|
Patient Price Information List
|
|
|
|
In compliance with state law, MedCentral Health System is providing this price list containing our charges for room and board, emergency department, operating room, delivery, physical therapy and other procedures. The health system's charges are the same for all patients, but a patient's responsibility may vary, depending on payment plans negotiated with individual health insurers. Uninsured or underinsured patients should consult with our admitting and billing staff to determine whether they qualify for discounts. These prices are correct as of January 1, 2012.
|
|
|
Room and Board -- Per Day Charges
|
|
| |
|
|
|
|
|
|
|
|
|
Coronary care
|
|
|
|
|
|
|
|
|
CVICU
|
|
|
$2,297.00
|
|
|
|
|
Stepdown
|
|
|
$977.00
|
|
|
|
Intensive care
|
|
|
|
|
|
|
|
|
ICU
|
|
|
$1,705.00
|
|
|
|
|
Stepdown
|
|
|
$977.00
|
|
|
|
Nursery
|
|
|
|
$488.00
|
|
|
|
Nursery - Level 2 (Intensive Services)
|
|
$826.00
|
|
|
|
Oncology
|
|
$614.00
|
|
|
|
Psychiatric care
|
|
$983.00
|
|
|
|
Routine care (Med/Surg; OB)
|
|
$614.00
|
|
|
|
Rehab
|
|
$814.00
|
|
|
|
Hospice Inpatient (Med/Surg)
|
|
$614.00
|
|
|
|
Hospice Respite Care
|
|
$194.00
|
|
|
|
|
|
|
|
|
|
|
|
Labor and Delivery Charges
|
|
| |
|
The following list does not include charges for anesthesia, drugs, or supplies required for a particular delivery room procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.
|
|
|
Normal Delivery
|
|
Mom
|
|
$6,339.00
|
|
|
|
Normal Newborn
|
Baby
|
|
$2,084.00
|
|
|
|
Cesarean Section Delivery
|
|
|
$9,543.00
|
|
|
|
Fetal Monitoring - Fetal Non-Stress Test
|
|
|
$372.00
|
|
|
|
Labor Room per minute
|
|
|
$1.00
|
|
|
|
Amniocentesis *
|
|
|
$230.00
|
|
|
|
|
*(Other Tests may be done as well)
|
|
|
|
|
|
|
|
|
|
|
|
|
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 and the intensity of care 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.
|
|
| |
| |
| |
|
Level 1
|
|
|
|
$108.00
|
|
|
|
Level 2
|
|
|
|
$154.00
|
|
|
|
Level 3
|
|
|
|
$253.00
|
|
|
|
Level 4
|
|
|
|
$466.00
|
|
|
|
Level 5
|
|
|
|
$727.00
|
|
|
|
Critical care
|
|
|
|
$1,076.00
|
|
|
|
Level 2 Trauma Center - Activation
|
|
$4,256.00
|
|
|
|
Level 1 Trauma Center - Activation
|
|
$4,970.00
|
|
|
|
|
|
|
|
|
|
|
|
Operating Room Charges
|
|
| |
|
Operating Room charges are based on the complexity level, with Level 1 being the most basic. The following list does not include charges for anesthesia, drugs, or supplies required for a particular procedure. Fees for physician services or anesthesia administration are also not reflected, and will bill separately by the physician.
|
|
|
|
|
|
|
|
|
|
|
Per Minute O.R. Charges
|
|
|
|
|
|
|
Level I - per minute
|
$16.00
|
|
|
|
Level II - per minute
|
$49.00
|
|
|
|
Level III - per minute
|
$55.00
|
|
|
|
Level IV - per minute
|
$61.00
|
|
|
|
Level V - per minute
|
$67.00
|
|
|
|
Level VI - per minute
|
$73.00
|
|
|
|
|
|
|
|
|
|
|
|
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. Most Charge Units are based upon 15 minutes.
