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Fiscal Services

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:

Room and Board (Per Day Charges)

INTENSIVE CARE$1085
NURSERY$325
BIRTHING SUITE (LDR)$397
ROUTINE CARE$397
SENIOR CARE

REHAB

$858
$901

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$1151
FETAL MONITOR NON-STRESS TEST$207
LABOR ROOM PER HOUR$61

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$75
LEVEL 2$112
LEVEL 3$185
LEVEL 4$364
LEVEL 5$368
CRITICAL CARE$575

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$1028
MINOR-ADDITIONAL 15 MINUTES$201
MAJOR-SETUP CHARGE$1810
MAJOR-ADDITIONAL 15 MINUTES$270

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$55
PT GAIT TRAINING, 15 MINUTES$53
PT THERAPEUTIC ACTIVITY,15 MI$62
P.T. EVALUATION$174
PT NEUROMUSCULAR RE-ED  15 MI$55
PT ELECTRIC STIM- ATTENDED$49
OT NEUROMUSCULAR RE-ED 15 MIN$55
OT THERAPEUTIC EXERCISE 15 MI$55
PT HOT OR COLD PACKS$35
SPEECH TREATMENT$168

 
PT ULTRASOUND 15 MIN$49
PT GROUP THERAPEUTIC PROCEDUR$35

 
PT RE-EVALUATION$85
PT MANUAL THERAPY 15 MIN$57
OT  WHIRLPOOL$79
PT TRACTION, MECHANICAL$49


OT SENSORY INTEGRETION 15 MIN$59



 




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 REHABPHASE II VISIT EXERCISE PROG$103
CARDIAC REHABPHASE III SELF PAY  /MONTH$69
   
CARDIAC REHABPHASE III  2 DAYS/WK$62
PULMONARY FUNCTIONPFT ARTERIAL PUNCTURE$39
PULMONARY FUNCTIONLUNG VOLUME DETERMINATION$210
PULMONARY FUNCTIONSPIROMETRY, B & A DILATOR$233
PULMONARY FUNCTIONDIFFUSION CAPACITY$171
PULMONARY REHABEXERCISE SESSION$87
PULMONARY REHABPULSE OXIMETRY - SINGLE$58
PULMONARY REHABEDUCATIONAL SES. PULM REHAB$55
RESPIRATORY CAREAERO/MDI TREATMENT, SUBSEQUEN$52
RESPIRATORY CAREPULSE OXIMETRY, SINGLE$58
RESPIRATORY CAREOXYGEN, DAILY CHARGE$80
RESPIRATORY CAREAERO/MDI TREATMENT, INITIAL$67


 
RESPIRATORY CAREBRONCHOPULMONARY HYGIENE, SUB$58
   
RESPIRATORY CAREVENTILATOR DAILY, SUBSEQUENT$331
RESPIRATORY CAREHME/HUMIDIFIER$21
RESPIRATORY CAREBRONCHOPULM. HYGIENE, INITIAL$58


 
RESPIRATORY CAREVENTILATOR CIRCUIT$58
SLEEP LABPOLYSOMNOGRAPHY$2261
SLEEP LABPOLYSOMNOGRAPHY W/CPAP THERAP$2,472

Radiological Charges

The following charges reflect the hospital's 30 most common radiological procedures.

CT SCANOPTIRAY 320-125MLS$415
CT SCANCT HEAD W/O CONTRAST$688
CT SCANCORON SAG OBL W/ PROCESSING$413
CT SCANCT ABD W/O & W/CONT$996
CT SCANCT PELV W/O & W/CONT$996
CT SCANCT CHEST W/ CON$873
CT SCANCT PELVIS W/O CONT$823
CT SCANCT ABD W/O CONT$909
IMAGINGCHEST 2 VIEW FRNTL&LAT$139



IMAGINGCHEST, ONE VIEW PORT$100
IMAGINGFLUORO GUIDE FOR SPINE INJECT$232
IMAGINGFOOT CMPL MINI 3 VIEWS$113
IMAGINGHAND MINI 3 VIEWS$117
IMAGINGABD CMP AC ABD 1VIEW CHEST$225
IMAGINGANKLE CMPL MINI 3 VIEWS$106
IMAGINGSPINE LUMBOSA MINIMUM 4 VW$185
IMAGINGABD SINGL AP VIEW$122
IMAGINGHIP UNI CMPL MINI 2 VIEWS$145
IMAGINGOPTIRAY$82
IMAGINGSHLDR CMPL MINIMUM 2 VW$118
MRIOPTIMARK$176
MRIMRI SPINAL LUMB NO CON$1,477
NUCLEAR MEDICINETETROFOSMIN TC-99 M  (MYOVIEW$252
NUCLEAR MEDICINEMYOCARD PERF IMAG MX STUDY$900
NUCLEAR MEDICINEMYOCARD PERF W/EJEC FRAC$260
NUCLEAR MEDICINEMYO PER QUAL/QUAN WALL MO$151
ULTRASOUNDDUPLEX CAROTID ART BIL STDY$573
ULTRASOUNDABD MULT ORGAN COMPL$369
WOMENS WELLNESSDIGITAL SCREENING MAMMOGRAM$160

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 BANKCROSSMATCH$88
CHEMISTRYBASIC METABOLIC PANEL$64
CHEMISTRYCOMPRE METABOLIC PANEL$89
CHEMISTRYPROTHROMBIN TIME$33
CHEMISTRYCPK$59
CHEMISTRYLIPID PROFILE$70
CHEMISTRYTROPONIN, QUANTITATIVE$34
CHEMISTRYMYOGLOBIN$34
CHEMISTRYCKMB$76
CHEMISTRYTHYROID STIM HORMONE$63
CHEMISTRYHEPATIC FUNCTION PANEL$69
CHEMISTRYAPTT$52
CHEMISTRYGLYCOHEMOGLOBIN (A1C)$55
CHEMISTRYAMYLASE$30
CHEMISTRYLIPASE$28
CHEMISTRYFREE T4$58
CHEMISTRYMAGNESIUM$30



CYTOLOGYTHIN PREP-PAP SMEAR$63
HEMA & URINECBC WITH AUTO DIFF$58
HEMA & URINEURINALYSIS$32
HEMA & URINEURINE MICROSCOPIC$22
HEMA & URINEHEMOGLOBIN$26
HEMA & URINEHEMATOCRIT$26
HEMA & URINESED RATE$29
HISTOLOGYGROSS & MICRO LEVEL 4$84
MICROBIOLOGYDEFINITIVE ORGANISM IDENT$33
MICROBIOLOGYURINE CULTURE$65
MICROBIOLOGYBLOOD CULTURE$88
MICROBIOLOGYMIC SENSITIVITY$63

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