370]
Vancomycin hcl injection [HCPCS J3370]
Injection, vancomycin hcl, 500 mg
60% lower than market
Salina Surgical Hospital Patient Information Price List
OUTPATIENT SUPPLIES
OUTPATIENT SUPPLIES
Description
Variance
Ocular imp, aqueous drain de [HCPCS C1783]
Ocular imp, aqueous drain de [HCPCS C1783]
2% higher than market
Salina Surgical Hospital Patient Information Price List
OUTPATIENT SURGICAL SERVICES
OUTPATIENT SURGICAL SERVICES
Description
Variance
Anti-cancer drug injection into bladder [HCPCS 51720]
Anti-cancer drug injection into bladder [HCPCS 51720]
321% higher than market
Bladder and urethra (bladder canal) examination with endoscope for diagnosis [HCPCS 52000]
Bladder and urethra (bladder canal) examination with endoscope for diagnosis [HCPCS 52000]
62% lower than market
Blood or fluid collection incision and drainage [HCPCS 10140]
Blood or fluid collection incision and drainage [HCPCS 10140]
73% lower than market
Bone implant removal (deep) [HCPCS 20680]
Bone implant removal (deep) [HCPCS 20680]
24% higher than market
Bone joints removal of bones between wrist and fingers [HCPCS 25447]
Bone joints removal of bones between wrist and fingers [HCPCS 25447]
80% lower than market
Broken lower forearm bone or growth plate separation treatment with hardware insertion (3 or more fragments, open treatment) [HCPCS 25609]
Broken lower forearm bone or growth plate separation treatment with hardware insertion (3 or more fragments, open treatment) [HCPCS 25609]
1% higher than market
Colon (large bowel) examination and injections beneath lining of colon with flexible endoscope [HCPCS 45381]
Colon (large bowel) examination and injections beneath lining of colon with flexible endoscope [HCPCS 45381]
22% lower than market
Colorectal cancer screening; colonoscopy on invididual not meeting high risk [HCPCS G0121]
Colorectal cancer screening; colonoscopy on invididual not meeting high risk [HCPCS G0121]
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
76% lower than market
Colorectal scrn; hi risk ind [HCPCS G0105]
Colorectal scrn; hi risk ind [HCPCS G0105]
Colorectal cancer screening; colonoscopy on individual at high risk
75% lower than market
Dialysis graft repair (open procedure) [HCPCS 36832]
Dialysis graft repair (open procedure) [HCPCS 36832]
50% lower than market
Esophagus, stomach, and/or upper small bowel examination and injections with endoscope [HCPCS 43236]
Esophagus, stomach, and/or upper small bowel examination and injections with endoscope [HCPCS 43236]
29% lower than market
Eye fluid drainage device insertion (external approach) [HCPCS 66183]
Eye fluid drainage device insertion (external approach) [HCPCS 66183]
25% lower than market
Fluid accumulation removal in sperm reservoir [HCPCS 54840]
Fluid accumulation removal in sperm reservoir [HCPCS 54840]
42% lower than market
Foreign body, stone, or stent removal from urethra (bladder canal) or bladder with endoscope (simple) [HCPCS 52310]
Foreign body, stone, or stent removal from urethra (bladder canal) or bladder with endoscope (simple) [HCPCS 52310]
63% lower than market
Gallbladder and pancreatic, liver, and bile ducts examination and pancreatic or bile duct widening by balloon with endoscope [HCPCS 43277]
Gallbladder and pancreatic, liver, and bile ducts examination and pancreatic or bile duct widening by balloon with endoscope [HCPCS 43277]
87% higher than market
Healthy skin and tissue transfer to repair adjacent wound of forehead, cheeks, chin, mouth, neck, underarms, genitalia, hands, and/or feet (10 sq cm or less) [HCPCS 14040]
Healthy skin and tissue transfer to repair adjacent wound of forehead, cheeks, chin, mouth, neck, underarms, genitalia, hands, and/or feet (10 sq cm or less) [HCPCS 14040]
72% lower than market
Intermediate repair of wound of scalp, underarms, trunk, arms, and/or legs (12.6 to 20.0 cm) [HCPCS 12035]
Intermediate repair of wound of scalp, underarms, trunk, arms, and/or legs (12.6 to 20.0 cm) [HCPCS 12035]
38% lower than market
Intermediate repair of wound of scalp, underarms, trunk, arms, and/or legs (2.6 to 7.5 cm) [HCPCS 12032]
Intermediate repair of wound of scalp, underarms, trunk, arms, and/or legs (2.6 to 7.5 cm) [HCPCS 12032]
17% lower than market
Large joint or joint capsule fluid removal and/or injection with needle [HCPCS 20610]
Large joint or joint capsule fluid removal and/or injection with needle [HCPCS 20610]
Arthrocentesis, aspiration, and/or injection of a joint or bursa is performed. Arthrocentesis and aspiration is performed to remove fluid from a joint or bursa in order to diagnose the cause of joint effusion and/or to reduce pain caused by the excess fluid. Injection of a joint or bursa may be performed in conjunction with the arthrocentesis procedure and is typically performed using an anti-inflammatory medication such as a steroid to reduce inflammation of the joint or bursa. The skin over the joint is cleansed. A local anesthetic is injected as needed. A needle with a syringe attached is inserted into the affected joint or bursa. Fluid is removed and sent for separately reportable laboratory analysis. This may be followed by a separate injection of medication into the joint or bursa.
