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 $1,185
NURSERY $356
BIRTHING SUITE (LDR) $433
ROUTINE CARE $433
SENIOR CARE
REHAB

$938
$985

 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 $82
LEVEL 2 $123
LEVEL 3 $203
LEVEL 4 $397
LEVEL 5 $402
CRITICAL CARE $628

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 $1,123
MINOR-ADDITIONAL 15 MINUTES $219
MAJOR-SETUP CHARGE $1,978
MAJOR-ADDITIONAL 15 MINUTES $295

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 $60
PT GAIT TRAINING, 15 MINUTES $57
PT THERAPEUTIC ACTIVITY,15 MI $68
P.T. EVALUATION $190
PT NEUROMUSCULAR RE-ED  15 MI $60
PT ELECTRIC STIM- ATTENDED $54
OT NEUROMUSCULAR RE-ED 15 MIN $60
OT THERAPEUTIC EXERCISE 15 MI $60
PT HOT OR COLD PACKS $38
SPEECH TREATMENT $183
   
PT ULTRASOUND 15 MIN $54
PT GROUP THERAPEUTIC PROCEDUR $38
   
PT RE-EVALUATION $93
PT MANUAL THERAPY 15 MIN $62
OT WHIRLPOOL $87
PT TRACTION, MECHANICAL $54
   
OT SENSORY INTEGRETION 15 MIN $64
   
   
   
   

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 $113
CARDIAC REHAB PHASE III SELF PAY  /MONTH $75
     
CARDIAC REHAB PHASE III  2 DAYS/WK $68
PULMONARY FUNCTION PFT ARTERIAL PUNCTURE $43
PULMONARY FUNCTION LUNG VOLUME DETERMINATION $230
PULMONARY FUNCTION SPIROMETRY, B & A DILATOR $254
PULMONARY FUNCTION DIFFUSION CAPACITY $187
     
 EKG/EEG   $119
     
RESPIRATORY CARE AERO/MDI TREATMENT, SUBSEQUEN $56
RESPIRATORY CARE PULSE OXIMETRY, SINGLE $63
RESPIRATORY CARE OXYGEN, DAILY CHARGE $88
RESPIRATORY CARE AERO/MDI TREATMENT, INITIAL $73
     
RESPIRATORY CARE BRONCHOPULMONARY HYGIENE, SUB $63
     
RESPIRATORY CARE VENTILATOR DAILY, SUBSEQUENT $361
RESPIRATORY CARE HME/HUMIDIFIER $23
RESPIRATORY CARE BRONCHOPULM. HYGIENE, INITIAL $63
     
RESPIRATORY CARE VENTILATOR CIRCUIT $63
SLEEP LAB POLYSOMNOGRAPHY $2,701
SLEEP LAB POLYSOMNOGRAPHY W/CPAP THERAP $2,623

Radiological Charges

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

CT SCAN OPTIRAY 320-125MLS $454
CT SCAN CT HEAD W/O CONTRAST $752
CT SCAN CT ABD W/O & W/ CONT  $1,088
CT SCAN CT PELVIS W/O & W/ CONT $1,088
CT SCAN    
CT SCAN CT CHEST W/ CON $954
CT SCAN CT PELVIS W/O CONT $899
CT SCAN CT ABD W/O CONT $994
IMAGING CHEST 2 VIEW FRNTL&LAT $152
     
IMAGING CHEST, ONE VIEW PORT $109
     
IMAGING FOOT CMPL MINI 3 VIEWS $124
IMAGING HAND MINI 3 VIEWS $128
IMAGING ABD CMP AC ABD 1VIEW CHEST $245
IMAGING ANKLE CMPL MINI 3 VIEWS $116
IMAGING SPINE LUMBOSA MINIMUM 4 VW $203
IMAGING ABD SINGL AP VIEW $133
IMAGING HIP UNI CMPL MINI 2 VIEWS $159
IMAGING OPTIRAY $90
IMAGING SHLDR CMPL MINIMUM 2 VW $129
MRI OPTIMARK $192
MRI MRI SPINAL LUMB NO CON $1,614
NUCLEAR MEDICINE TETROFOSMIN TC-99 M  (MYOVIEW $276
NUCLEAR MEDICINE MYOCARD PERF IMAG MX STUDY $984
     
     
ULTRASOUND DUPLEX CAROTID ART BIL STDY $626
ULTRASOUND ABD MULT ORGAN COMPL $403
WOMENS WELLNESS DIGITAL SCREENING MAMMOGRAM $174

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 $96
CHEMISTRY BASIC METABOLIC PANEL $70
CHEMISTRY COMPRE METABOLIC PANEL $97
CHEMISTRY PROTHROMBIN TIME $36
CHEMISTRY CPK $64
CHEMISTRY LIPID PROFILE $77
CHEMISTRY TROPONIN, QUANTITATIVE $37
CHEMISTRY MYOGLOBIN $37
CHEMISTRY CKMB $83
CHEMISTRY THYROID STIM HORMONE $69
CHEMISTRY HEPATIC FUNCTION PANEL $75
CHEMISTRY APTT $56
CHEMISTRY GLYCOHEMOGLOBIN (A1C) $60
CHEMISTRY AMYLASE $32
CHEMISTRY LIPASE $30
CHEMISTRY FREE T4 $63
CHEMISTRY MAGNESIUM $33
     
CYTOLOGY THIN PREP-PAP SMEAR $69
HEMA & URINE CBC WITH AUTO DIFF $63
HEMA & URINE URINALYSIS $35
HEMA & URINE URINE MICROSCOPIC $24
HEMA & URINE HEMOGLOBIN $28
HEMA & URINE HEMATOCRIT $28
HEMA & URINE SED RATE $32
HISTOLOGY GROSS & MICRO LEVEL 4 $92
MICROBIOLOGY DEFINITIVE ORGANISM IDENT $36
MICROBIOLOGY URINE CULTURE $71
MICROBIOLOGY BLOOD CULTURE $96
MICROBIOLOGY MIC SENSITIVITY $69
200 East State Street   |   Alliance, Ohio 44601   |   Phone: (330) 596-6000   |   info@achosp.org
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