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| ROOM RATES: | LABORATORY: | |||
| Private Med/Surg | $407.00/Day | Activated Partial Thromboplastin Time (APTT) | $33.30 | |
| Semi Private Med/Surg | $397.00/Day | Amylase | $29.50 | |
| Intensive Care | $984.00/Day | Basic Metabolic Panel (BMP) | $87.40 | |
| Intermediate Unit (Telemetry) | $629.00/Day | Blood Cultures | $46.70 | |
| Skilled Nursing Unit - Semi Private | $232.00/Day | Blood Urea Nitrogen (BUN) | $29.50 | |
| Skilled Nursing Unit - Private | $248.00/Day | Creative Kinase, Total (CK or CPK) | $29.50 | |
| Obstetrics Room | $407.00/Day | Creative Kinase, Myocardium (CK-MB) | $52.60 | |
| Pediatrics Semi-Private | $388.00/Day | Creatinine | $29.50 | |
| Pediatrics - Private | $402.00/Day | Complete Blood Count (CBC) | $40.80 | |
| Nursery Border | $315.00/Day | Complete Blood Count w/o differential (CBC no diff) | $29.50 | |
| Nursery Newborn | $304.00/Day | Comprehensive Metabolic Panel (CMP) | $96.50 | |
| Complete Urinalysis (UA) Referral | $29.50 | |||
| Differential Manual (MDIFF) Services | $17.80 | |||
| RADIOLOGY: | Erythrocyte Sedimentation Rate (ESR) | $23.30 | ||
| Skull | $133.00 | Glycosylated Hemoglobin (AIC) | $46.70 | |
| Chest | $108.00 | Gram Stain | $18.55 | |
| Ribs | $115.00 | Hemoglobin (HGB) | $17.80 | |
| Abdomen Series | $141.00 | Hematocrit (HCT) | $17.80 | |
| Pelvis | $86.00 | Hepatic Function Panel | $53.60 | |
| Cervical Spine | $155.00 | Lactate Dehydrogenase (LDH) | $29.50 | |
| Thoracic Spine | $151.00 | Lipase | $33.30 | |
| Lumbar Spine | $215.00 | Lipid Panel | $116.30 | |
| Finger | $64.00 | Magnesium (MG) | $42.40 | |
| Hand | $79.00 | Phosphorus (Phos) | $34.90 | |
| Wrist | $77.00 | Pregnancy Test, Qualitative | $58.40 | |
| Elbow | $118.00 | Prothrombin Time (PT) | $29.50 | |
| Forearm | $78.00 | Thyroid Stimulating Hormone (TSH) | $85.20 | |
| Shoulder | $81.00 | Troponin I | $45.10 | |
| Hip Complete | $101.00 | Urine Culture | $46.70 | |
| Knee | $103.00 | Venipuncture Charge | $14.00 | |
| Lower Leg | $76.00 | Ankle | $83.00 | Charge does not include fee for services of pathologist |
| Foot | $83.00 | Please contact MD Billing at 304-387-3000 to obtain these charges | Toe(s) | $98.00 |
| Sinus | $133.00 | Upper GI Series | $294.00 | |
| Intravenous Pyelogram | $280.00 | |||
| Mammogram Screening | $81.00 | |||
| Mammogram - Diagnostic | $176.00 | Emergency Room: | ||
| CT Sinus | $559.00 | Emergency Level I | $81.00 | |
| CT Head | $716.00 | Emergency Level II | $119.00 | |
| CT Chest | $738.00 | Emergency Level III | $215.00 | |
| CT Abdomen | $753.00 | Emergency Level IV | $402.00 | |
| CT Pelvis | $753.00 | Emergency Level V | $590.00 | |
| Cast Room | $81.00 | |||
| Charge does not include fee for services of radiologist | Additional charges for select surgical procedures | $27.00-$375.00 | ||
| Please contact East Liverpool Imaging, Inc at 877-868-2059 ext. 223 to obtain these charges | Charge does not include fee for services of emergency room physician. Please contact Tri-State Emergency Physicians at 877-868-2059 ext. 266 to obtain these charges. | |||
| Surgical Room Time: | Common Speech and Hearing Services: | |||
| Per 30 Minute Increment | $1,274.00 | Assessment Aphasia With Interpretatin and Report | $88.00 | |
| Special Procedure Room per 30 minitures | $1061.00 | Cognitive Skills Development Each 15 minutes | $62.00 | |
| Recovery Room | $637.00 | Dysphagia Evaluation | $167.00 | |
| Evaluation up to 30 minutes | $167.00 | |||
| Additional Charges for Non-Routine Supplies | Evaluation over 30 minutes | $188.00 | ||
