Patient Price Information List
In compliance with state law, Alliance Community Hospital is providing this price list containing our charges for room and board, emergency department, operating room, labor and 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/or billing staff to determine whether they qualify for discounts. These prices are correct as of January 2, 2012.
To view a downloadable patient price list from Alliance Community Hospital, click here.
To view other patient price lists, click on the links below:
- Salem Community Hospital - Salem, Ohio
- Mercy Medical Center - Canton, Ohio
- Robinson Memorial Hospital - Ravenna, Ohio
Room and Board (Per Day Charges)
| INTENSIVE CARE | $1053.00 |
| NURSERY | $316.00 |
| BIRTHING SUITE (LDR) | $385.00 |
| ROUTINE CARE | $385.00 |
| SENIOR CARE REHAB | $833.00 |
Labor and Delivery
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.
| NORMAL DELIVERY | $1121.00 |
| FETAL MONITOR NON-STRESS TEST | $107.00 |
| LABOR ROOM PER HOUR | $59.00 |
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.
| LEVEL 1 | $73.00 |
| LEVEL 2 | $109.00 |
| LEVEL 3 | $180.00 |
| LEVEL 4 | $353.00 |
| LEVEL 5 | $357.00 |
| CRITICAL CARE | $558.00 |
Operating Room Charges
Operating Room charges are based on the complexity level, with Minor 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.
| MINOR-SETUP CHARGE | $998.00 |
| MINOR-ADDITIONAL 15 MINUTES | $195.00 |
| MAJOR-SETUP CHARGE | $1,757.00 |
| MAJOR-ADDITIONAL 15 MINUTES | $262.00 |
Therapy Services Charges
The following charges reflect the most common services offered by our Therapy Services department. Patients may have additional charges depending on the services performed.
| PT THERAPEUTIC EXER, 15 MIN | $53.00 |
| PT GAIT TRAINING, 15 MINUTES | $51.00 |
| PT THERAPEUTIC ACTIVITY,15 MI | $60.00 |
| P.T. EVALUATION | $169.00 |
| PT NEUROMUSCULAR RE-ED 15 MI | $53.00 |
| PT ELECTRIC STIM- ATTENDED | $48.00 |
| OT NEUROMUSCULAR RE-ED 15 MIN | $53.00 |
| OT THERAPEUTIC EXERCISE 15 MI | $53.00 |
| PT HOT OR COLD PACKS | $34.00 |
| SPEECH TREATMENT | $163.00 |
| PT ULTRASOUND 15 MIN | $48.00 |
| PT GROUP THERAPEUTIC PROCEDUR | $34.00 |
| PT RE-EVALUATION | $83.00 |
| PT MANUAL THERAPY 15 MIN | $55.00 |
| OT WHIRLPOOL | $77.00 |
| PT TRACTION, MECHANICAL | $48.00 |
| OT SENSORY INTEGRETION 15 MIN | $57.00 |
Cardio-Pulmonary Charges
The following charges reflect the most common services offered by our Cardio-Pulmonary department. Patients may have additional charges depending on the services performed.
| CARDIAC REHAB | PHASE II VISIT EXERCISE PROG | $100.00 |
| CARDIAC REHAB | PHASE III SELF PAY /MONTH | $67.00 |
| CARDIAC REHAB | PHASE III 2 DAYS/WK | $60.00 |
| PULMONARY FUNCTION | PFT ARTERIAL PUNCTURE | $38.00 |
| PULMONARY FUNCTION | LUNG VOLUME DETERMINATION | $204.00 |
| PULMONARY FUNCTION | SPIROMETRY, B & A DILATOR | $226.00 |
| PULMONARY FUNCTION | DIFFUSION CAPACITY | $166.00 |
| PULMONARY REHAB | EXERCISE SESSION | $84.00 |
| PULMONARY REHAB | PULSE OXIMETRY - SINGLE | $56.00 |
| PULMONARY REHAB | EDUCATIONAL SES. PULM REHAB | $53.00 |
| RESPIRATORY CARE | AERO/MDI TREATMENT, SUBSEQUEN | $50.00 |
| RESPIRATORY CARE | PULSE OXIMETRY, SINGLE | $56.00 |
| RESPIRATORY CARE | OXYGEN, DAILY CHARGE | $78.00 |
| RESPIRATORY CARE | AERO/MDI TREATMENT, INITIAL | $65.00 |
| RESPIRATORY CARE | BRONCHOPULMONARY HYGIENE, SUB | $56.00 |
| RESPIRATORY CARE | VENTILATOR DAILY, SUBSEQUENT | $321.00 |
| RESPIRATORY CARE | HME/HUMIDIFIER | $20.00 |
| RESPIRATORY CARE | BRONCHOPULM. HYGIENE, INITIAL | $56.00 |
| RESPIRATORY CARE | VENTILATOR CIRCUIT | $56.00 |
| SLEEP LAB | POLYSOMNOGRAPHY | $2,195.00 |
| SLEEP LAB | POLYSOMNOGRAPHY W/CPAP THERAP | $2,400.00 |
Radiological Charges
The following charges reflect the hospital's 30 most common radiological procedures.
