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 1, 2016.

To view other patient price lists, click on the links below:

Room and Board (Per Day Charges)

INTENSIVE CARE $1,221
NURSERY $366
BIRTHING SUITE (LDR) $446
ROUTINE CARE $446
SENIOR CARE
REHAB

$966
$1,014

 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 $85
LEVEL 2 $126
LEVEL 3 $209
LEVEL 4 $409
LEVEL 5 $414
CRITICAL CARE $647

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 $1,167
MINOR-ADDITIONAL 15 MINUTES $226
MAJOR-SETUP CHARGE $2,047
MAJOR-ADDITIONAL 15 MINUTES $304

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 $61
PT GAIT TRAINING, 15 MINUTES $59
PT THERAPEUTIC ACTIVITY,15 MI $70
P.T. EVALUATION $145
PT NEUROMUSCULAR RE-ED  15 MI $61
PT ELECTRIC STIM- ATTENDED $56
OT NEUROMUSCULAR RE-ED 15 MIN $61
OT THERAPEUTIC EXERCISE 15 MI $61
PT HOT OR COLD PACKS $39
SPEECH TREATMENT $189
   
PT ULTRASOUND 15 MIN $56
PT GROUP THERAPEUTIC PROCEDUR $39
   
PT RE-EVALUATION $220
PT MANUAL THERAPY 15 MIN $64
OT WHIRLPOOL $89
PT TRACTION, MECHANICAL $56
   
OT SENSORY INTEGRETION 15 MIN $66
   
   
   
   

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 $116
CARDIAC REHAB PHASE III SELF PAY  /MONTH $78
     
CARDIAC REHAB PHASE III  2 DAYS/WK $70
PULMONARY FUNCTION PFT ARTERIAL PUNCTURE $44
PULMONARY FUNCTION LUNG VOLUME DETERMINATION $236
PULMONARY FUNCTION SPIROMETRY, B & A DILATOR $262
PULMONARY FUNCTION DIFFUSION CAPACITY $192
     
 EKG/EEG   $123
     
RESPIRATORY CARE AERO/MDI TREATMENT, SUBSEQUEN $58
RESPIRATORY CARE PULSE OXIMETRY, SINGLE $65
RESPIRATORY CARE OXYGEN, DAILY CHARGE $90
RESPIRATORY CARE AERO/MDI TREATMENT, INITIAL $75
     
RESPIRATORY CARE BRONCHOPULMONARY HYGIENE, SUB $65
     
RESPIRATORY CARE VENTILATOR DAILY, SUBSEQUENT $372
RESPIRATORY CARE HME/HUMIDIFIER $23
RESPIRATORY CARE BRONCHOPULM. HYGIENE, INITIAL $65
     
RESPIRATORY CARE VENTILATOR CIRCUIT $65
SLEEP LAB POLYSOMNOGRAPHY $2,545
SLEEP LAB POLYSOMNOGRAPHY W/CPAP THERAP $2,782

Radiological Charges

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

CT SCAN OPTIRAY 320-125MLS $467
CT SCAN CT HEAD W/O CONTRAST $774
CT SCAN CT ABD W/O & W/ CONT  $1,121
CT SCAN CT PELVIS W/O & W/ CONT $1,121
CT SCAN    
CT SCAN CT CHEST W/ CON $983
CT SCAN CT PELVIS W/O CONT $926
CT SCAN CT ABD W/O CONT $1,024
IMAGING CHEST 2 VIEW FRNTL&LAT $222
     
IMAGING CHEST, ONE VIEW PORT $222
     
IMAGING FOOT CMPL MINI 3 VIEWS $128
IMAGING HAND MINI 3 VIEWS $132
IMAGING ABD CMP AC ABD 1VIEW CHEST $253
IMAGING ANKLE CMPL MINI 3 VIEWS $119
IMAGING SPINE LUMBOSA MINIMUM 4 VW $209
IMAGING ABD SINGL AP VIEW $222
IMAGING HIP UNI CMPL MINI 2 VIEWS $163
IMAGING OPTIRAY $93
IMAGING SHLDR CMPL MINIMUM 2 VW $133
MRI OPTIMARK $198
MRI MRI SPINAL LUMB NO CON $1,662
NUCLEAR MEDICINE TETROFOSMIN TC-99 M  (MYOVIEW $284
NUCLEAR MEDICINE MYOCARD PERF IMAG MX STUDY $1,013
     
     
ULTRASOUND DUPLEX CAROTID ART BIL STDY $645
ULTRASOUND ABD MULT ORGAN COMPL $415
WOMENS WELLNESS DIGITAL SCREENING MAMMOGRAM $180

Laboratory Charges

The following charges reflect the hospital's 30 most common laboratory procedures.  All blood draws will automatically include a $17 Venipuncture charge.

BLOOD BANK CROSSMATCH $99
CHEMISTRY BASIC METABOLIC PANEL $72
CHEMISTRY COMPRE METABOLIC PANEL $100
CHEMISTRY PROTHROMBIN TIME $37
CHEMISTRY CPK $66
CHEMISTRY LIPID PROFILE $79
CHEMISTRY TROPONIN, QUANTITATIVE $38
CHEMISTRY MYOGLOBIN $38
CHEMISTRY CKMB $86
CHEMISTRY THYROID STIM HORMONE $71
CHEMISTRY HEPATIC FUNCTION PANEL $78
CHEMISTRY APTT $58
CHEMISTRY GLYCOHEMOGLOBIN (A1C) $61
CHEMISTRY AMYLASE $32
CHEMISTRY LIPASE $31
CHEMISTRY FREE T4 $65
CHEMISTRY MAGNESIUM $34
     
CYTOLOGY THIN PREP-PAP SMEAR $71
HEMA & URINE CBC WITH AUTO DIFF $65
HEMA & URINE URINALYSIS $36
HEMA & URINE URINE MICROSCOPIC $24
HEMA & URINE HEMOGLOBIN $29
HEMA & URINE HEMATOCRIT $29
HEMA & URINE SED RATE $32
HISTOLOGY GROSS & MICRO LEVEL 4 $95
MICROBIOLOGY DEFINITIVE ORGANISM IDENT $32
MICROBIOLOGY URINE CULTURE $73
MICROBIOLOGY BLOOD CULTURE $99
MICROBIOLOGY MIC SENSITIVITY $71
200 East State Street   |   Alliance, Ohio 44601   |   Phone: (330) 596-6000   |   info@achosp.org
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