In compliance with state law, UH Conneaut Medical Center is providing this price list containing our charges for room and board, emergency department, operating room, delivery, physical therapy and other procedures. The hospital's charges are the same for all patients, but a patient's responsibility may vary, depending on payment plans negotiated with individual health insurers. Uninsured or underinsured patients should consult with our admitting and billing staff to determine whether they qualify for discounts. These prices are correct as of January 1, 2012.
Room and Board – Per Day Charges
| |
|
Charge |
| Adult Intensive care |
|
| |
Neuro/Cardio/Medical/Surgical |
1,755.00
|
| |
Telemetry/ICU Stepdown |
1,285.00
|
| Routine Care |
|
| |
Semi-Private |
945.00
|
| Critical Access Swing Bed |
|
520.00
|
Labor and Delivery Charges
| This Service is not provided at UH Conneaut Medical
Center |
Emergency Department Charges
Emergency Department charges are based on the level of emergency care provided to our patients. The levels, with level 1 representing basic emergency care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. They also do not include fees for Emergency Department physicians, who will bill separately for their services.
| |
|
Charges |
| Level 1 |
|
202.00
|
| Level 2 |
|
397.00 |
| Level 3 |
|
786.00 |
| Level 4 |
|
1,178.00 |
| Level 5 |
|
1,570.00 |
| Critical Care |
|
1,961.00 |
Operating Room Charges
Operating Room charges are based on the complexity level, with level 1 being the most complex for a particular operation. There is an initial, set-up charge as well as an additional charge for each minute. The following list does not include charges for anesthesia, drugs, or supplies required for the operating room procedure. Fees for professional services of the surgeon and anesthesiologist will be billed by the physician.
| |
Set-Up Charge |
Per Minute Charge |
| Level 1 |
2,440.00
|
31.00
|
| Level 2 |
2,091.00
|
29.00
|
| Level 3 |
960.00
0 |
17.00
|
Physical Therapy Charges
The following charges reflect the most common services offered by our Physical Therapy department. Patients may have additional charges, depending on the services performed.
| |
|
Charge |
| Electrical Stimulation Unattended |
|
65.00
|
| Gait Training Therapy ea 15min |
|
97.00
|
| Manual Therapy ea 15min |
|
109.00
|
| Neuromuscular Re-education each 15 min |
|
105.00
|
| PT Evaluation |
|
248.00
|
| Self Care Home mgmt Training |
|
105.00
|
| Therapeutic Activities ea 15min |
|
110.00
|
| Therapeutic Exercise ea 15min |
|
110.00
|
Occupational Therapy Charges
This Service is not provided at UH Conneaut Medical
Center
Pulmonary Therapy Charges
The following charges reflect the most common services offered by our Pulmonary Therapy department. Patients may have additional charges, depending on the services performed.
| |
|
Charge |
| ABG any combo pH/pCO2/pO2/CO2/HCO3
|
|
288.00
|
| Aerosol Inhalation Treatment
|
|
106.00
|
| Aerosol with Device Education
|
|
122.00
|
| Airway Clearance Subsequent
|
|
160.00
|
| BIPAP
|
|
697.00
|
| Diffusing Capacity
|
|
266.00
|
| Lung Volume |
|
293.00
|
| Pre//Post Spirometry
|
|
491.00
|
| Pulse Ox Single Determination |
|
108.00
|
| Shunt Study |
|
58.00
|
| Spirometry /Vital Capacity |
|
160.00
|
| Ventilation Assist Initial Day IP/OBSV |
|
858.00
|
| Ventilat'n Assist ea Subsqnt Day IP/Obsv
|
|
552.00
|
Cardiology Charges
The following charges reflect the most common services offered by our Cardiology department. Patients may have additional charges, depending on the services performed.
| |
|
Charge |
| Cardiac Stress Test |
|
1,145.00
|
| Echo Real Time Complete w/Spectral |
|
2,990.00
|
| EKG 12 Lead Tracing |
|
240.00
|
X-Ray and Radiological Charges
The following charges reflect the hospital's most common x-ray and radiological procedures.
| |
|
Charge |
| Abdomen Complete Decub and or erect |
|
210.00
|
| Abdomen Single Anteroposterior |
|
193.00
|
| Ankle Complete Min 3 Views |
|
310.00
|
| CAD w/phys revw/interp scr mamm |
|
51.00
|
| Chest 2 Views Frontal/Lateral |
|
358.00
|
| CT Head wo contrast
|
|
1,879.00
|
| CT Abdomen and Pelvis with contrast material
|
|
4,902.00
|
| Dexa 1 or More Sites Axial Skeleton
|
|
539.00
|
| Digital Mammography Screening
|
|
255.00
|
| Duplex Scan Extracranial Arteries Complete Bilat
|
|
1,366.00
|
| Duplex Scan Veins Extrem Complete Bilat Study
|
|
819.00
|
| Duplex Scan Veins Extrem Unilat Limited Study
|
|
1,058.00
|
| Fluoroscopic Guide Thx Inj Procedure
|
|
697.00
|
| Foot Complete Min 3 Vews
|
|
330.00
|
| Hand Min 3 Views
|
|
270.00
|
| Hip Unilateral Complete Min 2 Views
|
|
254.00
|
| Knee 1 Or 2 Views
|
|
285.00
|
| Knee 3 Views
|
|
317.00
|
| Knee Complete 4 Or More Views
|
|
344.00
|
| Pelvis 1 Or 2 Views
|
|
212.00
|
| Shoulder Cmplt Min 2 Views
|
|
375.00
|
| Spine Cervical Min 4 Views
|
|
497.00
|
| Spine Lumbosacral 2 Or 3 Views
|
|
447.00
|
| Spine Lumbosacral Min 4 Views
|
|
621.00
|
| U S Abdominal Limited
|
|
719.00
|
| U S Pelvic Non-ob Complete
|
|
656.00
|
| US Transvaginal
|
|
959.00
|
| Wrist Complete Min 3 Views
|
|
358.00
|
Laboratory Charges
The following charges reflect the hospital's 30 most common laboratory procedures.
