Pricing Guide


Patient Price Information List 2011

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 1/1/10.

Room and Board — Per Day Charges
Charges
INTENSIVE CARE
LEVEL 1 2286.00
ROUTINE CARE 945.00
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.
Charges
NORMAL DELIVERY 1428.74
CESAREAN SECTION DELIVERY 2599.65
AMNIOCENTESIS 126.56
LABOR ROOM PER HOUR 52.68
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 of accommodations needed, the personnel resources, the intensity of care and the amount of time 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.
Charges
LEVEL 1 126.25
LEVEL 2 185.22
LEVEL 3 286.07
LEVEL 4 456.04
LEVEL 5 660.22
CRITICAL CARE 1107.60
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.
Charges
LEVEL 1 (SET-UP CHARGE) 1264.16
ADDITIONAL PER MINUTE CHARGE

57.04
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.
Charges
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.
Charges
OCCUPATIONAL THERAPY EVALUATION 143.29
IONTOPHORESIS, 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.
Charges
AEROSOL TREATMENT 36.94
DIFFUSION-SINGLE BREATH STUDY 248.01
ECHO (COMBINED) 967.32
ECHO COLOR FLOW 223.02
ECHO DOPPLER 356.80
EKG 103.04
IPPB TREATMENT 76.72
PFT WITH & WITHOUT BRONCH 535.90
PULMONARY RESIDUAL VOLUMES 275.39
X-Ray and Radiological Charges
The following charges reflect the hospital’s 30 most common x-ray and radiological procedures.
Charges
ABDOMEN 286.00
ABDOMEN (COMBINED W/CHEST) 350.40
ANKLE 324.25
CHEST XRAY ONE VIEW 141.12
CHEST XRAY – PORTABLE ONE VIEW 141.12
FOOT 240.49
HAND 302.29
KNEE 308.35
MAMMO SCREENING 128.79
MAMMOGRAPHY-BILATERAL 151.01
PELVIS 248.21
SHOULDER 327.32
SPINE, CERVICAL 437.24
SPINE, LUMBAR 571.41
WRIST 285.80
CT ABDOMEN WITH & WITHOUT CONTRAST 2687.13
CT ABDOMEN WITH CONTRAST 1527.82
CT ABDOMEN WITHOUT CONTRAST 1467.98
CT CERVICAL WITHOUT CONTRAST 1195.24
CT CHEST EXTENDED 2044.33
CT HEAD WITH & WITHOUT CONTRAST 1940.13
CT HEAD WITHOUT CONTRAST 1254.66
CT PELVIS WITH CONTRAST 1498.15
CT PELVIS WITHOUT CONTRAST 1325.26
MRI LUMBAR SPINE WITHOUT CONTRAST 2318.31
US BREAST 385.60
US CAROTID ARTERIES 585.75
US GALLBLADDER 758.06
US KIDNEY 758.06
US PELVIC AREA 637.29
US TRANS VAGINAL 1034.85
Laboratory Charges
The following charges reflect the hospital’s 30 most common laboratory procedures.
Charges
ANTIBODY SCREEN-RH 23.66
(ALT) (SGPT) 45.42
(AST) (SGPT) 44.31
BASIC METABOLIC PANEL 71.79
BILLIRUBIN-CONJUGATED 41.41
BLOOD CULTURE 88.51
BLOOD TYPE (ABO-Rh) 40.04
CBC W/DIFFERENTIAL 66.62
CBC WITHOUT DIFFERENTIAL 52.32
CHEM METABOLIC PANEL 103.43
CREATININE KINASE,MB FRACTION (CK-MB) 81.86
CREATININE-SERUM 43.94
ERYTHROCYTE SEDIMENTATION RATE 27.72
GLUCOSE, SERUM 33.65
HCG URINE PREG TEST 68.70
HEMOGLOBIN A1C (HPLC METHOD) 78.48
HUMAN PAPILLOMAVIRUS (HPV) 61.17
LIPASE SERUM 59.04
LIPID PROFILE 109.01
LIVER PROFILE 64.94
PAP, MONO LAYER 83.76
PROTHROMBIN TIME 34.20
PSA SCREENING 103.08
T4-FREE, SERUM 86.62
THROMBOPLASTIN TIME PARTIAL (PTT) 54.79
THYROID STIM HORMONE (TSH) 123.61
TOTAL THYROXINE (T4) 56.06
TROPONIN-I 95.84
URINALYSIS (STIX+MICRO) 32.57
URINE CULTURE 72.66