Summit County Physician / Clinic Costs

Location Service Description Plain English Description Procedure Description Procedure Code Self Pay Rate Payment Method
Summit CountySurgeryDebridement subcutaneous (under the skin) tissue - first 20 sq cmDebridement, Subsequesnt Tissue 20 Sq Cm/11042$115.08 Per Service
Summit CountySurgeryInsertion of drug implant deviceInsertion of Drug Implant Device11981$258.50 Per Service
Summit CountySurgeryTissue Transfer - additional 30 square cmTissue Transfer Additional 30 Square Cm14302$406.00 Per Service
Summit CountySurgeryDescuction of up to 14 benign lesionsDestruction of benign Lesion 1-1417110$203.50 Per Service
Summit CountySurgeryBreast biopsy with placement of clip/metallic pellet - with ultrasound guidanceBiopsy Breast 1st Lesion Ultrasound Imaging19083$326.40 Per Service
Summit CountySurgeryLarge oint aspiration or injection (shoulder, knee, hip) without ultraoundDrain/Inj Joint/Bursa W/O Ultrasound20610$110.00 Per Service
Summit CountySurgeryLarge joint aspiration or injection (shoulder, knee, hip) with ultrasound Drain/Inj Joint/Bursa W/Ultrasound20611$164.50 Per Service
Summit CountySurgeryInsertion of mechanical disk spacer during spine surgeryInsertion of Biomechanical Device22853$464.50 Per Service
Summit CountySurgeryReduction of shoulder dislocationTreat Shoulder Dislocation23650$536.82 Per Service
Summit CountySurgeryNonsurgical treatment of radius fracture at the wrist including ulnaTreat Fracture Radius/Ulna25600$602.00 Per Service
Summit CountySurgeryTotal Hip Arthroplasty (THA)Total Hip Arthroplasty27130$2,494.50 Per Service
Summit CountySurgeryTotal Knee Arthroplasty (TKA) Total Knee Arthroplasty27447$2,491.50 Per Service
Summit CountySurgeryArthroscopic shoulder surgery - decompression/repair of acromion/ligament releaseShoulder Arthroscopy/Surgery29826$324.00 Per Service
Summit CountySurgeryArthroscopic Cartilage RemovalKnee Arthroscopy/Surgery29881$995.00 Per Service
Summit CountySurgeryArthroscopic ACL RepairKnee Arthroscopy/Surgery29888$1,808.50 Per Service
Summit CountySurgeryRemoval of inferior nasal turbinateResect Inferior Turbinate30140$498.50 Per Service
Summit CountySurgeryRepair Of Nasal SeptumRepair Of Nasal Septum30520$1,111.50 Per Service
Summit CountySurgeryDiagnostic scope of the nose - unilateral or bilateralNasal Endoscopy Dx31231$381.50 Per Service
Summit CountySurgerySinus or Nasal surgery with biopsy or removal of polypsNasal/Sinus Endoscopy Surg31237$474.50 Per Service
Summit CountySurgeryScope of Larynx (voice box)Diagnostic Laryngoscopy31575$204.50 Per Service
Summit CountySurgeryRoutine VenipunctureRoutine Venipuncture36415$5.50 Per Service
Summit CountySurgeryEsophagus/Stomach/Intestine (EDG) with biopsy single/multipleEsophagus Biopsy Single/Multiple43239$301.99 Per Service
Summit CountySurgeryDiagnostic ColonoscopyDiagnostic Colonoscopy45378$406.52 Per Service
Summit CountySurgeryColonoscopy with biopsyColonoscopy And Biopsy45380$480.50 Per Service
Summit CountySurgeryColonoscopy with lesion/polyp removalColonoscopy W/Lesion Removal45385$574.56 Per Service
Summit CountySurgeryDiagnostic exam of the anus using an endoscopeDiagnostic Anoscopy Specimen46600$163.50 Per Service
Summit CountySurgeryCircumcision - ClampCircumcision W/Regional Block54150$187.23 Per Service
Summit CountySurgeryCervical biopsy with scopeBx/Curett Of Cervix W/Scope57454$274.50 Per Service
Summit CountySurgeryBiopsy of Uterine LiningBiopsy Of Uterus Lining58100$196.50 Per Service
Summit CountySurgeryInsertion of an Intrauterine Device (IUD)Insert Intrauterine Device58300$133.50 Per Service
Summit CountySurgeryRemoval of an Intrauterine Device (IUD)Remove Intrauterine Device58301$172.00 Per Service
