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| ROOM RATES: | LABORATORY: | |||
| Private Med/Surg | $395.00/Day | Activated Partial Thromboplastin Time (APTT) | $32.30 | |
| Semi Private Med/Surg | $385.00/Day | Amylase | $28.60 | |
| Intensive Care | $955.00/Day | Basic Metabolic Panel (BMP) | $84.80 | |
| Intermediate Unit (Telemetry) | $610.00/Day | Blood Cultures | $45.30 | |
| Skilled Nursing Unit - Semi Private | $225.00/Day | Blood Urea Nitrogen (BUN) | $28.60 | |
| Skilled Nursing Unit - Private | $240.00/Day | Creative Kinase, Total (CK or CPK) | $28.60 | |
| Obstetrics Room | $395.00/Day | Creative Kinase, Myocardium (CK-MB) | $51.00 | |
| Pediatrics Semi-Private | $376.00/Day | Creatinine | $28.60 | |
| Pediatrics - Private | $390.00/Day | Complete Blood Count (CBC) | $39.60 | |
| Nursery Border | $305.00/Day | Complete Blood Count w/o differential (CBC no diff) | $28.60 | |
| Nursery Newborn | $295.00/Day | Comprehensive Metabolic Panel (CMP) | $93.60 | |
| Complete Urinalysis (UA) Referral | $28.60 | |||
| Differential Manual (MDIFF) Services | $17.20 | |||
| RADIOLOGY: | Erythrocyte Sedimentation Rate (ESR) | $22.90 | ||
| Skull | $129.00 | Glycosylated Hemoglobin (AIC) | $45.30 | |
| Chest | $104.00 | Gram Stain | $18.20 | |
| Ribs | $111.00 | Hemoglobin (HGB) | $17.20 | |
| Abdomen Series | $136.00 | Hematocrit (HCT) | $17.20 | |
| Pelvis | $83.00 | Hepatic Function Panel | $52.00 | |
| Cervical Spine | $150.00 | Lactate Dehydrogenase (LDH) | $28.60 | |
| Thoracic Spine | $146.00 | Lipase | $32.30 | |
| Lumbar Spine | $208.00 | Lipid Panel | $112.90 | |
| Finger | $62.00 | Magnesium (MG) | $41.10 | |
| Hand | $76.00 | Phosphorus (Phos) | $33.80 | |
| Wrist | $74.00 | Pregnancy Test, Qualitative | $56.70 | |
| Elbow | $114.00 | Prothrombin Time (PT) | $28.60 | |
| Forearm | $75.00 | Thyroid Stimulating Hormone (TSH) | $82.70 | |
| Shoulder | $78.00 | Troponin I | $43.70 | |
| Hip Complete | $98.00 | Urine Culture | $45.30 | |
| Knee | $100.00 | Venipuncture Charge | $14.10font> | |
| Lower Leg | $73.00 | Ankle | $80.00 | Charge does not include fee for services of pathologist |
| Foot | $80.00 | Please contact MD Billing at 304-387-3000 to obtain these charges | Toe(s) | $95.00 |
| Sinus | $129.00 | Upper GI Series | $285.00 | |
| Intravenous Pyelogram | $271.00 | |||
| Mammogram Screening | $78.00 | |||
| Mammogram - Diagnostic | $170.00 | Emergency Room: | ||
| CT Sinus | $542.00 | Emergency Level I | $78.00 | |
| CT Head | $695.00 | Emergency Level II | $115.00 | |
| CT Chest | $738.00 | Emergency Level III | $208.00 | |
| CT Abdomen | $731.00 | Emergency Level IV | $390.00 | |
| CT Pelvis | $731.00 | Emergency Level V | $572.00 | |
| Cast Room | $78.00 | |||
| Charge does not include fee for services of radiologist | Additional charges for select surgical procedures | $26.00-$364.00 | ||
| 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 | $1,236.00 | Assessment Aphasia With Interpretatin and Report | $85.50 | |
| Special Procedure Room per 30 minitures | $1030.00 | Cognitive Skills Development Each 15 minutes | $60.00 | |
| Recovery Room | $618.00 | Dysphagia Evaluation | $162.00 | |
| Evaluation up to 30 minutes | $162.00 | |||
| Additional Charges for Non-Routine Supplies | Evaluation over 30 minutes | $182.00 | ||
| Motion Fluroscopy/Swallow | $180.00 | |||
