Pricing Guide
Patient Price Information List 2013
In compliance with state law, Southeastern Ohio Regional Medical Center is providing this price list containing our charges for room and board, emergency department, operating room, delivery, physical therapy and other procedures. The hospital’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 03/01/13.
| Description | Price |
| Room and Board – Per Day Charges | |
| Intensive Care, Level 1 | 2520.00 |
| Routine Care | 1040.00 |
| LABOR AND DELIVERY CHARGES | |
| Normal Delivery | 1572.64 |
| Cesarean Section Delivery Base Fee | 1288.83 |
| Labor Room Per Minute Charge | 58.15 |
| Amniocentesis | 387.96 |
| Nursery | 750.00 |
| EMERGENCY DEPARTMENT 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. | |
| – | |
| ED Level 1 | 138.97 |
| ED Level 2 | 203.88 |
| ED Level 3 | 314.88 |
| ED Level 4 | 511.88 |
| ED Level 5 | 726.72 |
| Critical Care | 1171.91 |
| Operating Room Charges | |
| Operating Room charges are based on the complexity level, with level 1 being the most basic, for a particular operation. There is an initial, set-up charge as well as an additional charge for each 15 minutes while the operation is being performed. | |
| – | |
| Level 1 (Set-Up Charge) | 1,325.22 |
| Additional Per minute Charge | 62.79 |
| 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. | |
| – | |
| Physical therapy Evaluation | 143.29 |
| Aquatic Therapy, EA 15 min | 82.85 |
| Electric Stimulation, Manual | 70.05 |
| Electrical Stimulation | 61.68 |
| Estim (unattended) Non-Wound Care | 64.48 |
| Functional Capacity | 57.55 |
| Gait Training, EA 15 min | 59.87 |
| Iontoophoresis, EA 15 min | 72.52 |
| Kinetic Exercise, EA 15 min | 79.28 |
| Manual Therapy, EA 15 min | 73.24 |
| Traction, Mechanical | 75.49 |
| Ultrasound, EA 15 min | 57.82 |
| Work Conditioning EA hour | 79.98 |
| 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. | |
| – | |
| Occupational Therapy Evaluation | 151.76 |
| Iontoophoresis, EA 15 min | 72.52 |
| Massage, EA 15 min | 52.74 |
| Self Care/Home MNGMT TR, EA 15 min | 73.28 |
| Therapeutic Activities, EA 15 min | 71.44 |
| Therapeutic Exercise, EA 15 min | 79.84 |
| Ultrasound, EA 15 min | 57.82 |
| Whirlpool | 67.04 |
| 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. | |
| – | |
| AIRWAY INHALATION TREATMENT INT | 35.58 |
| Diffusion-Single Breath Study | 272.99 |
| ECHO (Combined) | 395.89 |
| ECHO Color Flow | 345.48 |
| ECHO Doppler | 392.73 |
| EKG | 113.42 |
| IPPB Treatment | 35.58 |
| PFT with & without Bronch | 589.87 |
| Stress Test w/ Pharmaceutical | 2315.28 |
| Stress Test w/ exercise | 2315.28 |
| Pulmonary Residual Volumes | 303.12 |
| X-Ray and Radiological Charges | |
| The following charges reflect the hospital’s 30 most common x-ray and radiological procedures. | |
| – | |
| ABDOMEN | 314.80 |
| ABDOMEN (COMBINED W/CHEST) | 385.69 |
| ANKLE | 357.13 |
| CHEST XRAY | 155.34 |
| CHEST XRAY-PORTABLE | 155.34 |
| FOOT | 264.72 |
| HAND | 332.73 |
| KNEE | 339.40 |
| MAMMO SCREENING | 141.76 |
| MAMMOGRAPHY-BILATERAL | 166.22 |
| MAMMOGRAPHY-UNILATERAL | 141.76 |
| PELVIS | 273.21 |
| SHOULDER | 360.29 |
| SPINE, CERVICAL | 481.28 |
| SPINE, LUMBAR | 628.96 |
| WRIST | 314.58 |
| CT ABDOMEN WITH & WITHOUT CONTRACT | 2957.77 |
| CT ABDOMEN WITH CONTRACT | 1681.69 |
| CT ABD & PELVIS WITH & WITHOUT CONTRAST | 2957.77 |
| CT CERVICAL WITHOUT CONTRACT | 1315.62 |
| CT CHEST EXTENDED WITH CONTRAST | 2250.22 |
| CT HEAD WITH & WITHOUT CONTRAST | 2135.53 |
| CT HEAD WITHOUT CONTRACT | 1381.02 |
| CT PELVIS WITH CONTRAST | 1649.04 |
| CT PELVIS WITHOUT CONTRAST | 1458.73 |
| MRI LUMBAR SPINE WITHOUT CONTRAST | 2551.79 |
| US BREAST | 424.43 |
| US CAROTID ARTERIES | 644.70 |
| US GALLBLADDER | 834.40 |
| US KIDNEY | 834.40 |
| US PELVIC AREA | 701.47 |
| US TRANS VAGINAL | 1139.07 |
| LABORATORY CHARGES | |
| ANTIBODY SCREEN-RH | 59.16 |
| (ALT) (SGPT) | 38.00 |
| (AST) (SGPT) | 37.00 |
| BASIC METABOLIC PANEL | 102.25 |
| BILLIRUBIN-CONJUGATED | 35.00 |
| BLOOD CULTURE | 96.00 |
| CBC W/DIFFERENTIAL | 64.50 |
| CHEM METABOLIC PANEL | 142.00 |
| CREATININE KINASE, MB FRACTION (CK-MB) | 80.00 |
| CREATININE-SERUM | 30.48 |
| ERYTHROCYTE SEDIMENTATION RATE | 41.28 |
| GLUCOSE, SERUM | 27.70 |
| HCG URINE PREG TEST | 63.75 |
| HEMOGLOBIN A1C | 69.25 |
| HUMAN PAPILLOMAVIRUS (HPV) | 87.78 |
| LIPASE SERUM | 63.00 |
| LIPID PROFILE | 109.01 |
| LIVER PROFILE | 102.00 |
| PAP, MONO LAYER | 83.76 |
| PROTHROMBIN TIME | 49.23 |
| PSA SCREENING | 108.20 |
| T4-FREE, SERUM | 77.00 |
| THROMBOLPLASTIN TIME PARTIAL (PTT) | 49.00 |
| THYROID STIM HORMONE (TSH) | 106.85 |
| TOTAL THYROXINE (T4) | 59.88 |
| TROPONIN-I | 89.00 |
| URINALYSIS (STIX+MICRO) | 45.40 |
| URINE CULTURE | 68.55 |
