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Pricing Information

Pursuant to Section 3727.42 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 separate 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:
Med/Surg (60825500) $1150
Telemetry (60821500) $1150
Pediatric (60601239) $1050
Physical Rehab (60201100) $950
Behavioral Health (61801212) $800
Addiction Rec.Detox (61701212) $855
Addiction Rec.Rehab (61702212) $855
Skilled Nursing Fac.(60801212) $375
Intensive Care Unit (60531600) $1350
Coronary Care Unit (60502105) $1365
Coronary Care Unit Post OP (60451000) $2678
Family Birth Center (60301123) $1100
Nursery Regular (60301714) $675
Nursery Intermediate (60302070) $675
Nursery Intensive (60302100) $675

EMERGENCY DEPARTMENT:
ED Level 1 (61203030) $100
ED Level 2 (61209930) $191
ED Level 3 (61209931) $386
ED Level 4 (61209932) $595
ED Level 5 (61209933) $819
Critical Care,1st 60 minutes (61204200) $1671
Critical Care,each addl 30mi (61204205) $607

RADIOLOGY:
GD-Chest-Standard Pa & Lat (70417001) $293
GD-Chest single view only (70417203) $243
Mammograpy, screening Digtal (98504000) $251
CT-Head brain w/o Contrast (70420100) $1371
Abdominal series w/PA chest (70413130) $522
CT-Abdomen W & W/O Contrast (70420920) $2200
CT-Pelvis W & W/O Contrast (70421020) $2200
PortFilm Inter & Verific (704877415) $364
Device coplex (704877334) $1373
GD-Spine/Lumber-Min 4 views (70417011) $447
FL-Reposit Feed Tube Up to 1 hr (70413855) $503
Mammography,Bilateral (98500045) $388
Basic Calculation (704877300) $486
Continuing Phy Consult Weekly (704877336) $402
GD-Spine-cervical min 4 views (70417014) $393
CT-Pelvis w/o contrast (70421000) $1371
CT-Abdomen w/o contrast (70420900) $1371
US-Abdomen (70437069) $936
CT-Thorax w & w/o contrast (70422095) $2200
MR-Pituitary w & w/o contrast (70441155) $3733
GD-Knee right 4 or more views (70418075) $373
GD-Knee left 4 or move views (70418070) $373
NM-MIBI Spect-Stress-Seq (70456080) $3440
US-Pelvic (70437068) $704
NM-Bone Scan Whole Body (70457121) $1581
IM-Dxa Scan (central) (98500005) $424

EKG
ECG HOLTER, UP TO 48 HRS (70559910) $927
EKG (70559900) $186
HOLTER SCAN AND REPORT (70552000) $282

OPERATING ROOM:
Level one initial 30 min (61000800) $2473
Level two initial 30 min (61000805) $2517
Level three initial 30 min (61000810) $2930
Level four initial 30 min (61000815) $3104
Level five initial 30 min (61000820) $3267
Level one each add 15 min (610001005) $371
Level two each add 15 min (610001007) $382
Level three each add 15 min (610001008) $486
Level four each add 15 min (610001500) $530
Level five each add 15 min (610001505) $569

PHYSICAL THERAPY:
Aquatic Therapy, each 15 min. (70651335) $142
Functional Activity each 15 mi (70651135) $132
Gait Training-each 15 mi (70651130) $132
Group Exercises 15 mi (70653012) $132
Orthotics Fitting & Train 15 (70653005) $132
Pt Re Evaluation (70651360) $199
Ultrasound-ea 15 min (70651080) $132

OCCUPATIONAL THERAPY:
Functional Activities ea 15m (70704025) $132
Functional Gait Training 15 m (70704035 $132
Group Therapeutic Exercise (70704030) $132
Orthotics Fit/Training 15 mi (70702080) $132
OT Re-evaluation (70704060) $199
Paraffin Bath (70702030) $119
Ultrasound-each 15 min (70702095) $132

PULMONARY/RESPIRATORY:
Incentive Spirometry (70809360) $158
Arterial Blood Gas (70319345) $252
C-Pap Daily (70809570) $369
IPPB/SA Sub/treat. (70809350) $221
Pulse Oximetry Single (70809372) $100
Spirometry (70809332) $136
Cardiac Rehab (70852007) $182
Pulmonary Stress Test (70851014) $475
Sleep Study, NPT protocol (70951025) $2996
Sleep Study, Polysomnography (70951010) $2996

LAB:
CBC auto diff platelet (70358765) $114
Comprehensive metabolic (70319710) $237
T4 (70318911) $110
Liver Profile (70319605) $160
Arterial Blood Gases (70319345) $252
Magnesium (70318723) $86
Electrolyte Panel (70319340) $115
HC-A1C (70318677 $126
lipid Hcr Profile (70319257) $130
Hematocrit (HCT) (70358681) $45
Troponin I (70319595) $195
Hemoglobin (HGB) (70358669) $45
CKMB (70319365) $157
Blood Urea Nitrogen (70318744) $99
Creatinine-Serum (70318664) $88
Cell Block-TC (70331020) $100
Glucose (70318726) $88
TSH (70318914) $146
Blood Culture (70368922) $151
Routine Culture (70368995) $130
Routine Urinalysis (70379025) $88
Microbe Susceptible,Mic (70369004) $92
Urine Ketone (70378918) $56
Cross Match (70398740) $162
(RCR) ABO typing (70392200) $80
Prothrombin (70386954) $39
Phosphorus (70318694) $66
APTT (70357010) $89
Basic metabolic (70319236) $129
Culture Bacteria Aerobic (70361010) $116
Venipuncture (10319009) $21

URGENT CARE:
EX-URGENT CARE LEVEL 1 (61252000 $102
EX-URGENT CARE LEVEL 2 (61252050) $143
EX-URGENT CARE LEVEL 3 (61252060) $171
EX-URGENT CARE LEVEL 4 (61252070) $221
EX-URGENT CARE LEVEL 5 (61252080) $412