Patient Pricing Information

In compliance with state law, University Hospitals Portage 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 1/1/2017.

Room and Board – Per Day Charges

  Charge
Routine Care $1,991.00
Special Care $2,886.00
Intensive Care $5,171.00

Labor and Delivery Charges

The following list does not include charges for anesthesia, drugs, or supplies required for a particular delivery room procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.

  Charge
Normal Delivery $5,490.00
Cesarean Section Delivery $7,219.00
Labor Room Per Day $1,991.00
Newborn Bassinet $1,640.00

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.

  Charge
Level 1 $228.00
Level 2 $542.00
Level 3 $776.00
Level 4 $1,787.00
Level 5 $1,865.00

Operating Room Charges

Operating Room charges are based on the complexity level, with level 1 being the most basic, for a particular operation. There is not an additional charge for extended time in the operating room. However, the following rates do not include fees for drugs, non-routine supplies or additional ancillary testing that may be required for a particular surgical procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.

  Charge
Level 1 $4,066.00
Level 2 $5,464.00
Level 3 $6,237.00
Level 4 $7,763.00
Level 5 $8,849.00
Level 6 $10,303
Level 7 $12,177

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
Aqua Therapy – 15 Min $132.00
Electric Stimulation – Unattended $130.00
Evaluation – High Complexity $416.00
Manual Therapy – 15 Min $130.00
Re-Evaluation $205.00
Ultrasound – 15 Min $130.00

Occupational Therapy Charges

The following charges reflect the most common services offered by our Occupational Therapy department. Patients may have additional charges, depending on the services performed.

  Charge
Electric Stimulation – Unattended $130.00
Evaluation – High Complexity $416.00
Fluidotherapy $177.00
Manual Therapy – 15 Min $130.00
Re-Evaluation $217.00

Respiratory Therapy Charges

The following charges reflect the most common services offered by our Respiratory Therapy department. Patients may have additional charges, depending on the services performed.

  Charge
Carbon Monoxide Diff Cap $365.00
Cpap Initial Management $373.00
Pulse Ox Mult Determination $449.00
Pulse Ox Single Determination $174.00
Vent Assist Management Day One $537.00
Vent Assist Management Subsqnt $347.00

X-Ray And Radiological Charges

The following charges reflect the hospital’s most common x-ray and radiological procedures. The charge does not reflect the fee for services of the radiologist which will be billed separately by the Radiologist.

  Charge
X-ray Of Abdomen $509.00
Echo Exam Of Abdomen $1092.00
Ct Abdomen W/Dye $2,851.00
Ct Abdomen W/O Dye $2,294.00
X-ray Exam Of Ankle $396.00
MRI Brain Stem W/O Dye $3,645.00
CT Neck Spine W/O Dye $2,623.00
Chest – Portable $502.00
Chest X-Ray 1 View Frontal $249.00
Chest X-Ray 2 View Frontal/Lat $351.00
Ct Angiograpy Chest $5,004.00
X-Ray Exam Of Foot $396.00
X-Ray Exam Of Hand $396.00
Ct Head/Brain W/O Dye $1,956.00
X-Ray Exam Knee 4 Or More $483.00
X-Ray Exam Of Abdomen $413.00
Magnevist Per Ml $32.00
Mammo Scrn Digit Bil $504.00
Ultrasound Exam Pelvis $880.00
Ct Pelvis W/O Dye $2,259.00
Transvaginal Ultrasound Non-Ob $880.00
Ultrasound Abdo Back Wall Lmtd $956.00
Echo Guide For Biopsy $789.00
X-Ray Shoulder Min 2v (Rt Or Lt) $449.00
X-Ray Neck Spine Cervical 4/5 Views $689.00
X-Ray L-2 Spine 4/>Views $699.00
Ct Thorax W/ Dye $2,909.00

Laboratory Charges

The following charges reflect the hospital’s 30 most common laboratory procedures. The charge does not reflect the fee for services for the pathologist which will be billed separately by the pathologist.

  Charge
Auto Cbc W/D $166.00
Basic Metabolic Pnlmc $237.00
Blood Culture $299.00
Cardiac Bnp $156.00
CBC $104.00
Chlamydia Amp Dna $228.00
Ck-Mb $247.00
Comprehen Metabolic $410.00
CPK $36.00
Fingerstick $38.00
Glucose By Glucometer $61.00
Glycohemogolbin $68.00
Gram Stain $62.00
Hematocrit Pcv $44.00
Hemoglobin (Hgb) $61.00
Hepatic Func Panel Mc $205.00
Lipid Profile $159.00
Magnesium $117.00
Phlebotomy –Manual Chg $56.00
Phosphorus $36.00
Prothrombin Time – Pt $69.00
Protime By Coagucheck $45.00
Rout Urine w/Microscpy $91.00
Senstivity – Mic $97.00
Thromboplstn Time-Ptt $98.00
Troponin $120.00
Tsh $132.00
Urine Culture $216.00
Venipucture $56.00
Vitamin D: 25-Hydroxy $223.00

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