| CT SCAN | OPTIRAY 320-125MLS | $403.00 |
| CT SCAN | CT HEAD W/O CONTRAST | $668.00 |
| CT SCAN | CORON SAG OBL W/ PROCESSING | $401.00 |
| CT SCAN | CT ABD W/O & W/CONT | $967.00 |
| CT SCAN | CT PELV W/O & W/CONT | $967.00 |
| CT SCAN | CT CHEST W/ CON | $848.00 |
| CT SCAN | CT PELVIS W/O CONT | $799.00 |
| CT SCAN | CT ABD W/O CONT | $883.00 |
| IMAGING | CHEST 2 VIEW FRNTL&LAT | $135.00 |
| IMAGING | CHEST, ONE VIEW PORT | $97.00 |
| IMAGING | FLUORO GUIDE FOR SPINE INJECT | $225.00 |
| IMAGING | FOOT CMPL MINI 3 VIEWS | $110.00 |
| IMAGING | HAND MINI 3 VIEWS | $114.00 |
| IMAGING | ABD CMP AC ABD 1VIEW CHEST | $218.00 |
| IMAGING | ANKLE CMPL MINI 3 VIEWS | $103.00 |
| IMAGING | SPINE LUMBOSA MINIMUM 4 VW | $180.00 |
| IMAGING | ABD SINGL AP VIEW | $118.00 |
| IMAGING | HIP UNI CMPL MINI 2 VIEWS | $141.00 |
| IMAGING | OPTIRAY | $80.00 |
| IMAGING | SHLDR CMPL MINIMUM 2 VW | $115.00 |
| MRI | OPTIMARK | $144.00 |
| MRI | MRI SPINAL LUMB NO CON | $1,434.00 |
| NUCLEAR MEDICINE | TETROFOSMIN TC-99 M (MYOVIEW | $245.00 |
| NUCLEAR MEDICINE | MYOCARD PERF IMAG MX STUDY | $874.00 |
| NUCLEAR MEDICINE | MYOCARD PERF W/EJEC FRAC | $252.00 |
| NUCLEAR MEDICINE | MYO PER QUAL/QUAN WALL MO | $147.00 |
| ULTRASOUND | DUPLEX CAROTID ART BIL STDY | $556.00 |
| ULTRASOUND | ABD MULT ORGAN COMPL | $358.00 |
| WOMENS WELLNESS | DIGITAL SCREENING MAMMOGRAM | $155.00 |
Laboratory Charges
The following charges reflect the hospital's 30 most common laboratory procedures. All blood draws will automatically include a $15.00 Venipuncture charge.
| BLOOD BANK | CROSSMATCH | $85.00 |
| CHEMISTRY | BASIC METABOLIC PANEL | $62.00 |
| CHEMISTRY | COMPRE METABOLIC PANEL | $86.00 |
| CHEMISTRY | PROTHROMBIN TIME | $32.00 |
| CHEMISTRY | CPK | $57.00 |
| CHEMISTRY | LIPID PROFILE | $68.00 |
| CHEMISTRY | TROPONIN, QUANTITATIVE | $33.00 |
| CHEMISTRY | MYOGLOBIN | $33.00 |
| CHEMISTRY | CKMB | $74.00 |
| CHEMISTRY | THYROID STIM HORMONE | $61.00 |
| CHEMISTRY | HEPATIC FUNCTION PANEL | $67.00 |
| CHEMISTRY | APTT | $50.00 |
| CHEMISTRY | GLYCOHEMOGLOBIN (A1C) | $53.00 |
| CHEMISTRY | AMYLASE | $29.00 |
| CHEMISTRY | LIPASE | $27.00 |
| CHEMISTRY | FREE T4 | $56.00 |
| CHEMISTRY | MAGNESIUM | $29.00 |
| CYTOLOGY | THIN PREP-PAP SMEAR | $61.00 |
| HEMA & URINE | CBC WITH AUTO DIFF | $56.00 |
| HEMA & URINE | URINALYSIS | $31.00 |
| HEMA & URINE | URINE MICROSCOPIC | $21.00 |
| HEMA & URINE | HEMOGLOBIN | $25.00 |
| HEMA & URINE | HEMATOCRIT | $25.00 |
| HEMA & URINE | SED RATE | $28.00 |
| HISTOLOGY | GROSS & MICRO LEVEL 4 | $82.00 |
| MICROBIOLOGY | DEFINITIVE ORGANISM IDENT | $32.00 |
| MICROBIOLOGY | URINE CULTURE | $63.00 |
| MICROBIOLOGY | BLOOD CULTURE | $85.00 |
| MICROBIOLOGY | MIC SENSITIVITY | $61.00 |
