▸ Hospital · OH · CCN 360002
University Hospitals Samaritan Medical Center
1025 CENTER STREET, ASHLAND, OH, 44805-4098
28 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
158
of 209 target codes
Payers
30
with negotiated rates
Rates published
66,046
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 17 | — | — | $936 | $10,989 | $19,780 |
| Psychotherapy 30 minutes | CPT | 90832 | 38 | $264 | $198 | $93.46 | $224.4 | $261.62 |
| Psychotherapy 45 minutes | CPT | 90834 | 38 | $341 | $255.75 | $120.71 | $286.44 | $337.93 |
| Psychotherapy 60 minutes | CPT | 90837 | 38 | $421 | $315.75 | $137.87 | $353.64 | $417.21 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 38 | $162 | $121.5 | $57.35 | $137.7 | $364 |
| ED visit level 2 | CPT | 99282 | 38 | $278 | $208.5 | $98.41 | $237.41 | $494 |
| ED visit level 3 | CPT | 99283 | 38 | $464 | $348 | $164.26 | $396.26 | $832 |
| ED visit level 4 | CPT | 99284 | 38 | $727 | $545.25 | $257.36 | $620.86 | $1,248 |
| ED visit level 5 | CPT | 99285 | 38 | $1,141 | $855.75 | $403.91 | $974.42 | $1,560 |
| Critical care, first hour | CPT | 99291 | 38 | $1,598 | $1,198.5 | $565.69 | $1,358.3 | $1,583.62 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 38 | $1,996 | $1,497 | $95.07 | $1,676.64 | $1,978.04 |
| CT head with contrast | CPT | 70460 | 38 | $2,351 | $1,763.25 | $158.88 | $1,974.84 | $2,329.84 |
| CT head with and without contrast | CPT | 70470 | 38 | $2,206 | $1,654.5 | $158.88 | $1,853.04 | $2,186.15 |
| CT neck with contrast | CPT | 70491 | 38 | $2,504 | $1,878 | $158.88 | $2,103.36 | $2,481.46 |
| MRI brain without contrast | CPT | 70551 | 38 | $3,438 | $2,578.5 | $211.9 | $2,887.92 | $3,407.06 |
| MRI brain with contrast | CPT | 70552 | 38 | $3,660 | $2,745 | $332.56 | $3,074.4 | $3,627.06 |
| MRI brain with and without contrast | CPT | 70553 | 38 | $3,743 | $2,807.25 | $332.56 | $3,144.12 | $3,709.31 |
| Chest X-ray single view | CPT | 71045 | 38 | $315 | $236.25 | $78.58 | $264.6 | $312.17 |
| Chest X-ray 2 views | CPT | 71046 | 38 | $396 | $297 | $78.58 | $332.64 | $392.44 |
| Chest X-ray 3 views | CPT | 71047 | 38 | $445 | $333.75 | $78.58 | $373.8 | $441 |
| CT chest without contrast | CPT | 71250 | 38 | $1,996 | $1,497 | $95.07 | $1,676.64 | $1,978.04 |
| CT chest with contrast | CPT | 71260 | 38 | $2,218 | $1,663.5 | $158.88 | $1,863.12 | $2,198.04 |
| CT chest with and without contrast | CPT | 71270 | 38 | $2,874 | $2,155.5 | $158.88 | $2,414.16 | $2,848.13 |
| MRI chest without contrast | CPT | 71550 | 38 | $3,128 | $2,346 | $211.9 | $2,627.52 | $3,099.85 |
| MRI chest with contrast | CPT | 71551 | 38 | $3,308 | $2,481 | $692.39 | $2,778.72 | $3,278.23 |
| MRI chest with and without contrast | CPT | 71552 | 38 | $3,743 | $2,807.25 | $332.56 | $3,144.12 | $3,709.31 |
| Lumbosacral spine X-ray | CPT | 72100 | 38 | $376 | $282 | $95.07 | $315.84 | $372.62 |
| CT cervical spine without contrast | CPT | 72125 | 38 | $1,725 | $1,293.75 | $95.07 | $1,449 | $1,709.48 |
| CT thoracic spine without contrast | CPT | 72128 | 38 | $1,211 | $908.25 | $95.07 | $1,017.24 | $1,200.1 |
| CT lumbar spine without contrast | CPT | 72131 | 38 | $2,304 | $1,728 | $95.07 | $1,935.36 | $2,283.26 |
| MRI cervical spine without contrast | CPT | 72141 | 38 | $3,660 | $2,745 | $211.9 | $3,074.4 | $3,627.06 |
| MRI thoracic spine without contrast | CPT | 72146 | 38 | $3,651 | $2,738.25 | $211.9 | $3,066.84 | $3,618.14 |
