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Patient Pricing Information

Room and Board - Per Day Charges

The following represents the hospital charges for room and care services only. The charges below do not include the fees for drugs, non-routine supplies and procedures that may be rendered during an inpatient visit.

Medical/Surgical - Semi Private  $ 628.08
Medical/Surgical - Private  $ 726.18
Progressive Pulmonary Care  $ 803.36
Intensive Care  $ 1,841.91
Pyschiatry  $ 726.18
Nursery  $ 346.19
Special Care Nursery  $ 687.96
Premie Baby Nursery  $ 845.25
Nursery Intensive Care  $ 1,511.16
Labor and Delivery  $ 726.18
   
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Labor, Delivery and Newborn Charges

The following list does not include anesthesia, drugs, or supplies for services rendered.

 CPT Code

Normal Delivery

 59409 $ 2,301.05

Labor and Delivery Triage Fee (Outpatient Only)

 59899 $ 170.63
Hearing Screening Newborn, 1st Intial  92587  $ 107.49
Circumcision  54150  $ 2,614.91
Fetal Non-Stress Test  59025  $ 190.93
     
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The following represents the average hospital charges per case. Note: This represents average charges per case based upon actual cases reviewed. Final charges will vary based upon total operating time, drugs, supplies and services utilized.
C-Section Delivery  For CASE  $ 6,176.21
     

 Emergency Department Charges

The following represents the hospital charges for each level of emergency care provided to patients. A Level 1 represents a basic emergency visit. A Level 5 represents a more comprehensive emergency visit. The charges below do not include the fees for drugs, supplies or additional procedures that may be rendered during the emergency department visit.
   CPT Code  
Triage - Level 1  99281  $ 87.47
Level 1  99281  $ 319.73
Level 2  99282  $ 528.47
Level 3  99283  $ 843.78
Level 4  99284  $ 1,300.95
Level 5  99285  $ 1,818.39
Critical Care  99291  $ 2,563.68
Critical Care Additional  99292  $ 483.63
     
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 Operating Room Charges
The following represents the hospital charges for each level of surgery that is provided at our hospital. A Level One represents a basic operating room procedure. A Level Three is a more comprehensive procedure, which utilizes more services. In addition, there are separate levels for Robotic Surgery or Laser Surgery Cases, which includes the use of special equipment. The following list does not include charges for anesthesia, drugs, supplies or implants/devices for services rendered.
Level One 0-30 Minutes    $ 1,392.92
Level One Each Add'l 15 Minutes    $ 41.35
Level Two 0-30 Minutes    $ 1,449.72
Level Two Each Add'l 15 Minutes    $ 1,554.83
Level Three 0-30 Minutes    $ 122.40
Laser 0-30 Minutes    $ 69.29
DaVinci Robotic 0-30 Minutes    $ 3,387.03
DaVinci Robotic Each Add'l 15 Minutes    $ 69.29
     
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NonInvasive Cardiology Charges
The following represents the hospital charges for the most common procedures for the Noninvasive Cardiology Department.
   CPT Code  
Electrocardiogram, Tracing Only, WO Inter/Report  93005  $ 60.38
Echo Trasth Complete W/2D, M-Mode, Spect Dop Color Flow Cop  93306  $ 679.33
Doppler Echocardiography Color Flow Velocity Mapping  93325  $ 141.12
Stress Echocardiography  93350  $ 679.33
Tee W Image Doc; W Probe Interpretation & Report  93312  $ 706.90
Doppler Echo Pulsed Wave W Spectral Display; Complete  93320  $ 234.47
     
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Physical Therapy Charges
The following represents the hospital charges for the most common procedures for the Physical Therapy Department.
   CPT Code  
Therapeutic Exercise, EA 15 Min                      97110  $ 37.49
Manual Therapy Techniques, EA 15 Min  97140  $ 37.49
Gait Training, EA 15 Min  97116  $ 27.20
Physical Therapy Evaluation  97001  $ 108.05
Therapeutic Activities, Direct, EA 15 Min  97530  $ 27.20
Application of Modality, Hot or Cold  97010  $ 27.20
Apply Ultrasound, EA 15 Min  97035  $ 37.49
Therapeutic Group, EA 15 Min  97150  $ 35.28
     

