Patient Price Information List
In compliance with state law, Fisher-Titus Medical Center provides this price list. 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 financial counselors to determine whether they qualify for discounts. These prices are correct as of January 1, 2010.
Room and Board - Per Day Charges
|
Charges |
| Routine - Private Room Care |
$795.00 |
| Obstetrics - Private Room Care |
$795.00 |
| Nursery |
$685.00 |
| Intermediate Care - Private Room |
$1,000.00 |
| Intensive Care - Private Room |
$1,635.00 |
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.
|
Charges |
| Level 1 |
$101.10 |
| Level 2 |
$138.50 |
| Level 3 |
$228.70 |
| Level 4 |
$433.35 |
| Level 5 |
$713.70 |
| Critical Care |
$1,113.40 |
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 an initial set-up charge as well as an additional charge for each 15 minutes while the operation is being performed.
|
|
First 30 Minutes |
Each Additional 15 Minutes |
|
Level 1 |
$577.50 |
$183.85 |
|
Level 2 |
$1,032.10 |
$367.80 |
|
Level 3 |
$1,255.50 |
$464.40 |
|
Level 4 |
$1,538.90 |
$572.75 |
|
Level 5 |
$1,766.00 |
$671.70 |
|
Level 6 |
$2,006.80 |
$756.75 |
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. Total charges will depend on the length of stay.
|
Charges |
| Labor & Delivery Services-Day of Delivery |
$2,039.25 |
| Amniocentesis |
$165.50 |
| Fetal Monitor Non-Stess Test |
$222.00 |
Physical & Occupational Therapy Charges
The following charges reflect the most common services offered by our Occupational and Physical Therapy departments. Patients may have additional charges, depending on the services performed.
| CPT |
Procedure |
Charge |
| 97110 |
Exercise Therapy-15 Minutes |
$51.60 |
| 97530 |
Functional Activity-15 Minutes |
$51.60 |
| 97035 |
Ultrasound Therapy-One Area |
$69.56 |
Cardio/Pulmonary Therapy Charges
The following charges reflect the most common services offered by our Cardio/Pulmonary Therapy department. Patients may have additional charges, depending on the services performed.
| CPT |
Procedure |
Charge |
| 82805 |
Blood Gas Analysis |
$117.25 |
| 93005 |
Electrocardiogram Without Interpretation |
$102.55 |
X-Ray and Radiological Charges
The following charges reflect the hospital's 30 most common x-ray and radiological procedures only. The patient will be billed separately by the Radiologist for the professional fee associated with reading the xray or image.
| CPT |
Procedure |
Charge |
| 74022 |
Complete Acute Abdomen Series |
$313.90 |
| 74000 |
Abdomen Single View |
$185.15 |
| 71010 |
Chest Single View |
$177.50 |
| 71020 |
Chest Two Views |
$244.00 |
| 74160 |
CT Abdomen With Contrast |
$1,227.40 |
| 70450 |
CT Brain Without Contrast |
$1,113.10 |
| 72193 |
CT Pelvis With Contrast |
$1,283.67 |
| 93971 |
Duplex Extremity Veins Unilateral |
$466.50 |
| 76645 |
Echo Breast Unilateral |
$416.85 |
| 76705 |
Echo Gall Bladder |
$627.75 |
| 76856 |
Echo Pelvis |
$674.35 |
| 70140 |
Facial Bones Less Than 3 Views |
$212.60 |
| 76090 |
Diagnostic Mammogram Unilateral |
$109.45 |
| 76091 |
Diagnostic Mammogram Bilateral |
$193.00 |
| 76092 |
Screening Mammogram Bilateral |
$104.70 |
| 78480 |
Myocardial Perfusion Study |
$541.50 |
| 78478 |
Myocardial Perfusion With Wall Motion |
$541.50 |
| 72170 |
Pelvis 2 Views |
$193.00 |
| 70553 |
MRI Brain Without Contrast Then With |
$3,068.60 |
| 72148 |
MRI Lumbar Spine Without Contrast |
$2,346.55 |
| 71260 |
CT Chest With Contrast |
$1,283.65 |
| 74400 |
Urography Intravenous |
$551.70 |
| 78465 |
Myocardial Perfusion Multiple Studies |
$2,166.10 |
| 76083 |
Computerized Analysis Mammogram |
$31.95 |
| 72110 |
Lumbar Spine 4 Views |
$479.40 |
| 76075 |
Dexa Bone Density |
$329.85 |
| 73140 |
Finger 2 Views |
$140.00 |
| 73630 |
Foot 3 Views |
$233.27 |
| 93880 |
Duplex Scan Extracraial Arteries Study |
$705.60 |
| 73610 |
Ankle 3 Views or More |
$233.25 |
Laboratory Charges
The following charges reflect the hospital's 30 most common laboratory procedures.