|
|
| |
| |
|
ANKLE/FOOT STRAPPING
|
$74.00
|
|
|
ELECTRICAL STIMULATION-ATTENDED
|
$54.00
|
|
|
ELECTRICAL STIMULATION-UNATTENDED
|
$54.00
|
|
|
FUNCTIONAL ACTIVITY/UNIT
|
$84.00
|
|
|
GAIT TRAINING/UNIT
|
$76.00
|
|
|
GROUP THERAPY/UNIT
|
$97.00
|
|
|
INITIAL EVALUATION ACUTE (NON-PEDIATRIC)
|
$186.00
|
|
|
IONTOPHORESIS/UNIT
|
$80.00
|
|
|
MANUAL THERAPY/UNIT
|
$84.00
|
|
|
MECHANICAL TRACTION/UNIT
|
$42.00
|
|
|
NEUROMUSCULAR RE-ED/UNIT
|
$84.00
|
|
|
ORTHOTIC FITTING TRAINING/UNIT
|
$63.00
|
|
|
PHYSICAL PERFORMANCE TEST/UNIT
|
$58.00
|
|
|
PROSTHETIC TRAINING/UNIT
|
$73.00
|
|
|
RE-EVALUATION-PT
|
$98.00
|
|
|
SELF CARE MANAGEMENT TRAINING/UNIT
|
$84.00
|
|
|
SHOULDER STRAPPING
|
$74.00
|
|
|
THERAPEUTIC EXERCISE/UNIT
|
$84.00
|
|
|
WHEELCHAIR MGT/UNIT
|
$84.00
|
|
|
WHIRLPOOL/UNIT
|
$73.00
|
|
|
WOUND CARE SMALL < = 20 SQ.CM.
|
$99.00
|
|
|
|
|
|
|
|
|
|
|
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.
|
|
| |
| |
|
CLINICAL DRIVING EVALUATION
|
$400.00
|
|
|
COGNITIVE INTEGRATION/UNIT
|
$84.00
|
|
|
COMMUNITY/WORK RE-INTEGRATION
|
$84.00
|
|
|
CONFERENCE
|
$61.00
|
|
|
CONTRAST BATHS
|
$57.00
|
|
|
DYNAMIC SPLINT-APPLICATION FINGER
|
$100.00
|
|
|
GROUP THERAPEUTIC ACTIVITIES
|
$97.00
|
|
|
LEISURE ASSESSMENT-(PER UNIT)
|
$96.00
|
|
|
MANUAL THERAPY TECHNIQUES
|
$84.00
|
|
|
NEUROMUSCULAR RE-ED
|
$84.00
|
|
|
ON THE ROAD TRAINING-PER 15MINUTES
|
$25.00
|
|
|
ORTHOTIC FITTING/TRAIN
|
$63.00
|
|
|
OT EVALUATION
|
$186.00
|
|
|
OT RE-EVALUATION
|
$98.00
|
|
|
PARAFFIN BATH
|
$49.00
|
|
|
RECREATION CONFERENCE
|
$84.00
|
|
|
RECREATION THERAPY GROUP
|
$97.00
|
|
|
SELF-CARING MANAGEMENT TRAINING-UNIT
|
|
$84.00
|
|
|
SENSORY INTEGRATION
|
|
|
|
$89.00
|
|
|
STATIC SPLINT APPLICATION - FINGER
|
$105.00
|
|
|
STATIC SPLINT APPLICATION - SHORT ARM
|
$146.00
|
|
|
THERAPEUTIC ACTIVITIES, DIRECT
|
$84.00
|
|
|
THERAPEUTIC EXERCISES
|
$84.00
|
|
|
THERAPEUTIC MASSAGE-EA 15 MIN
|
$60.00
|
|
|
THERMAL-CRYO MODALITY
|
$34.00
|
|
|
ULTRASOUND-EA 15 MIN
|
$61.00
|
|
|
WHIRLPOOL
|
$73.00
|
|
|
|
|
|
|
|
|
|
|
Cardiology and Pulmonary Therapy Charges
|
|
| |
|
The following charges reflect the most common services offered by our Cardiology and Pulmonary Therapy departments. Patients may have additional charges, depending on the services performed.
|
|
| |
| |
|
ARTERIAL PUNCTURE
|
$69.00
|
|
|
BLOOD GAS W/COOX
|
$135.00
|
|
|
CARDIAC REHAB VISIT
|
$133.00
|
|
|
CARDIAC REHAB PHASE III
|
$133.00
|
|
|
CPAP (DAILY)
|
$235.00
|
|
|
HOLTER MONITOR SCANNING
|
$312.00
|
|
|
HOLTER MONITOR RECORDING
|
$345.00
|
|
|
PULMONARY STRESS TESTING - 6 MINUTE WALK TEST
|
$121.00
|
|
|
MDI-INITIAL I
|
$63.00
|
|
|
MDI-SUBSEQUENT I
|
$63.00
|
|
|
SPONTANEOUS AEROSOL TREATMENT-INITIAL
|
$63.00
|
|
|
SPONTANEOUS AEROSOL TREATMENT-SUBSEQUENT
|
$63.00
|
|
|
VENTILATOR-EACH SUBSEQUENT DAY
|
$452.00
|
|
|
VENTILATOR-INITIAL DAY
|
$757.00
|
|
|
CPR (CARDIOPULMONARY RESUSCITATION)
|
$543.00
|
|
|
|
|
|
|
X-Ray and Radiological Charges
|
|
| |
|
The following charges reflect the hospital's most common x-ray and radiological procedures.
