▸ Hospital · OH · CCN 360078

University Hospitals Portage Medical Center

6847 N. CHESTNUT STREET, RAVENNA, OH, 44266-1204

99 bedsAcute Care Hospitals2

Compliance grade

100/100

Rates published

66,902

last crawl 2026-05-24

Procedures tracked

189

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All OH hospitals JSON

Source MRF: https://sthpiprd.blob.core.windows.net/machine-readable-files/7891/461382538-1043641897_university-hospitals-health-system_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	19	—	—	$1,123	$9,635.77	$18,787
Psychiatric diagnostic evaluation	CPT	90791	17	—	—	$148.95	$148.95	$268.11
Psychiatric eval with medical services	CPT	90792	17	—	—	$148.95	$148.95	$268.11
Psychotherapy 30 minutes	CPT	90832	37	$248	$186	$59.52	$151.53	$268.11
Psychotherapy 45 minutes	CPT	90834	37	$342	$256.5	$82.08	$188.1	$307.8
Psychotherapy 60 minutes	CPT	90837	37	$421	$315.75	$101.04	$231.55	$378.9
Crisis psychotherapy 60 minutes	CPT	90839	17	—	—	$148.95	$148.95	$268.11
emergency
ED visit level 1	CPT	99281	37	$400	$300	$81.63	$200	$782
ED visit level 2	CPT	99282	37	$654	$490.5	$146.81	$327	$1,066
ED visit level 3	CPT	99283	37	$1,090	$817.5	$256.69	$545	$1,703
ED visit level 4	CPT	99284	37	$1,711	$1,283.25	$394.75	$855.5	$1,877
ED visit level 5	CPT	99285	37	$5,300	$3,975	$467.28	$2,117.78	$4,770
Critical care, first hour	CPT	99291	37	$3,766	$2,824.5	$781.13	$1,883	$3,389.4
imaging
CT head without contrast	CPT	70450	37	$1,612	$1,209	$98.58	$900	$1,847
CT head with contrast	CPT	70460	37	$1,918	$1,438.5	$165.03	$975	$1,847
CT head with and without contrast	CPT	70470	37	$2,088	$1,566	$165.03	$1,044	$1,879.2
CT neck with contrast	CPT	70491	37	$2,218	$1,663.5	$165.03	$1,109	$1,996.2
MRI brain without contrast	CPT	70551	37	$2,668	$2,001	$224.08	$1,377	$2,461
MRI brain with contrast	CPT	70552	37	$2,837	$2,127.75	$331.07	$1,418.5	$2,553.3
MRI brain with and without contrast	CPT	70553	37	$3,007	$2,255.25	$331.07	$1,503.5	$2,706.3
Chest X-ray single view	CPT	71045	37	$375	$281.25	$40.64	$187.5	$577.88
Chest X-ray 2 views	CPT	71046	37	$469	$351.75	$55.49	$234.5	$577.88
Chest X-ray 3 views	CPT	71047	37	$641	$480.75	$70.36	$320.5	$577.88
CT chest without contrast	CPT	71250	37	$1,948	$1,461	$98.58	$975	$1,847
CT chest with contrast	CPT	71260	37	$2,240	$1,680	$165.03	$1,120	$2,016
CT chest with and without contrast	CPT	71270	37	$2,345	$1,758.75	$165.03	$1,172.5	$2,110.5
MRI chest without contrast	CPT	71550	37	$2,331	$1,748.25	$224.08	$1,305.36	$2,461
MRI chest with contrast	CPT	71551	37	$2,699	$2,024.25	$647.76	$1,377	$2,461
MRI chest with and without contrast	CPT	71552	37	$3,689	$2,766.75	$331.07	$1,844.5	$3,320.1
Lumbosacral spine X-ray	CPT	72100	37	$563	$422.25	$69.53	$281.5	$777.76
CT cervical spine without contrast	CPT	72125	37	$2,011	$1,508.25	$98.58	$1,005.5	$1,847
CT thoracic spine without contrast	CPT	72128	37	$1,877	$1,407.75	$98.58	$975	$1,847
CT lumbar spine without contrast	CPT	72131	37	$2,224	$1,668	$98.58	$1,112	$2,001.6
MRI cervical spine without contrast	CPT	72141	37	$2,813	$2,109.75	$224.08	$1,406.5	$2,531.7
MRI thoracic spine without contrast	CPT	72146	37	$2,905	$2,178.75	$224.08	$1,452.5	$2,614.5
MRI lumbar spine without contrast	CPT	72148	37	$2,905	$2,178.75	$224.08	$1,452.5	$2,614.5
