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Patient Price Information

Patient Price Information

In compliance with state law, Lima Memorial Health System is providing this price list containing our charges for room and board, emergency, 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 01/01/16. For more information about patient pricing, call 419-226-5040.

Room and Board – Per-Day Charges

Charges
Routine Care $847.55
Obstetrics Inpatient $904.05
Transitional Care Inpatient $510.79
Labor/Delivery Birthing Room $1,243.07
Pediatrics Inpatient $847.55
Rehab Inpatient $624.93
Nursery $1,203.52
Intensive Care $1,582.09
HVU Inpatient $1,630.52
CIU Inpatient $1,356.08

Labor and Delivery Charges

The following list does not include charges for room rates, 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.

Charges
Normal Delivery $4,906.00
Cesarean Section Delivery $8,806.00
Amniocentesis $1,503.35

Emergency Department Charges

Emergency Center 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 Center physicians, radiologists or pathologists, who will bill separately for their services.

Charges
Emergency Level 1 $104.43
Emergency Level 2 $265.94
Emergency Level 3 $546.26
Emergency Level 4 $990.74
Emergency Level 5 $1,313.07
Trauma Care - Level 1 $11,933.86
Trauma Care - Level 2 $8,353.08
Trauma Care - Level 3 $4,117.32
Critical Care $2,413.41

Operating Room Charges

Operating room charges are based on the complexity level, with Level 1 being the most basic, for a particular operation. The prices will vary by the amount of time it takes as well as by the complexity of the procedure. These charges do not include fees for anesthesiology, drugs, supplies, or additional ancillary procedures that may be required for a particular operation.

Charges

Level 1 - Includes procedures with minimal equipment and usually two to three nurses (one being an RN)

Initial Setup Charge $4,858.15
Each Addtl. 15 minutes $669.65

Level 2 - Includes procedures that require additional equipment (power drill, saws, video, laser). Would also require two or more nurses. If critical, procedure/patient will need two RNs.

Initial Setup Charge $5,324.00
Each Addtl. 15 minutes $970.82

Level 3 - Includes procedures done in the open-heart rooms, except pacemakers done in the open-heart rooms (which will be charged as a Level 2).

Initial Setup Charge $12,608.20
Each Addtl. 15 minutes $1,805.22

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.

Charges
Therapeutic Exercise - 15 minutes $99.15
Gait Training - 15 minutes $111.86
Aquatic Therapy - 15 minutes $138.27
Dynamic Therapeutic Act - 15 minutes $119.31
PT Evaluation - Inpatient/WC $285.00
Neuromuscular Re-Education $138.27
Group Therapy - Rehab $142.91
Manual Therapy - 15 minutes $137.98
Electric Stimulation (Unattended) $98.44
Wheelchair Mobility Training - 15 minutes $83.00
Mechanical Traction $127.74
Vasopneumatic Pump $111.21
ADL Training - 15 minutes $101.32
Concussion Management (Initial Assessment) $100.00
Concussion Management (Follow-up Assessment) $75.00
Iontophoresis - 15 minutes $142.09
PT Re-evaluation $168.38
Phonophoresis $114.76

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.

Charges
Therapeutic Exercise - 15 minutes $99.15
Self-Care/Home Mgmt. Training - 15 minutes $101.32
Neuromuscular Re-Education - 15 minutes $138.27
Evaluation $285.00
Manual Therapy $137.98
Hot or Cold Packs $37.58
Therapeutic Exercise - 15 minutes $99.15
Rehab-Group Therapeutic Procedure $142.91
Therapeutic Activities - 15 minutes $119.31
Parrafin Bath Therapy $85.67
Electric Stim (Unattended) $98.44
Ultrasound $114.76
Whirlpool Therapy $144.28
Massage Therapy $112.72
Sensory Integration $127.45
Re-evaluation $168.38
Iontophoresis $142.09
Electric Stim (Attended) $136.76
Rehab-Cognitive Skills $118.95

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.

Charges
Pre & Post Spirometry $581.55
CO Diffusion $227.81
Spirometry $518.58
Broncho Provocation Test $1,303.86
Oximetry Measurement Single $119.17
Oximetry Sleep Study $396.34
Oximetry Measurement Multiple with Exercise $198.18

X-Ray and Radiological Charges

The following charges reflect the hospital's 30 most common X-ray and radiological procedures. These charges would not include any radiologist's fees that would be billed separately by their office.