|
|
| |
| |
|
ANKLE, MINIMUM 2 VIEWS
|
$228.00
|
|
|
BARIUM SWALLOW (ESOPHAGUS) UPPER GI
|
$391.00
|
|
|
CHEST PA AND LATERAL
|
$225.00
|
|
|
CHEST (ONE VIEW ONLY)
|
$167.00
|
|
|
ELBOW, MINIMUM 3 VIEWS
|
$240.00
|
|
|
FOOT, MINIMUM 3 VIEWS
|
$237.00
|
|
|
FOREARM
|
$213.00
|
|
|
GI, SMALL BOWEL
|
$884.00
|
|
|
HAND, 2 VIEWS
|
$152.00
|
|
|
IVP (INTAVENOUS PYELOGRAPHY)
|
$565.00
|
|
|
KNEE, 1 OR 2 VIEWS
|
$212.00
|
|
|
KUB - XRAY ABDOMEN
|
$205.00
|
|
|
KUB - COMPLETE 2 OR MORE VIEWS
|
$258.00
|
|
|
KUB UPRRIGHT, CROSSFIRE AND CHEST LATERAL/PA
|
$345.00
|
|
|
LEG (TIBIA/FIBULA)
|
$231.00
|
|
|
MODIFIED BARIUM/COOKIE SWALLOW
|
$358.00
|
|
|
PELVIS WITH PUBIC BONE
|
$135.00
|
|
|
RIBS,UNILATERAL
|
$246.00
|
|
|
SHOULDER, COMPLETE (MINIMUM 2-VIEWS)
|
$248.00
|
|
|
SHOULDER, 1 VIEW
|
$218.00
|
|
|
SPINE, CERVICAL,MULTIPLE VIEWS (AP,LATERAL,FLEX,EXT)
|
$362.00
|
|
|
SPINE, CERVICAL-ROUTINE VIEWS
|
$370.00
|
|
|
SPINE, LUMBOSACRAL (2-3 VIEWS)
|
$261.00
|
|
|
SPINE, DORSAL (THORACIC)
|
$315.00
|
|
|
WRIST (CARPAL SERIES)
|
$231.00
|
|
|
|
|
|
|
MAMMOGRAM SCREENING - DIGITAL - UNILATERAL
|
$218.00
|
|
|
MAMMOGRAM SCREENING - DIGITAL - BILATERAL
|
$369.00
|
|
|
MAMMOGRAM DIAGNOSTIC - DIGITAL - UNILATERAL
|
$342.00
|
|
|
MAMMOGRAM DIAGNOSTIC - DIGITAL - BILATERAL
|
$437.00
|
|
|
|
|
|
|
MRI UPPER EXTREMITY WITH & WITHOUT CONTRAST
|
$2,356.00
|
|
|
MRI THORACIC SPINE WITHOUT CONTRAST
|
$2,129.00
|
|
|
MRI THORACIC SPINE WITH & WITHOUT CONTRAST
|
$2,692.00
|
|
|
MRI PELVIS WITHOUT CONTRAST
|
$2,194.00
|
|
|
MRI PELVIS WITH & WITHOUT CONTRAST
|
$2,739.00
|
|
|
MRI ORBITS FACE & NECK WITHOUT CONTRAST
|
$1,802.00
|
|
|
MRI ORBITS FACE & NECK WITH & WITHOUT CONTRAST
|
$1,543.00
|
|
|
MRI LUMBAR SPINE WITHOUT CONTRAST
|
$2,504.00
|
|
|
MRI LUMBAR SPINE WITH & WITHOUT CONTRAST
|
$2,976.00
|
|
|
MRI LOWER EXTREMITY WITHOUT CONTRAST
|
$2,135.00
|
|
|
MRI LOWER EXTREMITY WITH & WITHOUT CONTRAST
|
$2,475.00
|
|
|
MRI SPINE CANAL-CERVICAL WITHOUT CONTRAST
|