MRI lumbar spine with and without contrast	CPT	72149	37	$3,130	$2,347.5	$331.07	$1,565	$2,817
MRI cervical spine with and without contrast	CPT	72156	37	$3,321	$2,490.75	$331.07	$1,660.5	$2,988.9
MRI lumbar spine with contrast	CPT	72158	37	$3,321	$2,490.75	$331.07	$1,660.5	$2,988.9
CT pelvis without contrast	CPT	72192	37	$1,786	$1,339.5	$98.58	$975	$1,847
CT pelvis with contrast	CPT	72193	37	$2,193	$1,644.75	$165.03	$1,096.5	$1,973.7
Shoulder X-ray	CPT	73030	37	$591	$443.25	$60.45	$295.5	$577.88
Humerus X-ray	CPT	73060	37	$466	$349.5	$57.97	$233	$577.88
Hand X-ray 3 views	CPT	73130	37	$553	$414.75	$67.04	$276.5	$577.88
MRI upper extremity joint without contrast	CPT	73221	37	$2,727	$2,045.25	$224.08	$1,377	$2,461
MRI upper extremity joint with and without contrast	CPT	73223	37	$3,370	$2,527.5	$331.07	$1,685	$3,033
Knee X-ray 1-2 views	CPT	73560	37	$363	$272.25	$62.91	$181.5	$577.88
Ankle X-ray 3 views	CPT	73610	37	$509	$381.75	$67.88	$254.5	$577.88
MRI lower extremity joint without contrast	CPT	73721	37	$3,370	$2,527.5	$224.08	$1,685	$3,033
MRI lower extremity joint with and without contrast	CPT	73723	37	$3,370	$2,527.5	$331.07	$1,685	$3,033
CT abdomen without contrast	CPT	74150	37	$2,208	$1,656	$98.58	$1,104	$1,987.2
CT abdomen with contrast	CPT	74160	37	$2,516	$1,887	$165.03	$1,258	$2,264.4
CT abdomen with and without contrast	CPT	74170	37	$2,627	$1,970.25	$165.03	$1,313.5	$2,364.3
CT abdomen and pelvis without contrast	CPT	74176	37	$3,101	$2,325.75	$224.08	$1,550.5	$2,790.9
CT abdomen and pelvis with contrast	CPT	74177	37	$3,197	$2,397.75	$331.07	$1,598.5	$2,877.3
CT abdomen and pelvis with and without contrast	CPT	74178	37	$3,340	$2,505	$331.07	$1,670	$3,006
MRI abdomen without contrast	CPT	74181	37	$2,930	$2,197.5	$224.08	$1,465	$2,637
MRI abdomen with and without contrast	CPT	74183	37	$3,371	$2,528.25	$331.07	$1,685.5	$3,033.9
Abdominal ultrasound complete	CPT	76700	37	$1,436	$1,077	$98.58	$718	$1,292.4
Abdominal ultrasound limited	CPT	76705	37	$965	$723.75	$98.58	$482.5	$868.5
Retroperitoneal ultrasound complete	CPT	76770	37	$1,247	$935.25	$98.58	$623.5	$1,122.3
Obstetric ultrasound first trimester	CPT	76801	37	$1,028	$771	$98.58	$514	$925.2
Obstetric ultrasound after first trimester	CPT	76805	37	$1,112	$834	$98.58	$556	$1,000.8
Obstetric ultrasound with fetal anatomy	CPT	76811	37	$1,174	$880.5	$204.28	$587	$1,643.87
Transvaginal ultrasound	CPT	76830	37	$1,125	$843.75	$98.58	$562.5	$1,012.5
Pelvic ultrasound complete	CPT	76856	37	$1,179	$884.25	$98.58	$589.5	$1,061.1
Scrotal ultrasound	CPT	76870	37	$943	$707.25	$98.58	$471.5	$848.7
Diagnostic mammography unilateral	CPT	77065	37	$644	$483	$77.58	$322	$622.03
Diagnostic mammography bilateral	CPT	77066	37	$840	$630	$98.8	$420	$792.86
Screening mammography bilateral	CPT	77067	37	$653	$489.75	$81.66	$326.5	$655.29
EKG tracing only	CPT	93005	37	$375	$281.25	$55.07	$187.5	$337.5
Transthoracic echocardiogram complete	CPT	93306	37	$2,726	$2,044.5	$508.3	$1,363	$2,453.4
Transthoracic echocardiogram	CPT	93307	37	$1,639	$1,229.25	$224.08	$819.5	$1,475.1
Stress echocardiogram	CPT	93350	37	$2,499	$1,874.25	$508.3	$1,249.5	$2,249.1
inpatient
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	19	—	—	$13,404	$14,074	$33,106
