Pricing Information
Pursuant to Section 3727.12 of the Ohio Revised Code, you are entitled, upon request, to a list of our charges for room and board and a selected number of radiology, laboratory, emergency department, operating room, delivery room, physical therapy, occupational therapy and respiratory therapy services.
Trinity Health System, as part of our mission, provides charity care to patients who qualify under the charity guidelines. Uninsured or underinsured patients should consult with our Central Registration or Patient Accounting staff to determine if they qualify for charity programs or other discounts.
Hospital charges are the same for all patients, but a patient's responsibility may vary, depending on your individual insurance coverage. Your hospital bill will include separage charges for other services/items received during your stay, such as supplies and drugs. The charges listed below are only reflective of the charge for that specific item.
Hospital bills do not include the professional billing for Emergency Room Physicians, Hospital Pathologists, Anesthesiologists, or Radiologists. You will receive a separate bill from these physicians for their services.
| INPATIENT ROOM RATES: | OPERATING ROOM: | ||
| Med/Surg (60825500) | $750 | Major OR Room, 15 minutes (61000701) | $1406 |
| Telemetry (60821500) | 850 | Major OR Room, 8 hrs or over (61000717) | 8969 |
| Pediatric (60601239) | 750 | Cardiac OR Room, 30 minutes (61051000) | 1869 |
| Physical Rehab (60201100) | 700 | Cardiac OR Room, 12 hrs or over(61051115) | 14571 |
| Mental Health (61801212) | 750 | PHYSICAL THERAPY: | |
| Addiction Rec.Detox (61701212) | 720 | Aquatic Therapy, each 15 min. (70651335) | $102 |
| Addiction Rec.Rehab (61702212) | 720 | Debridement, each 15 min. (70651485) | 124 |
| Skilled Nursing Fac.(60801212) | 350 | Functional Activity each 15 mi (70651135) | 96 |
| Nursing Facility (60901414) | 220 | Gait Training-each 15 mi (70651130) | 96 |
| Intensive Care Unit (60531600) | 1050 | Group Exercises 15 mi (70653012) | 96 |
| Coronary Care Unit (60502105) | 1050 | Orthotics Fitting & Train 15 (70653005) | 96 |
| Coronary Care Unit Post OP (60451000) | 2450 | Pt Evaluation (70651545) | 230 |
| Family Birth Center (60301123) | 750 | Pt Re Evaluation (70651360) | 96 |
| Nursery Regular (60301714) | 610 | Ultrasound-ea 15 min (70651080) | 96 |
| Nursery Intermediate (60302070) | 630 | Whirlpool (70651035) | 96 |
| Nursery Intensive (60302100) | 640 | OCCUPATIONAL THERAPY: | |
| EMERGENCY DEPARTMENT: | Debridement-each 15 min (70702550) | $124 | |
| ED Level 1 (61203030) | $75 | Functional Activities ea 15m (70704025) | 73 |
| ED Level 2 (61209930) | 146 | Functional Gait Training 15 m (70704035 | 96 |
| ED Level 3 (61209931) | 298 | Group Therapeutic Exercise (70704030) | 73 |
| ED Level 4 (61209932) | 461 | Orthotics Fit/Training 15 mi (70702080) | 72 |
| ED Level 5 (61209933) | 635 | OT Evaluation (70704150) | 230 |
| Critical Care,1st 60 minutes (61204200) | 916 | OT Re-evaluation (70704060) | 142 |
| Critical Care,each addl 30mi (61204205) | 146 | Paraffin Bath (70702030) | 86 |
| RADIOLOGY: | Ultrasound-each 15 min (70702095) | 73 | |