| MRI lumbar spine without contrast | CPT | 72148 | 38 | $3,660 | $2,745 | $211.9 | $3,074.4 | $3,627.06 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 38 | $3,838 | $2,878.5 | $332.56 | $3,223.92 | $3,803.46 |
| MRI cervical spine with and without contrast | CPT | 72156 | 38 | $3,743 | $2,807.25 | $332.56 | $3,144.12 | $3,709.31 |
| MRI lumbar spine with contrast | CPT | 72158 | 38 | $3,743 | $2,807.25 | $332.56 | $3,144.12 | $3,709.31 |
| CT pelvis without contrast | CPT | 72192 | 38 | $1,930 | $1,447.5 | $95.07 | $1,621.2 | $1,912.63 |
| CT pelvis with contrast | CPT | 72193 | 38 | $2,055 | $1,541.25 | $158.88 | $1,726.2 | $2,036.51 |
| Shoulder X-ray | CPT | 73030 | 38 | $354 | $265.5 | $78.58 | $297.36 | $350.81 |
| Humerus X-ray | CPT | 73060 | 38 | $303 | $227.25 | $78.58 | $254.52 | $300.27 |
| Hand X-ray 3 views | CPT | 73130 | 38 | $303 | $227.25 | $78.58 | $254.52 | $300.27 |
| MRI upper extremity joint without contrast | CPT | 73221 | 38 | $3,660 | $2,745 | $211.9 | $3,074.4 | $3,627.06 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 38 | $3,660 | $2,745 | $332.56 | $3,074.4 | $3,627.06 |
| Knee X-ray 1-2 views | CPT | 73560 | 38 | $237 | $177.75 | $78.58 | $199.08 | $234.87 |
| Ankle X-ray 3 views | CPT | 73610 | 38 | $303 | $227.25 | $78.58 | $254.52 | $300.27 |
| MRI lower extremity joint without contrast | CPT | 73721 | 38 | $3,660 | $2,745 | $211.9 | $3,074.4 | $3,627.06 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 38 | $3,660 | $2,745 | $332.56 | $3,074.4 | $3,627.06 |
| CT abdomen without contrast | CPT | 74150 | 38 | $1,891 | $1,418.25 | $95.07 | $1,588.44 | $1,873.98 |
| CT abdomen with contrast | CPT | 74160 | 38 | $2,186 | $1,639.5 | $158.88 | $1,836.24 | $2,166.33 |
| CT abdomen with and without contrast | CPT | 74170 | 38 | $2,625 | $1,968.75 | $158.88 | $2,205 | $2,601.38 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 38 | $3,674 | $2,755.5 | $211.9 | $3,086.16 | $3,640.93 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 38 | $4,078 | $3,058.5 | $332.56 | $3,425.52 | $4,041.3 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 38 | $4,629 | $3,471.75 | $332.56 | $3,888.36 | $4,587.34 |
| MRI abdomen without contrast | CPT | 74181 | 38 | $3,128 | $2,346 | $211.9 | $2,627.52 | $3,099.85 |
| MRI abdomen with and without contrast | CPT | 74183 | 38 | $3,660 | $2,745 | $332.56 | $3,074.4 | $3,627.06 |
| Abdominal ultrasound complete | CPT | 76700 | 38 | $1,280 | $960 | $95.07 | $1,075.2 | $1,268.48 |
| Abdominal ultrasound limited | CPT | 76705 | 38 | $943 | $707.25 | $95.07 | $792.12 | $934.51 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 38 | $1,034 | $775.5 | $95.07 | $868.56 | $1,024.69 |
| Obstetric ultrasound first trimester | CPT | 76801 | 38 | $783 | $587.25 | $95.07 | $657.72 | $775.95 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 38 | $902 | $676.5 | $95.07 | $757.68 | $893.88 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 38 | $1,244 | $933 | $161.25 | $1,044.96 | $1,232.8 |
| Transvaginal ultrasound | CPT | 76830 | 38 | $903 | $677.25 | $95.07 | $758.52 | $894.87 |
| Pelvic ultrasound complete | CPT | 76856 | 38 | $944 | $708 | $95.07 | $792.96 | $935.5 |
| Scrotal ultrasound | CPT | 76870 | 38 | $944 | $708 | $95.07 | $792.96 | $935.5 |