Intracranial hemorrhage/CVA w CC	MS-DRG	065	19	—	—	$7,082.49	$7,436.61	$16,924
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	19	—	—	$4,945.97	$5,193.27	$11,455
Respiratory infections & inflammations w MCC	MS-DRG	177	19	—	—	$10,981	$11,530	$26,903
COPD w MCC	MS-DRG	190	19	—	—	$7,772.33	$8,160.95	$18,690
COPD w CC	MS-DRG	191	19	—	—	$6,056.49	$6,359.31	$14,298
COPD w/o CC/MCC	MS-DRG	192	19	—	—	$4,678.73	$4,912.67	$10,771
Simple pneumonia & pleurisy w CC	MS-DRG	194	19	—	—	$5,802.26	$6,092.37	$13,647
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	19	—	—	$4,519.45	$4,745.42	$10,364
AMI discharged alive w MCC	MS-DRG	280	19	—	—	$11,143	$11,700	$27,318
AMI discharged alive w CC	MS-DRG	281	19	—	—	$6,464.15	$6,787.36	$15,342
AMI discharged alive w/o CC/MCC	MS-DRG	282	19	—	—	$5,185.23	$5,444.49	$12,068
Heart failure & shock w MCC	MS-DRG	291	19	—	—	$8,954.36	$9,402.08	$21,716
Heart failure & shock w CC	MS-DRG	292	19	—	—	$6,070.13	$6,373.64	$14,333
Heart failure & shock w/o CC/MCC	MS-DRG	293	19	—	—	$4,038.31	$4,240.23	$9,132.01
Cardiac arrhythmia w MCC	MS-DRG	308	19	—	—	$8,311.34	$8,726.91	$20,070
Cardiac arrhythmia w CC	MS-DRG	309	19	—	—	$5,277.55	$5,541.43	$12,304
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	19	—	—	$4,108.51	$4,313.94	$9,311.76
GI hemorrhage w CC	MS-DRG	378	19	—	—	$6,880.93	$7,224.98	$16,408
GI hemorrhage w/o CC/MCC	MS-DRG	379	19	—	—	$4,610.47	$4,840.99	$10,597
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	19	—	—	$5,544.12	$5,821.33	$12,987
Fractures of femur w/o MCC	MS-DRG	533	19	—	—	$10,385	$10,905	$25,379
Kidney/UTI w MCC	MS-DRG	689	19	—	—	$8,079.87	$8,483.86	$19,477
Kidney/UTI w/o MCC	MS-DRG	690	19	—	—	$5,689.12	$5,973.58	$13,358
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	19	—	—	$13,228	$13,889	$32,655
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	19	—	—	$7,174.15	$7,532.86	$17,159
lab
Basic metabolic panel (BMP)	CPT	80048	37	$158	$118.5	$8.46	$79	$142.2
General health panel	CPT	80050	1	—	—	$89.45	$94.42	$99.39
Electrolyte panel	CPT	80051	37	$154	$115.5	$7.01	$77	$138.6
Comprehensive metabolic panel	CPT	80053	37	$254	$190.5	$10.56	$127	$228.6
Lipid panel	CPT	80061	37	$184	$138	$13.39	$50.74	$165.6
Renal function panel	CPT	80069	37	$241	$180.75	$8.68	$120.5	$216.9
Hepatic function panel	CPT	80076	37	$182	$136.5	$8.17	$91	$163.8
Urinalysis non-automated	CPT	81002	37	$44	$33	$3.48	$22	$39.6
Urinalysis automated	CPT	81003	37	$83	$62.25	$2.25	$41.5	$74.7
Glucose quantitative	CPT	82947	37	$58	$43.5	$3.93	$29	$52.2
Hemoglobin A1c	CPT	83036	37	$147	$110.25	$9.71	$73.5	$132.3
Thyroid stimulating hormone (TSH)	CPT	84443	37	$175	$131.25	$16.8	$87.5	$157.5
Complete blood count with automated differential	CPT	85025	37	$134	$100.5	$7.77	$67	$120.6
Complete blood count without differential	CPT	85027	37	$116	$87	$6.47	$58	$104.4
Urine culture bacterial	CPT	87086	37	$162	$121.5	$8.07	$81	$145.8
Urine culture identification	CPT	87088	17	—	—	$8.09	$8.09	$19.41
Tissue exam by pathologist level IV	CPT	88305	37	$424	$318	$44.17	$218.67	$381.6
maternity
Fetal non-stress test	CPT	59025	17	—	—	$186.49	$186.49	$1,485.22
Routine obstetric care including vaginal delivery	CPT	59400	1	—	—	$2,191.1	$2,191.1	$2,191.1
Vaginal delivery only	CPT	59409	17	—	—	$2,191.1	$2,947.55	$5,305.59
