South Lyon Medical Center
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South Lyon Medical Center. This page also lists hospital-published cash prices for services and billing-code line items.
Overview
- CCN295011
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.
- Sterile Water, Saline And/Or Dextrose, Diluent/Flush, 10 MlSupply / DMEHCPCS A4216Hospital-published line item$11cashGross $15
- Injection, Dexamethasone Sodium Phosphate, 1 MgDrugHCPCS J1100Hospital-published line item$11cashGross $16
- Urinary Drainage Bag, Leg OR Abdomen, Vinyl, With OR Without Tube, With Straps, EachSupply / DMEHCPCS A4358Hospital-published line item$11cashGross $16
- Full Face Mask Used With Positive Airway Pressure Device, EachSupply / DMEHCPCS A7030Hospital-published line item$11cashGross $16
- Dtap Vaccine < 7 Yrs IMProcedureCPT 90700Hospital-published line item$11cashGross $16
- Light Compression Bandage, Elastic, Knitted/Woven, Width Greater Than OR Equal To Three Inches And Less Than Five Inches, Per YardSupply / DMEHCPCS A6449Hospital-published line item$11cashGross $16
- Gauze, Non-Impregnated, Non-Sterile, Pad Size 16 Sq. In. OR Less, Without Adhesive Border, Each DressingSupply / DMEHCPCS A6216Hospital-published line item$11cashGross $16
- Sterile Water/Saline, 500 MlSupply / DMEHCPCS A4217Hospital-published line item$11cashGross $16
- Injection, Aminophyllin, Up To 250 MgDrugHCPCS J0280Hospital-published line item$11cashGross $16
- 90654ProcedureCPT 90654Hospital-published line item$11cashGross $16
| Service / code | Self-pay cash↑ | Gross list |
|---|---|---|
Sterile Water, Saline And/Or Dextrose, Diluent/Flush, 10 Ml Supply / DMEHCPCS A4216Hospital-published line item | $11 | $15 |
Injection, Dexamethasone Sodium Phosphate, 1 Mg DrugHCPCS J1100Hospital-published line item | $11 | $16 |
Urinary Drainage Bag, Leg OR Abdomen, Vinyl, With OR Without Tube, With Straps, Each Supply / DMEHCPCS A4358Hospital-published line item | $11 | $16 |
Full Face Mask Used With Positive Airway Pressure Device, Each Supply / DMEHCPCS A7030Hospital-published line item | $11 | $16 |
Dtap Vaccine < 7 Yrs IM ProcedureCPT 90700Hospital-published line item | $11 | $16 |
Light Compression Bandage, Elastic, Knitted/Woven, Width Greater Than OR Equal To Three Inches And Less Than Five Inches, Per Yard Supply / DMEHCPCS A6449Hospital-published line item | $11 | $16 |
Gauze, Non-Impregnated, Non-Sterile, Pad Size 16 Sq. In. OR Less, Without Adhesive Border, Each Dressing Supply / DMEHCPCS A6216Hospital-published line item | $11 | $16 |
Sterile Water/Saline, 500 Ml Supply / DMEHCPCS A4217Hospital-published line item | $11 | $16 |
Injection, Aminophyllin, Up To 250 Mg DrugHCPCS J0280Hospital-published line item | $11 | $16 |
90654 ProcedureCPT 90654Hospital-published line item | $11 | $16 |
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