| Diagnostic mammography unilateral | CPT | 77065 | 38 | $537 | $402.75 | $79.49 | $451.08 | $532.17 |
| Diagnostic mammography bilateral | CPT | 77066 | 38 | $672 | $504 | $101.97 | $564.48 | $665.95 |
| Screening mammography bilateral | CPT | 77067 | 38 | $569 | $426.75 | $84.04 | $477.96 | $563.88 |
| EKG tracing only | CPT | 93005 | 38 | $214 | $160.5 | $52.89 | $179.76 | $212.07 |
| Transthoracic echocardiogram complete | CPT | 93306 | 38 | $2,168 | $1,626 | $477.06 | $1,821.12 | $2,148.49 |
| Transthoracic echocardiogram | CPT | 93307 | 38 | $1,459 | $1,094.25 | $211.9 | $1,225.56 | $1,445.87 |
| Stress echocardiogram | CPT | 93350 | 38 | $1,756 | $1,317 | $477.06 | $1,475.04 | $1,740.2 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 17 | — | — | $15,443 | $15,443 | $27,798 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 17 | — | — | $7,971.21 | $7,971.21 | $14,348 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 17 | — | — | $5,445.91 | $5,445.91 | $9,802.64 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 17 | — | — | $12,579 | $12,579 | $22,642 |
| COPD w MCC | MS-DRG | 190 | 17 | — | — | $8,786.59 | $8,786.59 | $15,816 |
| COPD w CC | MS-DRG | 191 | 17 | — | — | $6,758.51 | $6,758.51 | $12,165 |
| COPD w/o CC/MCC | MS-DRG | 192 | 17 | — | — | $5,130.06 | $5,130.06 | $9,234.11 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 17 | — | — | $6,458.02 | $6,458.02 | $11,624 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 17 | — | — | $4,941.76 | $4,941.76 | $8,895.17 |
| AMI discharged alive w MCC | MS-DRG | 280 | 17 | — | — | $12,770 | $12,770 | $22,987 |
| AMI discharged alive w CC | MS-DRG | 281 | 17 | — | — | $7,240.36 | $7,240.36 | $13,033 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 17 | — | — | $5,728.71 | $5,728.71 | $10,312 |
| Heart failure & shock w MCC | MS-DRG | 291 | 17 | — | — | $10,184 | $10,184 | $18,331 |
| Heart failure & shock w CC | MS-DRG | 292 | 17 | — | — | $6,774.65 | $6,774.65 | $12,194 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 17 | — | — | $4,373.07 | $4,373.07 | $7,871.53 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 17 | — | — | $9,423.68 | $9,423.68 | $16,963 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 17 | — | — | $5,837.84 | $5,837.84 | $10,508 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 17 | — | — | $4,456.08 | $4,456.08 | $8,020.94 |
| GI hemorrhage w CC | MS-DRG | 378 | 17 | — | — | $7,732.97 | $7,732.97 | $13,919 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 17 | — | — | $5,049.34 | $5,049.34 | $9,088.81 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 17 | — | — | $6,152.92 | $6,152.92 | $11,075 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 17 | — | — | $11,875 | $11,875 | $21,375 |
| Kidney/UTI w MCC | MS-DRG | 689 | 17 | — | — | $9,150.08 | $9,150.08 | $16,470 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 17 | — | — | $6,324.29 | $6,324.29 | $11,384 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 17 | — | — | $15,235 | $15,235 | $27,423 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 17 | — | — | $8,079.56 | $8,079.56 | $14,543 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 38 | $80 | $60 | $8.46 | $67.2 | $79.28 |
| Electrolyte panel | CPT | 80051 | 38 | $79 | $59.25 | $7.01 | $66.36 | $78.29 |
| Comprehensive metabolic panel | CPT | 80053 | 38 | $116 | $87 | $10.56 | $97.44 | $114.96 |