$2,614.00
|
|
|
MRI CERVICAL SPINE WITH & WITHOUT CONTRAST
|
$3,178.00
|
|
|
MRI BRAIN WITHOUT CONTRAST
|
$2,168.00
|
|
|
MRI BRAIN WITH & WITHOUT CONTRAST
|
$2,647.00
|
|
|
MRI ABDOMEN WITH & WITHOUT CONTRAST
|
$2,497.00
|
|
|
MRA NECK WITH & WITHOUT CONTRAST
|
$2,049.00
|
|
|
MRA HEAD WITHOUT CONTRAST
|
$1,584.00
|
|
|
MRA ABDOMEN WITH & WITHOUT CONTRAST
|
$2,289.00
|
|
|
|
|
|
|
CT BRAIN WITHOUT CONTRAST
|
$1,148.00
|
|
|
CT BRAIN WITH CONTRAST
|
$1,198.00
|
|
|
CT BRAIN WITH & WITHOUT CONTRAST
|
$1,562.00
|
|
|
CT PELVIS WITH ORAL CONTRAST
|
$1,236.00
|
|
|
CT PELVIS WITH IV & ORAL CONTRAST
|
$1,553.00
|
|
|
CT ABDOMEN WITHOUT IV CONTRAST, WITH OR WITHOUT ORAL CONTRAST
|
$1,258.00
|
|
|
CT ABDOMEN WITH IV CONTRAST-WITH OR WITHOUT ORAL CONTRAST
|
$1,496.00
|
|
|
CT ABDOMEN WITH & WITHOUT IV CONTRAST-WITH ORAL CONTRAST
|
$1,772.00
|
|
|
CT CHEST/MEDIASTINUM WITHOUT CONTRAST
|
$1,123.00
|
|
|
CT CHEST/MEDIASTINUM WITH CONTRAST
|
$1,397.00
|
|
|
CT CHEST/MEDIASTINUM WITH & WITHOUT CONTRAST
|
$1,427.00
|
|
|
CT CERVICAL SPINE MULTIPLE WITHOUT CONTRAST
|
$1,271.00
|
|
|
CT LUMBAR SPINE WITHOUT CONTRAST
|
$1,351.00
|
|
|
CT NECK WITH CONTRAST
|
$1,545.00
|
|
|
CT ORBIT, SELLA, POSTERIOR FOSSA OR OUTER/MIDDLE /INNER EAR WITH CONTRAST
|
$1,487.00
|
|
|
CT FACIAL BONES WITHOUT CONTRAST
|
$1,039.00
|
|
|
CT GUIDANCE PLACEMENT RADIATION FIELDS
|
$703.00
|
|
|
CT GUIDANCE FOR NEEDLE BIOPSY
|
$1,259.00
|
|
|
CTA CHEST, NON-CORONARY WITH & WITHOUT CONTRAST
|
$1,646.00
|
|
|
CTA ABDOMEN WITH & WITHOUT IV CONTRAST
|
$1,464.00
|
|
|
CTA PELVIS WITH & WITHOUT IV CONTRAST
|
$1,586.00
|
|
|
PET IMAGING - BRAIN FOR METABOLIC EVALUATION
|
$3,872.00
|
|
| PET IMAGING - SKULL BASE TO MID-THIGH |
$3,181.00
|
|
| PET IMAGING - WHOLE BODY |
$3,436.00
|
|
| PET IMAGING W/CONCURRENT CT SCAN - SKULL BASE TO MID-THIGH |
$4,266.00
|
|
|
|
|
|
|
|
|
|
|
Laboratory Charges
|
|
| |
|
The following charges reflect the hospital's 30 most common laboratory procedures.