Vaginal delivery with postpartum	CPT	59410	2	—	—	$2,191.1	$2,292.78	$2,547.19
Routine obstetric care with C-section	CPT	59510	1	—	—	$2,191.1	$2,191.1	$2,191.1
C-section delivery only	CPT	59514	2	—	—	$2,191.1	$3,264.22	$4,337.33
C-section with postpartum	CPT	59515	2	—	—	$2,191.1	$5,205.62	$5,784.48
office
Office visit, established patient, 5 min	CPT	99211	37	$140	$105	$30.24	$93.87	$215.04
Office visit, established patient, 10-19 min	CPT	99212	37	$146	$109.5	$31	$116.8	$215.04
Office visit, established patient, 20-29 minutes	CPT	99213	37	$162	$121.5	$31	$119.47	$215.04
Office visit, established patient, 30-39 minutes	CPT	99214	37	$189	$141.75	$31	$119.47	$215.04
Office visit, established patient, 40-54 min	CPT	99215	37	$216	$162	$31	$120.96	$215.04
preventive
Upper GI endoscopy diagnostic	CPT	43235	37	$3,224	$2,418	$773.76	$1,612	$2,901.6
Upper GI endoscopy with biopsy	CPT	43239	37	$3,160	$2,370	$758.4	$1,580	$3,601.91
Sigmoidoscopy diagnostic	CPT	45330	37	$2,261	$1,695.75	$542.64	$1,266.16	$2,547.19
Sigmoidoscopy with biopsy	CPT	45331	37	$2,490	$1,867.5	$597.6	$1,369.9	$2,547.19
Colonoscopy diagnostic	CPT	45378	37	$3,337	$2,502.75	$800.88	$1,668.5	$3,601.91
Colonoscopy with biopsy	CPT	45380	37	$3,254	$2,440.5	$780.96	$1,789.7	$3,601.91
Colonoscopy with polyp removal	CPT	45385	37	$3,170	$2,377.5	$760.8	$1,757.18	$3,601.91
surgery
Total shoulder arthroplasty	CPT	23472	17	—	—	$4,159.66	$17,048	$30,687
Hip hemiarthroplasty	CPT	27125	4	—	—	$2,970.45	$4,636.08	$6,599.21
Total hip replacement	CPT	27130	17	—	—	$4,159.66	$11,928	$21,471
Total knee replacement	CPT	27447	17	—	—	$2,673.4	$11,928	$29,370
Knee revision arthroplasty single component	CPT	27486	4	—	—	$2,673.4	$5,496.05	$6,599.21
Knee revision arthroplasty all components	CPT	27487	4	—	—	$2,673.4	$5,496.05	$6,599.21
Shoulder arthroscopy with decompression	CPT	29826	4	—	—	$845.62	$2,004.38	$4,084.98
Shoulder arthroscopy with rotator cuff repair	CPT	29827	17	—	—	$2,629.59	$6,622.52	$11,921
Knee arthroscopy with meniscectomy	CPT	29881	17	—	—	$2,388.57	$3,007.88	$5,414.19
ACL reconstruction	CPT	29888	17	—	—	$2,004.38	$6,622.52	$11,921
Major small/large bowel procedures w MCC	MS-DRG	329	19	—	—	$30,327	$31,843	$76,423
Major small/large bowel procedures w CC	MS-DRG	330	19	—	—	$15,839	$16,631	$39,339
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	19	—	—	$11,205	$11,766	$27,478
CABG single arterial graft	CPT	33533	2	—	—	$2,898.7	$3,618.02	$4,337.33
CABG 2 arterial grafts	CPT	33534	2	—	—	$2,898.7	$3,618.02	$4,337.33
CABG 3 arterial grafts	CPT	33535	2	—	—	$2,898.7	$3,618.02	$4,337.33
CABG 4+ arterial grafts	CPT	33536	2	—	—	$2,898.7	$3,618.02	$4,337.33
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	19	—	—	$11,253	$11,816	$27,601
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	19	—	—	$9,037.58	$9,489.46	$21,929
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	19	—	—	$23,419	$24,590	$58,741
Open appendectomy	CPT	44950	17	—	—	$2,191.1	$5,784.5	$10,412
Laparoscopic appendectomy	CPT	44970	17	—	—	$2,388.57	$5,408.69	$10,621
Major joint replacement w MCC	MS-DRG	469	19	—	—	$21,723	$22,810	$54,401
Major joint replacement w/o MCC	MS-DRG	470	19	—	—	$12,730	$13,367	$31,380
Laparoscopic cholecystectomy	CPT	47562	17	—	—	$4,337.33	$5,408.69	$9,735.63