Charges
Chest, 1 View Frontal $188.58
Chest, 2 View Frontal & Lateral $374.00
Comp Screen Mammogram Add-on $66.00
Mammogram Screening Digital $264.00
CT, Head or Brain, without Contrast $1,350.00
CT, Abdomen & Pelvis, with Contrast $4,213.66
Computer Dx Mammogram Add-on $66.00
US Abdomen Limited $1,133.00
CT, Abdomen & Pelvis, without Contrast $3,526.63
Hand, Min 3 Views $462.00
Abdomen-AP View $286.00
US Breast Limited Unilateral $715.00
Foot, Min 3 Views $446.05
Retroperitoneal Complete $900.00
Lumbar Spine 2-3 Views $418.00
Mammogram Unilateral Digital $286.00
Ankle, Min 3 Views $300.00
Dexa, Axial Skeleton Study $715.00
CT, Cervical Spine without Contrast $1,645.76
CT, Angiography Chest w/wo $3,276.07
Shoulder, Min 2 Views $492.44
CT, Chest with Contrast $2,117.85
Hip, Min 2 Views $330.00
Knee, 4 or More Views $605.00
Pelvis, 1-2 Views $308.00
Wrist, Complete, Min 3 Views $451.00
Mammogram Diagnostic Digital $385.00
Myocard Perf Spect MX Studies $4,950.00
Knee, 3 Views $451.00
Cervical Spine, 2-3 Views $407.00

Outpatient Laboratory Charges

The following charges reflect the hospital's most common outpatient laboratory procedures. Inpatient charges may vary from those shown here. These charges would not include any pathologist's fees that would be billed directly by their office.

Charges Regular Price Fee Schedule Price
Gross & Micro Level IV $306.54
Gram Stain $56.39 $10.63
Antibiotic Susceptibility $95.98 $27.50
Urine Bacterial ID Ea Organism $92.38  
Culture, Urine $59.98 $31.25
Culture, Screening Only $86.38  
Culture, Routine $153.57 $18.75
Culture, Blood $147.57  
APTT $56.40 $15.71
Prothrombin Time/INR (PT) $43.20 $18.75
CBC without Diff $60.00 $20.00
Complete Blood Count $92.41 $25.00
Hemoglobin HGB $30.00 $6.25
Hematocrit HCT $30.00 $6.25
Diff Scan (Bill Only) $14.40 $12.50
Manual Diff (Bill Only) $39.60 $18.75
Troponin $115.01  
Transferrin $68.10  
TSH $204.28 $58.68
T4 Free $181.58 $23.63
Magnesium $78.69  
Lipase $122.57  
Iron $83.22 $17.00
HGB A1C $151.32 $33.90
Blood Gases, Calc 02 ABG $190.66  
Creatinine Kinase, Total $81.71 $18.75
Urine Reflex Culture $61.71 $12.50
Capillary Puncture $22.25 $3.75
Collection Venous Blood Venipuncture $18.15 $7.50
Thinprep Pap, Screening $85.72  

CT / MRI Charges

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

Charges Regular Price Fee Schedule Price
CT Angio ABD & Pelvis with WO $3,241.28 $2,109.80
MRI Cervical Spine without Contrast $3,800.00  
US Breast Complete Unilateral $715.00  
MRI Upper Extrem Joint without Contrast $3,600.00 $2,074.60
OB Ultrasound Transvaginal US $632.50  
US Guide Needle Placement S & I $913.00  
CT Soft Tissue Neck with Contrast $1,964.61 $1,854.60
CT Angiography Neck with WO $2,366.26 $1,854.60
MRI Lower Extrem Joint without Contrast $3,485.52 $2,593.80
ECHO Scrotum and Contents $924.00  
US Guidance Vascular Access $975.98  
OB Ultrasound <14 Wks-Sng Gest $561.00  
NM Hepatobilia Sys Img with Pharm $1,890.00  
CT Chest without Contrast $1,690.54 $1,599.40
Transvaginal Ultrasound $935.00  
CT Maxillofacial Area without Contrast $1,146.02  
MRI Lumbar Spine without Contrast $3,600.00  
MRI Brain without Contrast $2,600.00  
Soft Tissue Head/Neck $792.00  
Pelvic Echo Non-OB Complete $1,034.00  
CT Chest with Contrast $2,117.85  
CT Angiography Chest with WO $3,276.07 $1,854.60
CT Cervical Spine without Contrast $1,645.76  
Retroperitoneal Complete $990.00  
US Breast Limited Unilateral $715.00  
CT Abdomen & Pelvis without Contrast $3,526.63 $3,197.70
US Abdomen Limited $1,133.00  
Myocard Perf Spect MX Studies $4,950.00  
CT Abdomen & Pelvis with Contrast $4,213.66 $3,710.30
CT Head or Brain without Contrast $1,350.00  

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