PATIENT PRICE INFORMATION

Harrison Community Hospital

In compliance with Section 3727.12 of the Ohio Revised Code, Harrison Community Hospital is providing this price list containing our charges for room and board, emergency department, operating room, physical therapy and other procedures. Hospital charges are the same for all patients, but a patient’s responsibility may vary, depending on payment plans negotiated with individual health insurers. Uninsured patients should consult with our admitting and billing staff to determine whether they qualify for charity programs or other discounts. The following prices are correct as of January 1, 2010.

ROOM AND BOARD ~ Per Day Charges:

Acute Care/Semi-private/Private

Acute Care/Isolation

Skilled Care/Private/Semi-private

Skilled Care/Isolation

Intensive Care

Comprehensive Care

Comprehensive Care/Isolation

$512

$572

$400

$460

$1,213

$992

$1,052

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.

Level 1 ER Services

Level 2 ER Services

Level 3 ER Services

Level 4 ER Services

Level 5 ER Services

Critical Care ER Services

$120.50

$180.75

$301.25

$439.50

$644.00

$870.50

OPERATING ROOM CHARGES

Operating Room charges are based on the type of procedure performed. Charges range from $3,762 to $12,732.25. Additional charges are incurred for surgical supplies utilized during the procedure. CRNA services are billed at $409.50 for first 15-minute unit and $78.75 per each additional 15-minute unit.

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.

PT evaluation

Ultrasound treatment, each 15 min.

Gait training

Therapeutic Exercise

Electrical Stimulation

$188.50

$ 59.50

$ 54.25

$ 62.75

CARDIOPULMONARY CHARGES

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

2-D Echocardiogram with Doppler/Color

Cardiac Rehabilitation

Oxygen Daily

EKG

Spontaneous Aerosol

Oxygen Saturation

$1,907.00

$ 341.25

$ 110.00

$ 77.75

$ 64.50

$ 24.25

X-RAY AND RADIOLOGICAL CHARGES

The following charges reflect the hospital’s 30 most common x-ray and radiological procedures.

Chest/lateral

Chest/AP

Lumbar spine

Cervical spine

CT head without contrast

CT abdomen without & with contrast

CT abdomen without contrast

CT pelvis with contrast

CT pelvis without contrast

CT chest without contrast

Nuclear Med Bone Scan

Nuclear Med Stress Test

Nuclear Med HIDA

Mammogram screening

$ 199.00

$ 118.50

$ 349.75

$ 263.00

$ 873.25

$1,407.50

$1,052.25

$1,134.50

$1,047.50

$1,037.75

$4,090.50

$ 943.50

$ 149.50

Ultrasound transvaginal

Ultrasound carotid bilateral

Ultrasound pelvic

Ultrasound abdomen limited study

Ultrasound kidneys

Ultrasound venous

MRI cervical

MRI knee

MRI lumbar

MRI shoulder

Ankle complete

Foot, 3 view

Knee, AP/Lateral/Oblique

$ 349.75

$ 751.25

$ 349.75

$ 406.00

$2,167.50

$2,304.00

$2,167.50

$ 132.00

$ 200.00

LABORATORY CHARGES

The following charges reflect the hospital’s 30 most common laboratory procedures.

Venipuncture

CBC

BNP

Lipid Panel

Protime/INR

CMP

BMP

Urinalysis w/micro

Urinalysis w/o micro

Creatinine

TSH

BUN

Troponin

CK-MB

$ 13.75

$ 61.75

$261.50

$106.00

$ 53.25

$159.25

$105.00

$ 37.25

$ 20.75

$ 49.75

$ 88.25

$ 49.75

$113.75

$106.00

Electrolytes

Hemoglobin A1C

AST(SGOT)

ALT(SGPT)

Glucose

Hepatic Panel

Vitamin B12

Urine culture

Magnesium

Sensitivity

Rapid Influenza

APTT

Blood culture

Glucose(BGM)

Sed Rate

$140.50

$123.00

$ 49.75

$246.75

$195.50

$ 79.50

$ 62.00

$ 38.50

$ 88.50

$ 57.00

$ 79.50

$ 32.25

$ 53.25

Pricing does not include services for Radiology or Pathology physicians. That information may be requested by contacting:

Pathology:

Dr. Nalini Shah

119 Second St., N.E.

New Philadelphia, OH 44663

Telephone: 330-364-6900

Radiology:

Harrison Radiology Assoc.

951 E. Market Street

Cadiz, OH 43907

Telephone: 740-942-4631

Consumers can access a number of government and private Websites, which provide additional information on hospitals’ charges and quality. For a complete listing of available online resources, please visit the Consumer’s Guide to Quality Health Care in Ohio at www.ohanet.org/portal.

Level 1 ER Physician Services

Level 2 ER Physician Services

Level 3 ER Physician Services

Level 4 ER Physician Services

Level 5 ER Physician Services

Critical Care ER Physician Services

(30-74 min) ea additional 30 min.

$ 78.75

$128.50

$272.00

$422.50

$660.50