| Lipid panel | CPT | 80061 | 38 | $140 | $105 | $13.39 | $53.49 | $138.74 |
| Renal function panel | CPT | 80069 | 38 | $173 | $129.75 | $8.68 | $145.32 | $171.44 |
| Hepatic function panel | CPT | 80076 | 38 | $71 | $53.25 | $8.17 | $59.64 | $70.36 |
| Urinalysis non-automated | CPT | 81002 | 38 | $23 | $17.25 | $3.48 | $19.32 | $22.79 |
| Urinalysis automated | CPT | 81003 | 38 | $63 | $47.25 | $2.25 | $52.92 | $62.43 |
| Glucose quantitative | CPT | 82947 | 38 | $58 | $43.5 | $3.93 | $43.2 | $57.48 |
| Hemoglobin A1c | CPT | 83036 | 38 | $114 | $85.5 | $9.71 | $95.76 | $112.97 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 38 | $199 | $149.25 | $16.8 | $167.16 | $197.21 |
| Complete blood count with automated differential | CPT | 85025 | 38 | $86 | $64.5 | $7.77 | $72.24 | $85.23 |
| Complete blood count without differential | CPT | 85027 | 38 | $86 | $64.5 | $6.47 | $72.24 | $85.23 |
| Urine culture bacterial | CPT | 87086 | 38 | $84 | $63 | $8.07 | $70.56 | $83.24 |
| Tissue exam by pathologist level IV | CPT | 88305 | 38 | $237 | $177.75 | $28.67 | $74.68 | $234.87 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 38 | $522 | $391.5 | $172.32 | $438.48 | $517.3 |
| office | ||||||||
| Office visit, established patient, 5 min | CPT | 99211 | 37 | $144 | $108 | $42.83 | $110.11 | $205.76 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 37 | $216 | $162 | $76.46 | $183.6 | $214.06 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 37 | $270 | $202.5 | $95.58 | $229.5 | $267.57 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 37 | $300 | $225 | $105.14 | $255 | $297.3 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 37 | $317 | $237.75 | $112.22 | $269.45 | $314.15 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 38 | $2,382 | $1,786.5 | $783.89 | $2,000.88 | $2,360.56 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 38 | $2,664 | $1,998 | $783.89 | $2,237.76 | $2,640.02 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 38 | $1,713 | $1,284.75 | $606.4 | $1,439.34 | $1,697.58 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 38 | $1,622 | $1,216.5 | $574.19 | $1,382.35 | $1,607.4 |
| Colonoscopy diagnostic | CPT | 45378 | 38 | $2,602 | $1,951.5 | $790.35 | $2,185.68 | $2,578.58 |
| Colonoscopy with biopsy | CPT | 45380 | 38 | $2,309 | $1,731.75 | $817.39 | $1,939.56 | $2,288.22 |
| Colonoscopy with polyp removal | CPT | 45385 | 38 | $2,404 | $1,803 | $851.02 | $2,019.36 | $2,382.36 |
| surgery | ||||||||
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $2,359 | $2,359 | $2,359 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 1 | — | — | $3,960 | $3,960 | $3,960 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 1 | — | — | $2,590 | $2,590 | $2,590 |
| ACL reconstruction | CPT | 29888 | 1 | — | — | $2,359 | $2,359 | $2,359 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 17 | — | — | $35,445 | $35,445 | $63,801 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 17 | — | — | $18,321 | $18,321 | $32,979 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 17 | — | — | $12,844 | $12,844 | $23,120 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 17 | — | — | $12,901 | $12,901 | $23,222 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 17 | — | — | $10,282 | $10,282 | $18,508 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 17 | — | — | $27,281 | $27,281 | $49,105 |
