Memorial Hospital Shiloh
,
Memorial Hospital Shiloh. This page also lists hospital-published cash prices for services and billing-code line items.
Overview
- CCN140307
Procedures & prices
Hospital-published price lines. These are billing-code items from the hospital transparency file, not a personalized estimate. Cash is the self-pay price; gross is the pre-discount list price.
Price definitions
- Cash
- — self-pay price (no insurance)
- Gross
- — chargemaster list price; the pre-discount sticker rate, rarely what anyone pays
- Negotiated range
- — min–max of rates the hospital negotiated with insurers
- Payers
- — number of insurers with a published rate (“0” / “—” = none)
Available here:CashGross listInsurer-negotiated rates were not published for these rows.
- Heterophile Antibody TiterLab testCPT 86309Hospital-published line item$10cashGross $17
- Injection, Garamycin, Gentamicin, Up To 80 MgDrugHCPCS J1580Hospital-published line item$10cashGross $17
- Visual Acuity ScreenProcedureCPT 99173Hospital-published line item$11cashGross $18
- Bilirubin Total TranscutLab testCPT 88720Hospital-published line item$11cashGross $18
- Injection, Sumatriptan Succinate, 6 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered)DrugHCPCS J3030Hospital-published line item$11cashGross $19
- Injection, Succinylcholine Chloride, Up To 20 MgDrugHCPCS J0330Hospital-published line item$12cashGross $19
- Injection, Hydralazine Hcl, Up To 20 MgDrugHCPCS J0360Hospital-published line item$12cashGross $20
- Microscopic Exam Of UrineLab testCPT 81015Hospital-published line item$13cashGross $21
- Injection, Amiodarone Hydrochloride, 30 MgDrugHCPCS J0282Hospital-published line item$13cashGross $21
- Tacrolimus Imme Rel Oral 1mgDrugHCPCS J7507Hospital-published line item$13cashGross $22
| Service / code | Self-pay cash↑ | Gross list |
|---|---|---|
Heterophile Antibody Titer Lab testCPT 86309Hospital-published line item | $10 | $17 |
Injection, Garamycin, Gentamicin, Up To 80 Mg DrugHCPCS J1580Hospital-published line item | $10 | $17 |
Visual Acuity Screen ProcedureCPT 99173Hospital-published line item | $11 | $18 |
Bilirubin Total Transcut Lab testCPT 88720Hospital-published line item | $11 | $18 |
Injection, Sumatriptan Succinate, 6 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) DrugHCPCS J3030Hospital-published line item | $11 | $19 |
Injection, Succinylcholine Chloride, Up To 20 Mg DrugHCPCS J0330Hospital-published line item | $12 | $19 |
Injection, Hydralazine Hcl, Up To 20 Mg DrugHCPCS J0360Hospital-published line item | $12 | $20 |
Microscopic Exam Of Urine Lab testCPT 81015Hospital-published line item | $13 | $21 |
Injection, Amiodarone Hydrochloride, 30 Mg DrugHCPCS J0282Hospital-published line item | $13 | $21 |
Tacrolimus Imme Rel Oral 1mg DrugHCPCS J7507Hospital-published line item | $13 | $22 |
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