| |
|
Charge |
| Amyylase |
|
88.00
|
| APTT |
|
89.00
|
| Basic Metabolic Panel |
|
110.00
|
| Celiac Genetics DNA Probe Ea |
|
21.00
|
| CK CPK Total |
|
88.00
|
| CK-MB |
|
134.00
|
| Complete CBC Auto |
|
85.00
|
| Complete CBC Auto with Auto Diff |
|
141.00 |
| Comprehensive Metabolic Panel |
|
143.00
|
| Culture Bacterial Blood Aerobic |
|
174.00
|
| Culture ID Aerobic |
|
57.00
|
| Culture Other Source |
|
142.00
|
| Culture Urine CC |
|
114.00
|
| Drug Screen Rapid |
|
46.00
|
| Glucose Quant Blood
|
|
71.00
|
| Hematocrit
|
|
37.00
|
| Hemoglobin Glycated A1C
|
|
118.00
|
| Hepatic Function Panel |
|
189.00
|
| Lipase |
|
88.00
|
| Lipid Panel |
|
118.00
|
| Magnesium |
|
79.00
|
| Mycobact Susc MIC/TB/AFB
|
|
79.00
|
| Natriuretic Peptide |
|
247.00
|
| Prothrombin Time |
|
72.00
|
| Thyroid TSH |
|
97.00
|
| Thyroxine total T4
|
|
125.00
|
| Troponin Quant |
|
188.00
|
| Urinalysis auto w/microscopy |
|
60.00
|
| Urinalysis Auto wo microscopy |
|
31.00
|
| Venipuncture |
|
38.00
|
Surgical Pathology
| |
|
Charge |
| Level IV Surgical Pathology
|
|
529.00
|
Hospital Billing Policies
University Hospitals will provide care without discrimination for emergency medical conditions regardless of a patients’ ability to pay and will adhere to University Hospital’s Credit and Collection Policy.
There is no doubt that health insurance benefit plans are confusing. Most plans do not provide 100% coverage for a hospital bill. Each plan has its own set of rules, exclusions and services that are not covered.
It is your responsibility to be familiar with your specific benefit plan. If you are unsure of your coverage for a particular medical procedure or test, you should call the customer service telephone number on your insurance card before scheduling the procedure.
Your health insurance policy is a contract between you and your insurance company. As a service to you, University Hospitals will submit claim(s) to your health insurance provider(s). By working together, we can minimize misunderstandings, payment delays and billing costs. However, you are ultimately responsible for any charges not covered by your benefit plan.
Depending on your plan(s), you may be required to get approval (pre-certification) before you receive hospital services. Even in a life-threatening situation, your benefit plan(s) may require you to contact them within 24 hours of receiving hospital care. We will assist you in doing that, but if approval is not obtained from your insurance company, you are responsible for paying for your hospital care. Also, obtaining approval does not guarantee that the cost of the service is completely covered by your benefit plan(s) making you responsible for any charges not covered.
Some insurance companies have established “usual, customary and reasonable” (UCR) maximum dollar amounts they will pay for certain procedures. Any amount of money the insurance company will not pay because it exceeds the UCR amount is your responsibility.
If University Hospitals does not participate in your insurance plan, you can still receive services at UH; however, your insurance company will consider our services “out of network”. “Out of network” services will result in the patient being responsible for a larger portion of the bill.
Whether you are insured or uninsured, University Hospitals participates in Ohio’s Hospital Care Assurance Program (HCAP). Under state law, we must provide, without charge, certain basic, medically necessary hospital services to individuals who meet specific guidelines. “Basic Medically Necessary Hospital Services” include all inpatient and outpatient services covered under the Medicaid Program except organ transplants and associated services. This program covers hospital charges only. Associated professional physician charges are NOT eligible. Patients who meet the guidelines must fill out an application for HCAP.
- Individuals must be residents of the State of Ohio
- Individuals cannot be enrolled in the Medicaid program; and
- Personal or family income is at or below the Federal Poverty Line
University Hospitals is committed to treating all patients with dignity and respect of their financial status or ability to pay. In support of this commitment, if you are uninsured, UH has established an Uninsured Charity Assistance program. Through this program, UH provides discounts on hospital bills on a sliding scale to Ohio residents who do not have health insurance and who meet certain criteria. If the patient’s family income ranges between 100-400 percent of the Federal Poverty Guidelines, you may be eligible for a discount. Discounts may be extended up to 4 times the income identified in the Federal Poverty Guidelines.
If you are insured with exception circumstances that result in financial hardship and are unable to pay your bills, you may be eligible under our Medically Indigent Program to receive financial assistance.
For more information about University Hospitals Billing Policies, charges or Financial Assistance Programs, please call 216-844-8299 or toll free 1-800-859-5906 to speak to a Financial Counselor.