| Major joint replacement w MCC | MS-DRG | 469 | 17 | — | — | $25,276 | $25,276 | $45,497 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 17 | — | — | $14,646 | $14,646 | $26,364 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 17 | — | — | $22,758 | $22,758 | $40,964 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 17 | — | — | $16,102 | $16,102 | $28,984 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 17 | — | — | $12,348 | $12,348 | $22,226 |
| Open umbilical hernia repair | CPT | 49560 | 1 | — | — | $2,590 | $2,590 | $2,590 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 1 | — | — | $2,590 | $2,590 | $2,590 |
| Lap inguinal hernia repair | CPT | 49650 | 1 | — | — | $2,590 | $2,590 | $2,590 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 1 | — | — | $6,525 | $6,525 | $6,525 |
| Lap salpingo-oophorectomy | CPT | 58661 | 1 | — | — | $3,960 | $3,960 | $3,960 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 17 | — | — | $21,110 | $21,110 | $37,997 |
| OR procedure for obesity w CC | MS-DRG | 620 | 17 | — | — | $12,429 | $12,429 | $22,373 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 17 | — | — | $11,390 | $11,390 | $20,503 |
| Complex cataract surgery | CPT | 66982 | 1 | — | — | $4,725 | $4,725 | $4,725 |
| Cataract surgery with lens implant | CPT | 66984 | 1 | — | — | $4,725 | $4,725 | $4,725 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 17 | — | — | $9,368.34 | $9,368.34 | $16,863 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 17 | — | — | $15,173 | $15,173 | $27,311 |
| PCI single major coronary artery | CPT | 92920 | 38 | $9,715 | $7,286.25 | $3,439.11 | $8,335.47 | $14,352 |
| PCI with drug-eluting stent | CPT | 92928 | 38 | $12,420 | $9,315 | $4,396.68 | $10,607 | $17,124 |
| PCI bypass graft | CPT | 92937 | 38 | $27,363 | $20,522 | $9,513.29 | $22,985 | $27,117 |
| Left heart catheterization | CPT | 93452 | 38 | $10,921 | $8,190.75 | $2,817.85 | $9,326.54 | $14,352 |
| Coronary angiography with cath | CPT | 93455 | 38 | $10,264 | $7,698 | $2,817.85 | $8,765.46 | $14,352 |
| Coronary angiography with bypass cath | CPT | 93458 | 38 | $10,278 | $7,708.5 | $2,817.85 | $8,777.41 | $14,352 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| university health employee plan (contigo) | 153 | $728 |
| Ambetter | 147 | $444.12 |
| Aetna | 147 | $770.64 |
| Anthem BCBS | 147 | $790.35 |
| CareSource | 147 | $444.12 |
| Cigna | 147 | $692.39 |
| devoted health | 147 | $246.73 |
| Humana | 147 | $246.73 |
| Molina | 147 | $246.73 |
| paramount | 147 | $254.13 |
| perennial advantage of ohio | 147 | $259.07 |
| primetime health plan | 147 | $246.73 |
| summacare | 147 | $712.53 |
| the health plan | 147 | $689.04 |
| UnitedHealthcare | 147 | $832.57 |
| valor health plans | 147 | $259.07 |
| WellCare | 147 | $246.73 |
| healthsmart | 104 | $1,089.9 |
| amish aid community plan | 104 | $524.86 |
| immergrun | 104 | $605.5 |
| jp farley | 104 | $1,089.9 |
| medical mutual of ohio | 104 | $857.18 |
| medical mutual traditional/health ohio | 104 | $847.7 |
| sunrise plain communities | 104 | $605.5 |
| amish church fund and workers aid plan | 104 | $524.86 |
| Multiplan | 104 | $1,089.9 |
| aultcare | 104 | $1,089.9 |
| beech street | 104 | $1,009.6 |
| buckeye plain ministries | 104 | $524.86 |
| ohio health choice | 104 | $1,043.38 |