Lap cholecystectomy with cholangiography	CPT	47563	17	—	—	$4,337.33	$5,408.69	$9,735.63
Hip & femur procedures except major joint w MCC	MS-DRG	480	19	—	—	$19,593	$20,572	$48,947
Hip & femur procedures except major joint w CC	MS-DRG	481	19	—	—	$13,961	$14,660	$34,533
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	19	—	—	$10,785	$11,325	$26,402
Open umbilical hernia repair	CPT	49560	2	—	—	$2,388.57	$2,530.99	$2,673.4
Umbilical hernia repair age 5+	CPT	49585	2	—	—	$2,388.57	$2,530.99	$2,673.4
Lap inguinal hernia repair	CPT	49650	17	—	—	$2,388.57	$5,408.69	$9,735.63
Lap incisional hernia repair	CPT	49652	2	—	—	$4,010.62	$4,720.39	$5,430.16
Total abdominal hysterectomy	CPT	58150	4	—	—	$3,476.8	$4,337.33	$8,037.09
Vaginal hysterectomy	CPT	58260	17	—	—	$3,476.8	$4,576.29	$8,237.32
Lap-assisted vaginal hysterectomy	CPT	58550	17	—	—	$4,010.62	$5,408.69	$9,735.63
Lap-assisted vaginal hysterectomy >250g	CPT	58552	17	—	—	$2,629.59	$9,651.62	$17,373
Lap salpingo-oophorectomy	CPT	58661	17	—	—	$2,629.59	$5,408.69	$9,735.63
OR procedure for obesity w MCC	MS-DRG	619	19	—	—	$18,198	$19,108	$45,377
OR procedure for obesity w CC	MS-DRG	620	19	—	—	$10,854	$11,397	$26,579
OR procedure for obesity w/o CC/MCC	MS-DRG	621	19	—	—	$9,975.17	$10,474	$24,329
Complex cataract surgery	CPT	66982	17	—	—	$2,114.33	$2,114.33	$7,715.73
Cataract surgery with lens implant	CPT	66984	17	—	—	$2,114.33	$2,114.33	$7,715.73
Intravitreal injection	CPT	67028	17	—	—	$307.49	$307.49	$2,547.19
Vitrectomy mechanical	CPT	67042	17	—	—	$2,673.4	$3,729.35	$6,712.83
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	19	—	—	$8,264.52	$8,677.75	$19,950
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	19	—	—	$13,175	$13,834	$32,520
PCI single major coronary artery	CPT	92920	37	$12,068	$9,051	$2,896.32	$6,697.74	$16,525
PCI with drug-eluting stent	CPT	92928	37	$15,429	$11,572	$3,702.96	$10,513	$18,924
PCI bypass graft	CPT	92937	37	$39,092	$29,319	$4,636.08	$19,546	$35,183
Left heart catheterization	CPT	93452	37	$15,603	$11,702	$2,981.74	$7,801.5	$16,525
Coronary angiography with cath	CPT	93455	37	$17,249	$12,937	$2,981.74	$8,624.5	$16,525
Coronary angiography with bypass cath	CPT	93458	37	$21,371	$16,028	$2,981.74	$10,686	$19,234

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 30)

Payer	Codes covered	Median rate
Anthem BCBS	184	$1,469.44
Cigna	184	$1,093.05
UnitedHealthcare	180	$1,847
Aetna	179	$1,848.34
WellCare	171	$331.07
Ambetter	171	$595.93
CareSource	171	$595.93
devoted health	171	$331.07
Humana	171	$331.07
medical mutual of ohio	171	$872.7
Molina	171	$331.07
paramount	171	$341.01
perennial advantage of ohio	171	$347.63
primetime health plan	171	$331.07
summacare	171	$331.07
the health plan	171	$1,285.68
valor health plans	171	$347.63
aultcare	146	$1,377
jp farley	146	$1,595
immergrun	103	$893
amish aid community plan	103	$821.56
medical mutual traditional/health ohio	103	$1,250.2
private healthcare system	103	$1,535.96
Multiplan	103	$1,607.4
ohio health choice	103	$1,279.3
beech street	103	$1,518
buckeye plain ministries	103	$821.56
ohio preferred network	103	$1,518
century health network	103	$1,518.1
christian healthcare ministries	103	$900

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