Hospital price profile
LODI COMMUNITY HOSPITAL
225 ELYRIA STREET, Lodi, OH 44254 · (330) 948-1222 · Map and directions
CMS quality snapshot
Overall hospital ratingNot available
Safety measures vs. national result0 better · 1 same · 0 worse
PSI-90 patient safetyNot Available
The hospital star rating is overall, not procedure-specific. PSI-90 reflects qualifying Medicare inpatient stays, not every outpatient encounter. View CMS source.
| Procedure | Context | Published cash | Comparison | Source |
|---|---|---|---|---|
| Blood drawHCPCS 36415 · ROUTINE VENIPUNCTURE | INPATIENT / FACILITY1 observed cash value(s) | $40.95 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Blood drawHCPCS 36415 · ROUTINE VENIPUNCTURE | OUTPATIENT / FACILITY1 observed cash value(s) | $40.95 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT headHCPCS 70450 · CT HEAD/BRAIN W/O CONTRAST MATERIAL | INPATIENT / FACILITY1 observed cash value(s) | $477.10 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT headHCPCS 70450 · CT HEAD/BRAIN W/O CONTRAST MATERIAL | OUTPATIENT / FACILITY1 observed cash value(s) | $477.10 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT head with contrastHCPCS 70460 · CT HEAD/BRAIN W/CONTRAST MATERIAL | INPATIENT / FACILITY1 observed cash value(s) | $798.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT head with contrastHCPCS 70460 · CT HEAD/BRAIN W/CONTRAST MATERIAL | OUTPATIENT / FACILITY1 observed cash value(s) | $798.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT head with/without contrastHCPCS 70470 · CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL | INPATIENT / FACILITY1 observed cash value(s) | $798.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT head with/without contrastHCPCS 70470 · CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL | OUTPATIENT / FACILITY1 observed cash value(s) | $798.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI brain without contrastHCPCS 70551 · MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | INPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI brain without contrastHCPCS 70551 · MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | OUTPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI brainHCPCS 70553 · MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | INPATIENT / FACILITY1 observed cash value(s) | $1,601.60 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI brainHCPCS 70553 · MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | OUTPATIENT / FACILITY1 observed cash value(s) | $1,601.60 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Chest X-rayHCPCS 71046 · RADIOLOGIC EXAM CHEST 2 VIEWS | INPATIENT / FACILITY1 observed cash value(s) | $395.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Chest X-rayHCPCS 71046 · RADIOLOGIC EXAM CHEST 2 VIEWS | OUTPATIENT / FACILITY1 observed cash value(s) | $395.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT chest without contrastHCPCS 71250 · DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST | INPATIENT / FACILITY1 observed cash value(s) | $477.10 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT chest without contrastHCPCS 71250 · DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST | OUTPATIENT / FACILITY1 observed cash value(s) | $477.10 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT chestHCPCS 71260 · DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST | INPATIENT / FACILITY1 observed cash value(s) | $798.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT chestHCPCS 71260 · DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST | OUTPATIENT / FACILITY1 observed cash value(s) | $798.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT angiography chestHCPCS 71275 · CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST | INPATIENT / FACILITY1 observed cash value(s) | $798.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT angiography chestHCPCS 71275 · CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST | OUTPATIENT / FACILITY1 observed cash value(s) | $798.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI cervical spineHCPCS 72141 · MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL | INPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI cervical spineHCPCS 72141 · MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL | OUTPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI thoracic spineHCPCS 72146 · MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL | INPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI thoracic spineHCPCS 72146 · MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL | OUTPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI lumbar spineHCPCS 72148 · MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | INPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI lumbar spineHCPCS 72148 · MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | OUTPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Shoulder X-rayHCPCS 73030 · RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS | INPATIENT / FACILITY1 observed cash value(s) | $395.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Shoulder X-rayHCPCS 73030 · RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS | OUTPATIENT / FACILITY1 observed cash value(s) | $395.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI shoulder / upper jointHCPCS 73221 · MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL | INPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI shoulder / upper jointHCPCS 73221 · MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL | OUTPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Knee X-rayHCPCS 73562 · RADIOLOGIC EXAMINATION KNEE 3 VIEWS | INPATIENT / FACILITY1 observed cash value(s) | $395.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Knee X-rayHCPCS 73562 · RADIOLOGIC EXAMINATION KNEE 3 VIEWS | OUTPATIENT / FACILITY1 observed cash value(s) | $395.