Summa Akron City, St. Thomas and ... - Summa Health System



In compliance with state law, Summa Akron City and St. Thomas Hospitals publishes charges for room and board, emergency department, labor and delivery, operating room, lab, radiology and other procedures. This publication is available upon request when visiting the hospital and may be found at . The hospital charges are consistent for all patients. The patient’s responsibility may vary, however, depending on insurance contracts with individual health insurers. Summa Health System offers financial assistance through the Ohio Hospital Care Assurance Program, Summa’s Charity and Uninsured Patient Charity Programs. For information contact Patient Financial Services at 234.312.5700.These prices are correct as of January 1, 2016.Room and Board per Day ChargesMedical/Surgical Semi-Private $2,610.50Nursery 1,997.75Chemical Dependency/Detox/Psychiatry 2,610.50Perinatal3,810.50Oncology 2,652.50Telemetry5,651.75ICU Step Down9,105.75Medical/Surgical Private 2,700.00Coronary/Intensive Care 12,907.25Labor and Delivery ChargesThe 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.Labor Room First Hr 521.50OB OR Level 1: First 30 Min2,620.00Labor Room each additional Hr 261.25OB OR Level 2: First 30 Min5,088.25Labor/Delivery Unit 537.75OB OR Level 3: First 30 Min7,509.25Birthing Room First Hr 4,591.50OB OR Level 1 or 2: each additional 15 Min 266.75Birthing Room High Risk First 30 Min 5,141.50OB OR Level 3: each additional 15 Min 413.75Birthing Room High Risk each additional 15 Min 102.00 OB PACU First 30 Min 473.00Delivery Room First 30 Min 4,851.75OB PACU each additional 15 Min 105.50Delivery Room each additional 15 Min 102.00Circumcision w/Regional Block 435.00Fetal Non-Stress 597.75Emergency Department ChargesEmergency Department charges are based on the level of emergency care provided to patients. There may be other hospital charges related to the emergency room visit (drugs, ancillary services, testing, anesthesia, etc.) Services provided by Emergency physicians will be billed by the physicians.Level 1 Emergency Exam 401.25Critical Care First Hour4,930.25Level 2 Emergency Exam 579.50Critical Care Addl 30 Min1,569.00Level 3 Emergency Exam1,138.00Pre-Notify Trauma Eval w/CC6,051.75Level 4 Emergency Exam1,788.00Pre-Notify Trauma Act w/CC9,738.75Level 5 Emergency Exam2,640.00Operating Room ChargesOperating Room Room Open Per MinuteLevel 1 1,961.0041.25Level 2 4,319.5043.50Level 3 5,618.0051.00Level 4 12,031.0082.75Anesthesia charges are a function of the type of anesthesia and the level of risk for the patient based on the patient’s overall health and risk for complications. Fees for anesthesia administration are not reflected and will be billed separately by your physician.Epidural ASA 1 First 30 Min 785.50 MAC ASA 4 First 30 Min 461.75 Epidural ASA 2 First 30 Min 864.00 MAC ASA 5 First 30 Min 507.75 Epidural ASA 3 First 30 Min 950.75 Regional ASA 1 First 30 Min 514.25 Epidural ASA 4 First 30 Min 1,045.75 Regional ASA 2 First 30 Min 565.75 Epidural ASA 5 First 30 Min 1,150.25 Regional ASA 3 First 30 Min 622.00 General ASA 1 First 30 Min 986.00 Regional ASA 4 First 30 Min 684.50 General ASA 2 First 30 Min 1,085.00 Regional ASA 5 First 30 Min 752.50 General ASA 3 First 30 Min 1,193.25 Spinal ASA 1 First 30 Min 630.00 General ASA 4 First 30 Min 1,315.50 Spinal ASA 2 First 30 Min 692.25 General ASA 5 First 30 Min 1,443.50 Spinal ASA 3 First 30 Min 762.00 MAC ASA 1 First 30 Min 347.25 Spinal ASA 4 First 30 Min 838.00 MAC ASA 2 First 30 Min 381.50 Spinal ASA 5 First 30 Min 922.25 MAC ASA 3 First 30 Min 420.25 each additional 15 Min all anesthesia 65.25 X-Ray and Radiological ChargesThe following charges reflect the hospital’s 30 most common Radiological procedures (in alphabetical order)Bone and or Jt Imag Whole Body2,876.75Mammog Scr-Bil w/Dig Image 373.25 CT Abd/Pelv w cont 4,638.75Myocard Perf Image Spect Mx5,223.50CT Abd/Pelv wo cont3,744.50PET