| CPT |
Procedure |
Charge |
| 36415 |
Venipuncture |
$17.10 |
| 80051 |
Electrolytes |
$97.00 |
| 82565 |
Creatinine (Serum) |
$38.35 |
| 84520 |
BUN |
$36.45 |
| 85027 |
Complete Blood Count |
$66.25 |
| 82962 |
AccuCheck Blood Glucose |
$16.65 |
| 85610 |
Prothrombin Time |
$39.65 |
| 82947 |
Glucose Quantitative (FBS) |
$36.45 |
| 85730 |
Thromboplastin Time (PTT) |
$49.35 |
| 81001 |
Urinalysis Routine |
$47.60 |
| 84484 |
Toponin Quantitative |
$68.80 |
| 82947 |
Glucose Post Prandia |
$36.00 |
| 82553 |
Creatinine Kinase MB Fraction Only |
$105.75 |
| 80076 |
Hepatic Function Panel |
$174.60 |
| 83874 |
Myglobin |
$130.15 |
| 80061 |
Lipid Profile |
$87.60 |
| 85018 |
Hemoglobin |
$27.55 |
| 85014 |
Hematocrit |
$27.55 |
| 87088 |
Culture Urine |
$69.50 |
| 82310 |
Blood Calcium |
$38.90 |
| 84450 |
Transferase Aspartrate Amino (SGOT) |
$38.30 |
| 84460 |
Transferase Alanine Amino (SGPT) |
$38.30 |
| 85025 |
Complete Blood Count With Differential |
$70.05 |
| 82947 |
Glucose Random |
$36.45 |
| 82550 |
Creatinine Kinase Total |
$38.90 |
| 84443 |
Thyroid Simulating Hormone (TSH) |
$106.85 |
| 83880 |
B-Type Natriuretic Peptide |
$195.20 |
| 84436 |
Thyroxine Total (T-4) |
$95.35 |
| 84479 |
Thyroid Hormone (T-3 Uptake) |
$101.65 |
| 84075 |
Phosphatate Alkaline |
$38.90 |
Hospital Billing Policies
Fisher-Titus Medical Center is a non-profit hospital and is committed to providing medically necessary services to all patients regardless of their ability to pay for the services rendered.
The Medical Center provides quality healthcare in a cost-effective manner to the residents of the Huron County area and maintains a strong financial foundation that includes the timely collection of accounts. Our billing and collection policy incorporates expectations for payment of services based on consistent criteria that considers the individuals financial condition and circumstance.
For patients covered by insurance, the Medical Center submits claims directly to the patients insurer on a timely basis. The patients liability (or balance owing) after insurance payments are received is pursued according to established collection guidelines. The Medical Center does not charge interest on patient accounts.
Uninsured or underinsured patients with balances owing can be screened for Medicaid eligibility and financial assistance. If the patient does not qualify for Medicaid or financial assistance, payment arrangements are available through the financial counseling office.
Financial Counseling has two full time counselors available to assist patients in completing the financial assistance process and to help patients resolve the self-pay portion of their accounts. The financial counselors can be reached at 1.800.589.3862 or 419.660.2678 or 419.660.2679.
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 visi