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Ankle X-rayHCPCS 73610 · RADEX ANKLE COMPLETE MINIMUM 3 VIEWS | INPATIENT / FACILITY1 observed cash value(s) | $395.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Ankle X-rayHCPCS 73610 · RADEX ANKLE COMPLETE MINIMUM 3 VIEWS | OUTPATIENT / FACILITY1 observed cash value(s) | $395.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI knee / lower jointHCPCS 73721 · MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | INPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| MRI knee / lower jointHCPCS 73721 · MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | OUTPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT abdomen & pelvis without contrastHCPCS 74176 · CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL | INPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT abdomen & pelvis without contrastHCPCS 74176 · CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL | OUTPATIENT / FACILITY1 observed cash value(s) | $1,084.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT abdomen & pelvisHCPCS 74177 · CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | INPATIENT / FACILITY1 observed cash value(s) | $1,601.60 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT abdomen & pelvisHCPCS 74177 · CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | OUTPATIENT / FACILITY1 observed cash value(s) | $1,601.60 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT abdomen & pelvis with/without contrastHCPCS 74178 · CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE | INPATIENT / FACILITY1 observed cash value(s) | $1,601.60 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CT abdomen & pelvis with/without contrastHCPCS 74178 · CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE | OUTPATIENT / FACILITY1 observed cash value(s) | $1,601.60 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Breast ultrasoundHCPCS 76641 · US BREAST UNI REAL TIME WITH IMAGE COMPLETE | INPATIENT / FACILITY1 observed cash value(s) | $477.10 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Breast ultrasoundHCPCS 76641 · US BREAST UNI REAL TIME WITH IMAGE COMPLETE | OUTPATIENT / FACILITY1 observed cash value(s) | $477.10 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Transvaginal ultrasoundHCPCS 76830 · US TRANSVAGINAL | INPATIENT / FACILITY1 observed cash value(s) | $477.10 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Transvaginal ultrasoundHCPCS 76830 · US TRANSVAGINAL | OUTPATIENT / FACILITY1 observed cash value(s) | $477.10 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Pelvic ultrasoundHCPCS 76856 · US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE | INPATIENT / FACILITY1 observed cash value(s) | $477.10 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Pelvic ultrasoundHCPCS 76856 · US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE | OUTPATIENT / FACILITY1 observed cash value(s) | $477.10 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Diagnostic mammogramHCPCS 77065 · DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | OUTPATIENT / FACILITY1 observed cash value(s) | $365.95 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Diagnostic mammogramHCPCS 77065 · DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | INPATIENT / FACILITY1 observed cash value(s) | $365.95 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Screening mammogramHCPCS 77067 · SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | INPATIENT / FACILITY1 observed cash value(s) | $395.85 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Screening mammogramHCPCS 77067 · SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | OUTPATIENT / FACILITY1 observed cash value(s) | $395.85 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Nuclear stress imagingHCPCS 78452 · MYOCARDIAL SPECT MULTIPLE STUDIES | INPATIENT / FACILITY1 observed cash value(s) | $5,855.20 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Nuclear stress imagingHCPCS 78452 · MYOCARDIAL SPECT MULTIPLE STUDIES | OUTPATIENT / FACILITY1 observed cash value(s) | $5,855.20 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Comprehensive metabolic panelHCPCS 80053 · COMPRE META PANL | INPATIENT / FACILITY1 observed cash value(s) | $47.45 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Comprehensive metabolic panelHCPCS 80053 · COMPRE META PANL | OUTPATIENT / FACILITY1 observed cash value(s) | $47.45 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Lipid panelHCPCS 80061 · LIPID-LIPO PANEL 1 | INPATIENT / FACILITY1 observed cash value(s) | $59.80 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Lipid panelHCPCS 80061 · LIPID-LIPO PANEL 1 | OUTPATIENT / FACILITY1 observed cash value(s) | $59.80 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| UrinalysisHCPCS 81001 · URINALYSIS AUTO W SCPE | INPATIENT / FACILITY1 observed cash value(s) | $14.30 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| UrinalysisHCPCS 81001 · URINALYSIS AUTO W SCPE | OUTPATIENT / FACILITY1 observed cash value(s) | $14.30 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Vitamin D testHCPCS 82306 · VITAMIN D 25 HYDROXY | INPATIENT / FACILITY1 observed cash value(s) | $132.60 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Vitamin D testHCPCS 82306 · VITAMIN D 25 HYDROXY | OUTPATIENT / FACILITY1 observed cash value(s) | $132.60 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Ferritin testHCPCS 82728 · FERRITIN ASSAY | INPATIENT / FACILITY1 observed cash value(s) | $61.10 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Ferritin testHCPCS 82728 · FERRITIN ASSAY | OUTPATIENT / FACILITY1 observed cash value(s) | $61.10 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Hemoglobin A1cHCPCS 83036 · HGB A1C GLYCOSYLATED | INPATIENT / FACILITY1 observed cash value(s) | $43.55 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Hemoglobin A1cHCPCS 83036 · HGB A1C GLYCOSYLATED | OUTPATIENT / FACILITY1 observed cash value(s) | $43.55 