|
|
| |
| |
|
AMYLASE SERUM
|
|
|
|
$74.00
|
|
|
CBC (NO DIFFERENTIAL)
|
|
|
|
$49.00
|
|
|
CBC (WITH MACHINE DIFFERENTIAL)
|
|
$78.00
|
|
|
CHEM 8 (BASIC METABOLIC)
|
|
|
$102.00
|
|
|
COMPREHENSIVE METABOLIC PANEL
|
|
$191.00
|
|
|
CREATININE,SERUM
|
|
|
|
$35.00
|
|
|
CULTURE, BLOOD
|
|
|
|
$107.00
|
|
|
CULTURE, URINE
|
|
|
|
$76.00
|
|
|
GLUCOSE
|
|
|
|
|
$34.00
|
|
|
HEMATOCRIT
|
|
|
|
|
$26.00
|
|
|
HEMOGLOBIN
|
|
|
|
|
$26.00
|
|
|
HEMOGLOBIN A1C
|
|
|
|
$88.00
|
|
|
HEMOGRAM
|
|
|
|
|
$62.00
|
|
|
HEPATIC FUNCTION-PANEL
|
|
|
$113.00
|
|
|
LIPID PROFILE
|
|
|
|
|
$136.00
|
|
|
MAGNESIUM SERUM
|
|
|
|
$47.00
|
|
|
MYOGLOBIN
|
|
|
|
|
$148.00
|
|
|
PARTIAL THROMBOPLASTIN TIME
|
|
|
$50.00
|
|
|
PHOSPHORUS SERUM
|
|
|
|
$40.00
|
|
|
POTASSIUM,SERUM
|
|
|
|
$26.00
|
|
|
PREGNANCY TEST, SERUM
|
|
|
$61.00
|
|
|
PREGNANCY TEST, URINE
|
|
|
$61.00
|
|
|
PROTHROMBIN TIME
|
|
|
|
$33.00
|
|
|
RENAL FUNCTION PANEL
|
|
|
$98.00
|
|
|
SENSITIVITY
|
|
|
|
|
$63.00
|
|
|
THYROID STIMULATING HORMONE
|
|
|
$130.00
|
|
|
THYROXINE T4 FREE
|
|
|
|
$114.00
|
|
|
TROPONIN-I
|
|
|
|
|
$88.00
|
|
|
URINALYSIS WITHOUT MICROSCOPIC
|
|
$29.00
|
|
|
VENIPUNCTURE
|
|
|
|
$17.00
|
|
|
|
|
|
|
|
|
|
|
MedCentral Collection and Billing Policies
|
|
| |
|
PHILOSOPHY:
MedCentral Health System has established a mission to meet the medical needs of the communities it serves. This mission requires MedCentral to maintain a strong financial position. To this end, we have established a policy of communicating the financial expectations to the patient. We will also provide the patient with information on payment and charity care options.
The employees of MedCentral Health System will always keep in mind the patient's financial situation and preserve the dignity of those involved. With the exception of "Life Style" procedures, no clinical services will be denied for an inability or unwillingness to pay.
POLICY:
MedCentral Health System's billing and credit policies are summarized below.
Third Party Insurance
- MedCentral will bill Medicare and Medicaid.
- MedCentral will bill third party commercial payers on behalf of the patient. We offer 45 days to the insurance company before you will be contacted to assist with the resolution of any unpaid insurance balance. If there is no resolution the account will become patient liability and the patient will be billed.
- MedCentral will not bill third party auto insurance if there is medical coverage available.
- MedCentral will not wait for a third party liability carrier or sued individual to pay a claim before enforcing our right to payment. MedCentral will not accept a letter of protection from an attorney involved in a law suit to recover third-party damages.
- MedCentral will honor discounts only with contracted insurance carriers.
Uninsured, Unresolved and Self-Pay Balances
- Emergent, Urgent and Labor and Delivery services covered under EMTALA (Emergency Medical Treatment and Active Labor Act) are not subject to prior payment.
- Known Deductibles, Copay and Coinsurance amounts are due at the time of service.
- Non-covered, self-insured, uninsured and "life style" services are payable at the time of service. (Life style procedures are defined as not medically necessary procedures such as non-restorative cosmetic surgery.)
- Patient balances that cannot be paid prior to service and balances after insurance payment or denial must be resolved in one of the following methods:
- Payment in full from personal funds
- Bank Loan Program underwritten by MedCentral
- Limited term time payments (Limited to 6 months)
- Uncompensated or Charity Care approvals
- Patient balances not resolved in one of the methods above will be billed on a prescribed time table over a 120 day period. During each of those billing encounters, and calls from a financial counselor will include information about the above payment options as well as our uncompensated care program.
- If the account has not had a satisfactory resolution within 120 days the claim may be submitted to an outside agency for professional collection assistance.
|
|
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
|
Consumers can access a number of government and private Websites, which provide additional information on hospitals' charges and quality. For a complete listing of available online resources, please visit the Consumer's Guide to Quality Health Care in Ohio at ohiohealthcareguide.org.
|
|
| |
| |
| |
| |
|
|
|
|
|
|
|