| Neuro Behavioral Exam with Report | $105.00 | |||
| Swallow Treatment 30 minutes | $104.00 | |||
| Treatment Individual-less than 30 minutes | $75.00 | |||
| Delivery Room: | Treatment Individual-more than 30 minutes | $130.00 | ||
| Labor Room Charge | $800.00 | Typanometry | $35.00 | |
| Vaginal Delivery Charge | $700.00 | |||
| C-Section Charge | $1200.00 | |||
| Recovery Room Charge | $600.00 | |||
| Observation Room per Hour | $15.00 | Respiratory Therapy: | ||
| Aerosol Treatment | $40.00 | |||
| Bronchodilator Challenge | $200.00 | |||
| IPPB Treatment, Initial | $50.00 | |||
| Common Physical Therapy Services: | IPPB Treatment, sebsequent | $40.00 | ||
| Debridement with Tools | $101.00 | Oxygen | $56.00/Day | |
| Electro Stimulation - Unattended | $48.00 | Postural Drainage | $45.00 | |
| Evaluation - Initial | $117.00 | Ventilation MGT, 1st Day | $275.00 | |
| Gait Training - 15 minutes | $53.00 | Ventilation MGT, Subsequent Day | $245.00/Day | |
| Group Treatment I | $53.00 | |||
| Iontophoresis - 15 minutes | $64.00 | |||
| Jobst Pump - 1 hour | $52.00 | |||
| Light Therapy | $40.00 | |||
| Manual Therapy Techniques - 15 minutes | $48.00 | East Liverpool City Hospital maintains billing policies and procedures intended | ||
| Massage - 15 minutes | $48.00 | to safeguard the financial well-being of the hospital while taking into account the economic realities | ||
| Neuromuscular Reeducation, Movement, Balance - 15 minutes | $53.00 | of its surrounding community. Efforts are made to bill in full | ||
| Physical Therapy Reevaluation | $75.00 | compliance with the regulations or guidelines of federal, state, and commercial payers. | ||
| Therapeutic Exercise 1 more area 15 minutes | $53.00 | When balance billing is permissible, patient accounts are subject to progressive collection efforts including | ||
| Therapeutic Activities 15 minutes | $43.00 | the use of collection agencies. However, patients who supply evidence of financial hardship | ||
| Ultrasound | $46.00 | may qualify for payment plans, partial forgiveness, or full forgiveness of account balances. | ||
| Whirlpool/Fluido Therapy | $48.00 | 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 | $64.00 | be submitted by email using the "Contact Us" option on the hospital's web site. | ||
| Community/Work Reintegration 15 minutes | $32.00 | |||
| Evaluation 20 minutes | $96.00 | |||
| Evaluation 21 - 40 minutes | $106.00 | |||
| Evaluation 41 - 60 minutes | $117.00 | |||
| Group Treatment 1 | $53.00 | |||
| Iontophoresis 15 minutes | $59.00 | |||
| Jobst Pump 1 hour | $52.00 | |||
| Manual Therapy Techniques | $48.00 | |||
| Neuromuscular Reeducation, Movement, Balance | $53.00 | |||
| Occupational Therapy Reevaluation | $75.00 | |||
| Paraffin Bath | $48.00 | |||
| Self-care/Home Management Training 15 minutes | $58.00 | |||
| Sensory Integration Techniques - 15 minutes | $58.00 | |||
| Splint, Finger Dynamic Application | $186.00 | |||
| Splint, Finger Static Application | $186.00 | |||
| Splint, Long Arm Application | $186.00 | |||
| Splint, Short Arm Dynamic Application | $186.00 | |||
| Therapeutic Exercise 1 More Area 15 minutes | $53.00 | |||
| Therapeutic Activities | $43.00 | |||
| Whirlpool/Fluido Therapy | $48.00 | |||
| Charge does not include fees for services of physicians. | ||||