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Iron testHCPCS 83540 · IRON TEST | INPATIENT / FACILITY1 observed cash value(s) | $29.25 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Iron testHCPCS 83540 · IRON TEST | OUTPATIENT / FACILITY1 observed cash value(s) | $29.25 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| TIBC testHCPCS 83550 · FE BINDING CAPACITY | INPATIENT / FACILITY1 observed cash value(s) | $39.00 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| TIBC testHCPCS 83550 · FE BINDING CAPACITY | OUTPATIENT / FACILITY1 observed cash value(s) | $39.00 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| PSA testHCPCS 84153 · PSA DIAGNOSTIC | INPATIENT / FACILITY1 observed cash value(s) | $82.55 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| PSA testHCPCS 84153 · PSA DIAGNOSTIC | OUTPATIENT / FACILITY1 observed cash value(s) | $82.55 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| TSH testHCPCS 84443 · TSH | OUTPATIENT / FACILITY1 observed cash value(s) | $75.40 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| TSH testHCPCS 84443 · TSH | INPATIENT / FACILITY1 observed cash value(s) | $75.40 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Pregnancy blood testHCPCS 84702 · HCG QUANT SERUM | INPATIENT / FACILITY1 observed cash value(s) | $67.59 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Pregnancy blood testHCPCS 84702 · HCG QUANT SERUM | OUTPATIENT / FACILITY1 observed cash value(s) | $67.59 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CBC with differentialHCPCS 85025 · CBC W/DIFF | INPATIENT / FACILITY1 observed cash value(s) | $35.10 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| CBC with differentialHCPCS 85025 · CBC W/DIFF | OUTPATIENT / FACILITY1 observed cash value(s) | $35.10 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Urine cultureHCPCS 87086 · CULT/COLONY COUNT QUANT URINE | INPATIENT / FACILITY1 observed cash value(s) | $36.40 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Urine cultureHCPCS 87086 · CULT/COLONY COUNT QUANT URINE | OUTPATIENT / FACILITY1 observed cash value(s) | $36.40 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| EchocardiogramHCPCS 93306 · ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST | INPATIENT / FACILITY1 observed cash value(s) | $2,049.44 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| EchocardiogramHCPCS 93306 · ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST | OUTPATIENT / FACILITY1 observed cash value(s) | $2,049.44 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| SpirometryHCPCS 94010 · SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ | INPATIENT / FACILITY1 observed cash value(s) | $468.00 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| SpirometryHCPCS 94010 · SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ | OUTPATIENT / FACILITY1 observed cash value(s) | $468.00 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Lung diffusion testHCPCS 94729 · CO DIFFUSING CAPACITY | OUTPATIENT / FACILITY1 observed cash value(s) | $393.25 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Lung diffusion testHCPCS 94729 · CO DIFFUSING CAPACITY | INPATIENT / FACILITY1 observed cash value(s) | $393.25 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Sleep studyHCPCS 95810 · POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | INPATIENT / FACILITY1 observed cash value(s) | $4,563.00 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Sleep studyHCPCS 95810 · POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | OUTPATIENT / FACILITY1 observed cash value(s) | $4,563.00 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Physical therapy exerciseHCPCS 97110 · THERA EXER 1 | INPATIENT / FACILITY1 observed cash value(s) | $167.70 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Physical therapy exerciseHCPCS 97110 · THERA EXER 1 | OUTPATIENT / FACILITY1 observed cash value(s) | $167.70 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Manual therapyHCPCS 97140 · MANUAL THERAPY 15MIN GP | INPATIENT / FACILITY1 observed cash value(s) | $156.65 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Manual therapyHCPCS 97140 · MANUAL THERAPY 15MIN GP | OUTPATIENT / FACILITY1 observed cash value(s) | $156.65 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| PT evaluation, low complexityHCPCS 97161 · VV EVALUATION LOW COMPLEXITY (97161) | INPATIENT / FACILITY1 observed cash value(s) | $393.25 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| PT evaluation, low complexityHCPCS 97161 · VV EVALUATION LOW COMPLEXITY (97161) | OUTPATIENT / FACILITY1 observed cash value(s) | $393.25 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| PT evaluation, moderate complexityHCPCS 97162 · VV EVALUATION MODERATE COMPLEXITY (97162) | INPATIENT / FACILITY1 observed cash value(s) | $393.25 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| PT evaluation, moderate complexityHCPCS 97162 · VV EVALUATION MODERATE COMPLEXITY (97162) | OUTPATIENT / FACILITY1 observed cash value(s) | $393.25 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Therapeutic activitiesHCPCS 97530 · THERA ACTIVITY DIR 15MIN | INPATIENT / FACILITY1 observed cash value(s) | $178.10 | InformationalThis row has a different care setting or billing class and is not ranked against outpatient facility prices. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
| Therapeutic activitiesHCPCS 97530 · THERA ACTIVITY DIR 15MIN | OUTPATIENT / FACILITY1 observed cash value(s) | $178.10 | ComparableSame exact code, outpatient setting, facility billing, and one published cash value. | 2026-10-31Confidence 100/100 · ingestion acfe1be3… |
About these prices
Every amount on this page comes from the hospital’s machine-readable file and remains tied to its exact billing code, care setting, and billing class. Rows with multiple published amounts show the source range and are not ranked as a single comparable price.