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Occupational Therapy Charges
The following represents the hospital charges for the most common procedures for the Occupational Therapy Department.
Therapeautic Exercise, EA 15 Min  97110  $ 37.49

Occupation Therapy Evaluation

 97003  $ 97.02
Self Care/Home Management Train, EA 15 Min  97535  $ 27.20
Therapeutic Activities, Direct, EA 15 Min  97530  $ 27.20
Manual Therapy Techniques, EA 15 Min  97140  $ 37.49
Neuromuscular Re-education, EA 15 Min  97112  $ 27.20
     
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Neurology Charges
The following represents the hospital charges for the most common procedures for the Neurology Department.
   CPT Code  
EEG Awake and Drowsy 20-40 Min  95816  $ 283.12
EEG Extended Monitoring, Greater than 1 Hour  95813  $ 283.12
     
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Cardiac and Pulmonary Rehab Charges
 The following represents the hospital charges for the most common procedures for Cardiac Rehab Program.
   CPT Code  
Cardiac Rehab W/ECG Monit  93798  $ 186.00
Cardiac Rehab Phase III Visit    $ 10.00
Cardiac Rehab Phase IV Visit    $ 7.70
Pulm Rehab W/ Exercise & Monitoring, Per Hour, Per Session  60424  $ 111.44
     
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Radiology Charges
The following charges represent the hospital's top 30 most common radiology procedures.
     
   CPT Code  
XRAY Chest, 2 Views  71020  $ 151.38
XRAY Chest, Frontal View, Portable  71010  $ 151.38
CT Head/Brain WO Contrast  70450  $ 696.78
Computed Tomography, ABD & Pelvis; W Contrast  74177  $ 744.56
CT Thorax W Contrast  71260  $ 743.82
US Echography, Abdominal, Complete  76700  $ 280.77
Computed Tomography, ABD & Pelvis; WO Contrast  74176  $ 483.96
XR Chest, Frontal View  71010  $ 151.38
XR Abdomen/KUB, Limited, 1 View  74000  $ 132.13
Ultrasound, Pelvic (Nonobstetric), Complete  76856  $ 229.32
US Duplex, Extremity Veins, Unilateral  93971  $ 252.11
US Echography, Transvaginal  76830  $ 280.77
XR Hand, Min 3 Views  73130  $ 110.99
XR Hip, Complete, Min 2 Views  73510  $ 151.41
Computer-Aided Detection: Screening Mammography  77052  $ 10.29
Mammography Producing Digital Imaging Screening Exam  G0202  $ 112.00
XR Ankle, Complete, Min 3 Views  73610  $ 110.99
XR Shoulder, Complete  73030  $ 127.16
US Pregnant Uterus, F/U, Per Fetus  76816  $ 69.83
XR ABD, Complete Acute Series, Single View Chest  74022  $ 221.38
XR Knee, Complete, 4 or More Views  73564  $ 155.09
CT Cervical Spine WO Contrast  72125  $ 736.47
XR Foot, Complete, Min 3 Views  73630  $ 110.99
XR Wrist, Complete  73110  $ 110.99
US Echography, Retroperitoneal (Renal), Complete  76770  $ 230.06
XR Spine, Lumbarsacral, AP & Bilateral  72100  $ 102.90
US Duplex, Extermity Veins, Bilateral  93970  $ 396.17
US PG Uterus, Fetal Anatomic Exam; Single/1st Gestation  76811  $ 170.52
Myocardial Perfusion Image, Tomographic; Multi Study/Rest/Stress  78452  $ 908.73
XR Spine, Lumbosacral, Complete, W Oblique Views  72110  $ 171.99
     