CT Skull Thigh9,006.00CT Cerv Spine wo cont2,735.00Ultrasound ABD w Image Doc Complt1,732.00 CT Head/Brain wo cont2,735.00Ultrasound ABD w Image Doc Ltd 1,229.50 CT Thorax w contr3,115.50Ultrasound Breast Limited 633.00 CTA Chest w/wo cont4,569.50Ultrasound Guid Needle Plcmt1,538.25 Digital Diag Mammography 464.50 Ultrasound Pelvic w/Docum Complt 869.50 DXA Bone Density 1+ Sites Axial1,183.25 Ultrasound Preg 1st Trim TA APP Sing 763.00 ECG Stress1,633.00Ultrasound Preg Transvaginal 1,168.00 Fluoro Guide Needle Plcmt1,253.00Ultrasound Transvaginal 1,326.50 Hepatobili Duct Image incl GB2,715.00XR Abd Complt Incl Decubitus 962.00 MRA Head wo cont3,899.25XR Abdomen Single AP View 465.00 MRI Any Jt Low Ext w cont 4,835.00XR Chest 1 View Front 547.00 MRI Brain w/wo cont6,735.75XR Chest PA and Lateral 647.25LaboratoryThe following charges reflect the hospital’s 30 most common laboratory procedures (in alphabetical order).Alerg SP-IGE Quan or SemiQuan 28.75Hepatic Function 182.00APTT 125.75Iron 116.00Autom Urinalysis WO Micro 74.00Lipase 192.25Bact Cult-Urine Quan Count 209.50Lipid Panel 223.75Basic Metabolic Panel 185.25Magnesium 107.00Blood Typing ABO 117.25Neisseria Amplif NA Probe 241.00Blood Typing RH 110.25Prothrombin Time 87.75Chlam Trach Amp Probe 241.00RBC AB Scrn Ea Techiq 238.00Compl Autom CBC W Plt 119.25Surgical Path Level IV 362.75Pl CBC W Plt W Autom Diff 119.25Troponin Quant 263.50Drug Screen Class List A 251.00Thyroid Stimulating Hormone (TSH) 169.50Comprehensive Metabolic Panel 348.00Urinalysis Complete 25.00Ferritin 218.50Urinalysis Microscopic Only 33.25Glucose by Meter 104.75Urine Pregnancy Visual color 214.25Hemoglobin A-1-C 182.00 Vitamin B-12 Level 260.25Occupational or Physical TherapyThe following charges reflect the most common services offered by our Occupational Therapy and Physical Therapy departments. Patients may have additional charges, depending on the services performed.Apply Finger Splint – Static 307.25PT Evaluation and Report 499.75Apply Short Arm Splint 707.75PT Re-Eval 499.75OT Evaluation and Report 524.50PT Tx Active Funct per 15 Min 289.75OT Re-Eval 436.00PT Tx Man Ther Tech per 15 Min 241.25OT Tx Man Ther per 15 Min 241.25PT Tx Proc Neuro per 15 Min 227.75OT Tx Proc per Min 251.25PT Tx Proc per 15 Min 251.25OT Whirlpool Therapy 342.25PT Tract Mech 228.75PT E Stim Unat 146.50PT US per 15 Min 241.25Pulmonary TherapyThe following charges reflect the most common services offered by our Pulmonary Therapy department. Patients may have additional charges, depending on the services performed.Arterial Puncture Blood for DX 921.75Hast w/ Report 226.50Behav Chng Smoking 3-10 min 77.75Intubation Emerg Proc 2,013.75Behavior Chng Smoking > 10 min 104.00Pos Airway Pressure CPAP1,259.50Blood Gas Mixed WO O2 Sat 370.25Potassium 79.50Bronchoprovocation3,268.25Pulm Funct Tst by Gas FRC/RV1,065.75Bronchospasm-Pre & Post BD1,042.00Pulm Funct Tst Pleth/FRC/RV 816.25Chest Pt; Subsequent 210.00Pulse OX Multi Det with Exercise 192.25CO Diffuse Capacity 791.75Pulse OX Sgl w/Procedure Only 315.25CO Expired Gas by IR 676.25Spirometry 664.25Evaluate Pt Use of Inhaler 313.25Vent Mgmt Inpt Init or Obs 1st Day 3,263.00Flow Volume Loop1,065.75Vent Mgmt Inpat Subq Day 1,949.25Hospital Billing PoliciesYour insurance providers, including Medicare, Medicaid, other primary insurance providers and secondary insurance providers are billed by Summa hospitals before a bill is sent to you. Interest will not be charged on any balance due after insurance payments are received. If you are not able to pay the amount you owe in full, please contact Patient Financial Services at the phone number noted on your bill to apply for financial assistance or arrange for a payment plan.???Emergency services are neither delayed nor withheld on the basis of a patient’s ability to pay. You may also find helpful consumer information at . ................
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