| GD-Chest-Standard Pa & Lat (70417001) | $214 | Whirlpool (70702035) | 96 |
| GD-Chest single view only (70417203) | 177 | PULMONARY/RESPIRATORY: | |
| Mammograpy, screening Digtal (98504000) | 194 | Incentive Spirometry (70809360) | $158 |
| DTMC 11-19 MEV (704877540) | 643 | Arterial Blood Gas (70319345) | 203 |
| CT-Head brain w/o Contrast (70420100) | 1014 | C-Pap Daily (70809570) | 271 |
| DTM - Complex (704877410) | 717 | IPPB/SA Sub/treat. (70809350) | 71 |
| Abdominal series w/PA chest (70413130) | 386 | Pulse Oximetry Single (70809372) | 71 |
| CT-Abdomen W & W/O Contrast (70420920) | 1631 | Spirometry (70809332) | 98 |
| CT-Pelvis W & W/O Contrast (70421020) | 1631 | Cardiac Rehab (70852007) | 133 |
| PortFilm Inter & Verific (704877415) | 296 | Pulmonary Stress Test (70851014) | 350 |
| Device coplex (704877334) | 1122 | Sleep Study, NPT protocol (70951025) | 2220 |
| GD-Spine/Lumber-Min 4 views (70417011) | 330 | Sleep Study, Polysomnography (70951010) | 2021 |
| FL-Reposit Feed Tube Up to 1 hr (70413855) | 369 | LAB: | |
| Mammography,Bilateral (98500045) | 300 | CBC auto diff platelet (70358765) | $81 |
| Basic Calculation (704877300) | 396 | Comprehensive metabolic (70319710) | 173 |
| Continuing Phy Consult Weekly (704877336) | 328 | T4 (70318911) | 78 |
| GD-Spine-cervical min 4 views (70417014) | 290 | Liver Profile (70319605) | 116 |
| CT-Pelvis w/o contrast (70421000) | 1014 | Arterial Blood Gases (70319345) | 203 |
| CT-Abdomen w/o contrast (70420900) | 1014 | Magnesium (70318723) | 61 |
| US-Abdomen (70437069) | 692 | Electrolyte Panel (70319340) | 82 |
| CT-Thorax w & w/o contrast (70422095) | 1631 | HC-A1C (70318677 | 92 |
| MR-Pituitary w & w/o contrast (70441155) | 2767 | lipid Hcr Profile (70319257) | 94 |
| GD-Knee right 4 or more views (70418075) | 274 | Hematocrit (HCT) (70358681) | 32 |
| GD-Knee left 4 or move views (70418070) | 274 | Troponin I (70319595) | 132 |
| Echo for radiation Tx Fields (704876950) | 244 | Hemoglobin (HGB) (70358669) | 30 |
| NM-MIBI Spect-Stress-Seq (70456080) | 2551 | CKMB (70319365) | 113 |
| US-Pelvic (70437068) | 452 | Blood Urea Nitrogen (70318744) | 70 |
| US-Breasts-Bilateral (70437300) | 542 | Creatinine-Serum (70318664) | 63 |
| NM-Bone Scan Whole Body (70457121) | 1170 | Cell Block-TC (70331020) | 71 |
| IM-Dxa Scan (central) (98500005) | 329 | Glucose (70318726) | 63 |
| TSH (70318914) | 105 | ||
| EKG | Blood Culture (70368922) | 109 | |
| ECG HOLTER, UP TO 48 HRS (70559910) | 685 | Basic metabolic (70319236) | 93 |
| EKG (70559900) | 135 | Routine Culture (70368995) | 94 |
| HOLTER SCAN AND REPORT (70552000) | 206 | Routine Urinalysis (70379025) | 63 |
| Microbe Susceptible,Mic (70369004) | 66 | ||
| Urine Ketone (70378918) | 68 | ||
| Cross Match (70398740) | 117 | ||
| (RCR) ABO typing (70392200) | 57 | ||
| Prothrombin (70386954) | 27 | ||
| Phosphorus (70318694) | 46 | ||
| APTT (70357010) | 64 | ||
| Culture Bacteria Aerobic (70361010) | 83 | ||
| URGENT CARE: | |||
| EX-URGENT CARE LEVEL 1 (61252000 | 73 | ||
| EX-URGENT CARE LEVEL 2 (61252050) | 103 | ||
| EX-URGENT CARE LEVEL 3 (61252060) | 124 | ||
| EX-URGENT CARE LEVEL 4 (61252070) | 145 | ||
| EX-URGENT CARE LEVEL 5 (61252080) | 155 | ||