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Lab Charges
The following charges represent the hospital's top 30 most common lab procedures.
   CPT Code  
Collection of Venous Blood By Venipuncture  36415  $ 14.00
Glucose; Quanitative, Point of Care  82947  $ 14.70
Basic Metabolic Panel (8)  80048  $ 14.00
CBC With Auto Differential  85025  $ 13.13
Prothrombin Time  85610  $ 7.00
CBC (Hemogram & PLT)  85027  $ 8.82
Comprehensive Metabolic Panel (14)  80053  $ 62.48
Troponin I, Quantitative  84484  $ 13.23
Tissue Level IV, Gross & Microscopic Examination  88305  $ 110.99
Magnesium  83735  $ 9.56
Transferase; Alanine Amino (ALT) (SGPT)  84460  $ 6.62
APTT  85730  $ 8.09
Hepatic Function Panel (7)  80076  $ 11.03
Transferase; Aspartate Amino (AST) (SGOT)  84450  $ 6.62
Lipid Profile  80061  $ 18.38
Thyroid Stimulation Hormone (TSH)  84443  $ 51.45
Glcosolated HGB  83036  $ 13.23
Vitamin D 25-OH  82306  $ 41.90
Gyn Cytopath/Thin Layer - Routine Screening  G0123  $ 58.80
Urine Culture With Colony Count  87086  $ 36.75
Urinalysis - Routine  81001  $ 4.26
Culture, Presumptive, Screening Only  87081  $ 82.32
Hematocrit (HCT); Automated  85014  $ 3.68
Chlamydia Trachomatis DNA By PCR  87491  $ 94.82
N. Gonorroheae RNA  87591  $ 94.82
Free Thyroxine  84439  $ 37.49
Blood Culture  87040  $ 13.97
SED Rate  85652  $19.11
Drug Screen, Single Class  G0431  $ 107.45
Cyanocobalamin (Vitamin B12)  82607  $ 24.50
     
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Procedural Based Charges
The following represent the average hospital charges per case for specific OUTPATIENT procedures. Note: This represents average charges per case based upon actual cases reviewed. Final charges will vary based upon services rendered.
   CPT Code  
Laparoscopic Cholecystectomy  47562  $ 6,134.04
PRP I/Hern Init Reduc More Than 5 Yr  49505  $ 3,663.57
Hysteroscopy, Biopsy  58558  $ 2,745.49
Upper GI Endoscopy, Biopsy  43239  $ 2,291.50
Diagnostic Colonoscopy  45378  $ 1,931.69
Mastectomy Partial  19301  $ 6,304.07
Dental Surgery Procedure  41899  $ 3,321.80
Knee Arthoscopy/Surgery  29881  $ 3,321.80
Hysteroscopy, Ablation  58563  $ 5,973.19
Removal of Tonsils  42826  $ 3,345.63
Colonoscopy and Biopsy  45390  $ 2,117.39
Cystouretero W/ Lithotripsy  52353  $ 5,332.51
Create Eardrum Opening  69436  $ 2,861.60
Cath Place Coronary Art Image SI; W/L Heart Cath  93458  $ 5,116.08
Carpal Tunnel Surgery  64721  $ 2,482.03
Low Back Disk Surgery  63030  $ 4, 575.64
Repair Bladder Defect  57288  $ 6,755.20
Laser Vaporization of Prostate  52648  $ 7,592.31
Cystoscopy and Treatment  52332  $ 4,317.05
Cataract Surgery  66984  $ 3,738.83
Colonoscopy, Lesion Removal  45385  $ 2,234.70
Correction of Bunion  28296  $ 3,602.77
Repair Umbilical Hernia  49585  $ 3,746.65
Laparascopy, Remove Adnexa  58661  $ 8,457.43
Repair of Nasal Septum  30520  $ 4,121.32
Shoulder Arthroscopy/Surgery  29826  $ 5,669.88
Knee Arthroscopy Surgery  29880  $ 3,385.02
Laparascopy, Appendectomy  44970  $ 10,354.84
     
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