| Motion Fluroscopy/Swallow | $186.00 | |||
| Neuro Behavioral Exam with Report | $109.00 | |||
| Swallow Treatment 30 minutes | $108.00 | |||
| Treatment Individual-less than 30 minutes | $78.00 | |||
| Delivery Room: | Treatment Individual-more than 30 minutes | $134.00 | ||
| Labor Room Charge | $824.00 | Typanometry | $37.00 | |
| Vaginal Delivery Charge | $721.00 | |||
| C-Section Charge | $1236.00 | |||
| Recovery Room Charge | $618.00 | |||
| Observation Room per Hour | $16.00 | Respiratory Therapy: | ||
| Aerosol Treatment | $42.00 | |||
| Bronchodilator Challenge | $206.00 | |||
| IPPB Treatment, Initial | $52.00 | |||
| Common Physical Therapy Services: | IPPB Treatment, sebsequent | $42.00 | ||
| Debridement with Tools | $105.00 | Oxygen | $58.00/Day | |
| Electro Stimulation - Unattended | $50.00 | Postural Drainage | $47.00 | |
| Evaluation - Initial | $121.00 | Ventilation MGT, 1st Day | $284.00 | |
| Gait Training - 15 minutes | $55.00 | Ventilation MGT, Subsequent Day | $253.00/Day | |
| Group Treatment I | $55.00 | |||
| Iontophoresis - 15 minutes | $66.00 | |||
| Jobst Pump - 1 hour | $54.00 | |||
| Light Therapy | $42.00 | |||
| Manual Therapy Techniques - 15 minutes | $50.00 | East Liverpool City Hospital maintains billing policies and procedures intended | ||
| Massage - 15 minutes | $50.00 | to safeguard the financial well-being of the hospital while taking into account the economic realities | ||
| Neuromuscular Reeducation, Movement, Balance - 15 minutes | $55.00 | of its surrounding community. Efforts are made to bill in full | ||
| Physical Therapy Reevaluation | $78.00 | compliance with the regulations or guidelines of federal, state, and commercial payers. | ||
| Therapeutic Exercise 1 more area 15 minutes | $55.00 | When balance billing is permissible, patient accounts are subject to progressive collection efforts including | ||
| Therapeutic Activities 15 minutes | $45.00 | the use of collection agencies. However, patients who supply evidence of financial hardship | ||
| Ultrasound | $48.00 | may qualify for payment plans, partial forgiveness, or full forgiveness of account balances. | ||
| Whirlpool/Fluido Therapy | $50.00 | The hospital does not apply interest to account balances. | ||
| More information about East Liverpool City Hospital's billing policies is available by | ||||
| Common Occupational Therapy Services: | contacting the Business Office at 330-386-2901 or 330-386-2047. Questions may also | |||
| Cognitive Skills Development 15 minutes | $66.00 | be submitted by email using the "Contact Us" option on the hospital's web site. | ||
| Community/Work Reintegration 15 minutes | $33.00 | |||
| Electro Stimulation - Unattended | $50 .00 | |||
| Evaluation 20 minutes | $99.00 | |||
| Evaluation 21 - 40 minutes | $110.00 | |||
| Evalutation 41 - 60 min | $121.00 | |||
| Group Treatment I | $55.00 | |||
| Jobst Pump 1 hour | $54.00 | |||
| Manual Therapy Techniques | $50.00 | |||
| Neuromuscular Reeducation, Movement, Balance | $55.00 | |||
| Occupational Therapy Reevaluation | $78.00 | |||
| Paraffin Bath | $50.00 | |||
| Self-care/Home Management Training 15 minutes | $60.00 | |||
| Sensory Integration Techniques - 15 minutes | $60.00 | |||
| Splint, Finger Dynamic Application | $192.00 | |||
| Splint, Finger Static Application | $192.00 | |||
| Splint, Long Arm Application | $192.00 | |||
| Splint, Short Arm Dynamic Application | $192.00 | |||
| Therapeutic Exercise 1 More Area 15 minutes | $55.00 | |||
| Therapeutic Activities | $45.00 | |||
| Whirlpool/Fluido Therapy | $50.00 | |||
| Charge does not include fees for services of physicians. | ||||