43% lower than market
Median nerve of hand release and/or relocation [HCPCS 64721]
Median nerve of hand release and/or relocation [HCPCS 64721]
11% lower than market
Mesh placement to repair incisional or abdominal hernia (open procedure) [HCPCS 49568]
Mesh placement to repair incisional or abdominal hernia (open procedure) [HCPCS 49568]
69% lower than market
Palm tissue removal with release of finger (1 finger) [HCPCS 26123]
Palm tissue removal with release of finger (1 finger) [HCPCS 26123]
67% lower than market
Relocation of arm vein with connection to arm artery (at any site) [HCPCS 36821]
Relocation of arm vein with connection to arm artery (at any site) [HCPCS 36821]
43% lower than market
Removal of cancerous skin lesion of trunk, arms, or legs (over 4.0 cm) [HCPCS 11606]
Removal of cancerous skin lesion of trunk, arms, or legs (over 4.0 cm) [HCPCS 11606]
18% lower than market
Skin and tissue removal (each additional 20 sq cm) [HCPCS 11045]
Skin and tissue removal (each additional 20 sq cm) [HCPCS 11045]
65% lower than market
Skin and tissue removal (first 20 sq cm or less) [HCPCS 11042]
Skin and tissue removal (first 20 sq cm or less) [HCPCS 11042]
18% lower than market
Tendon covering incision [HCPCS 26055]
Tendon covering incision [HCPCS 26055]
30% lower than market
Tendon lesion removal from finger or hand [HCPCS 26160]
Tendon lesion removal from finger or hand [HCPCS 26160]
82% lower than market
Ulnar nerve at elbow release and/or relocation [HCPCS 64718]
Ulnar nerve at elbow release and/or relocation [HCPCS 64718]
48% lower than market
Underarm lymph nodes biopsy or removal (open procedure) [HCPCS 38525]
Underarm lymph nodes biopsy or removal (open procedure) [HCPCS 38525]
59% lower than market
Ureter (urinary duct) catheter insertion with endoscope through the bladder area [HCPCS 52005]
Ureter (urinary duct) catheter insertion with endoscope through the bladder area [HCPCS 52005]
75% lower than market
Uterus polyp biopsy and/or removal with endoscope [HCPCS 58558]
Uterus polyp biopsy and/or removal with endoscope [HCPCS 58558]
26% lower than market
Wrist cyst removal (initial or primary) [HCPCS 25111]
Wrist cyst removal (initial or primary) [HCPCS 25111]
78% lower than market
Wrist ligament release with endoscope [HCPCS 29848]
Wrist ligament release with endoscope [HCPCS 29848]
55% lower than market
Salina Surgical Hospital Patient Information Price List
OUTPATIENT X-RAY AND RADIOLOGICAL
OUTPATIENT X-RAY AND RADIOLOGICAL
Description
Variance
X-ray of bile and/or pancreatic ducts during surgery including radiological supervision of procedure and interpretation of results [HCPCS 74300]
X-ray of bile and/or pancreatic ducts during surgery including radiological supervision of procedure and interpretation of results [HCPCS 74300]
60% lower than market
Salina Surgical Hospital Patient Information Price List
INPATIENT GENERAL SURGERY
INPATIENT GENERAL SURGERY
Description
Variance
Major small & large bowel procedures with complications
Major small & large bowel procedures with complications
50% lower than market
Major small & large bowel procedures without complications
Major small & large bowel procedures without complications
53% lower than market
Salina Surgical Hospital Patient Information Price List
INPATIENT ORTHOPEDIC SURGERY
INPATIENT ORTHOPEDIC SURGERY
Description
Variance
Hip & femur procedures except major joint with complications
Hip & femur procedures except major joint with complications
56% lower than market
Knee procedures without pdx of infection without complications
Knee procedures without pdx of infection without complications
32% lower than market
Lower extrem & humer proc except hip,foot,femur without complications
Lower extrem & humer proc except hip,foot,femur without complications
90% lower than market
Revision of hip or knee replacement with complications
Revision of hip or knee replacement with complications
28% lower than market
Total Knee or Hip Revision
Total Knee or Hip Revision
26% lower than market
Total Shoulder Replacement
Total Shoulder Replacement
26% lower than market
Salina Surgical Hospital Patient Information Price List
INPATIENT SURGERY FOR MALIGNANCY
INPATIENT SURGERY FOR MALIGNANCY
Description
Variance
Kidney & ureter procedures for neoplasm without complications
Kidney & ureter procedures for neoplasm without complications
33% lower than market
Salina Surgical Hospital Patient Information Price List
INPATIENT VASCULAR SURGERY
INPATIENT VASCULAR SURGERY
Description
Variance
Extracranial procedures without complications
Extracranial procedures without complications
52% lower than market
Salina Surgical Hospital Patient Information Price List
BILLING PROCESS AND INFORMATION
BILLING PROCESS AND INFORMATION
How You Can Help
Thank you for choosing Salina Surgical 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 Salina Surgical 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 Salina Surgical 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 Salina Surgical 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 785-827-0610.
If you need more information about the price of a future service, please contact our Customer Service at 785-827-0610. 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.
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