Summit CountySurgeryLaparoscopic total hysterectomy for a uterus of 250g or lessTlh W/T/O 250 G Or Less58571$1,626.50 Per Service
Summit CountySurgeryFetal Non Stress TestFetal Non-Stress Test59025$88.50 Per Service
Summit CountySurgery Routine Vaginal Delivery Package - includes:
  • Up to 13 prenatal visits (after initial visit)
  • Routine prenatal urinalysis tests
  • Labor, delivery
  • Uncomplicated postpartum care
Obstetrical Care59400$3,818.00 Per Service
Summit CountySurgeryPhysician charges of antepartum care onlyAntepartum Care Only59426$1,483.50 Per Service
Summit CountySurgery C-Section Delivery Package - includes:
  • Up to 13 prenatal visits (after initial visit)
  • Routine prenatal urinalysis tests
  • Labor, delivery
  • Uncomplicated postpartum care
Cesarean Delivery59510$4,235.50 Per Service
Summit CountySurgeryC-Section - Delivery OnlyCesarean Delivery Only59514$1,680.50 Per Service
Summit CountySurgerySpinal injection - epidural with imaging - Lumbar/Sacrum single levelInjection transforminal Epidural Lumbar/Sacral64483$214.00 Per Service
Summit CountySurgerySpinal Facet Injection with imaging - Lumbar/Sacrum single levelInjection Paravertebral Facet Joint L/S 1 Lev64493$175.70 Per Service
Summit CountySurgeryBilateral Chemodenervation of Muscle(s) (eg: Botox for Migraines)Chemodenervation of Muscle(s) for Migraine64615$269.00 Per Service
Summit CountyRadiologyChest X-Ray - 2 view Chest X-Ray 2 view Frontal&Lateral71020$50.50 Per Service
Summit CountyRadiologyX-Ray of Shoulder - completeX-Ray Exam Of Shoulder73030$53.50 Per Service
Summit CountyRadiologyX-Ray of Wrist - complete X-Ray Exam Of Wrist73110$63.50 Per Service
Summit CountyRadiologyX-Ray of Knee - 3 viewsX-Ray Exam Of Knee 373562$65.00 Per Service
Summit CountyRadiologyX-Ray of Ankle - completeX-Ray Exam Of Ankle73610$57.00 Per Service
Summit CountyRadiologyX-Ray of foot - completeX-Ray Exam Of Foot73630$53.50 Per Service
Summit CountyRadiologyUltrasound Breast Limited - UnilateralUltrasound Breast Limited76642$160.50 Per Service
Summit CountyRadiologyOB Ultrasound first trimester - Single FetusOB Ultrasound 76801$225.00 Per Service
Summit CountyRadiologyOB Ultrasound after first trimester - Single FetusOb Ultrasound >/= 14 Wks Single Fetus76805$259.50 Per Service
Summit CountyRadiologyOB Ultrasound Follow-Up Per FetusOB Ultrasound Follow-Up Per Fetus76816$211.00 Per Service
Summit CountyRadiologyTransvaginal ultrasound - obstetricTransvaginal Ultrasound Obstetric76817$177.00 Per Service
Summit CountyRadiologyTransvaginal ultrasound - not obstetricTransvaginal Ultrasound Non-Ob76830$222.50 Per Service
Summit CountyRadiology3D screening breast mammography - bilateralBreast Tomosynthesis Biopsy77063$99.50 Per Service
Summit CountyRadiologyScreening Mammogram - Bilateral Screening Mamm Bilat Incl Cad When Perf77067$245.00 Per Service
Summit CountyLab PathAutomated Urinalysis without microscopyUrinalysis Auto W/O Scope81003$5.00 Per Service
Summit CountyLab PathInfluenze A or B TestInfluenza Assay W/Optic87804$29.00 Per Service
Summit CountyLab PathStrep A TestStrep A Assay W/Optic87880$29.00 Per Service
Summit CountyMedicineImmunization admistration with counseling - ages of 0-18Im Admin 1St/Only Component90460$37.50 Per Service
Summit CountyMedicineImmunization administration with counseling - additional vaccines - ages of 0-18Im Admin Each Addl Component90461$23.00 Per Service
Summit CountyMedicineImmunization administration - initial vaccineImmunization Admin90471$37.50 Per Service
Summit CountyMedicineImmunization administration - additional administrationImmunization Admin Each Add90472$23.00 Per Service
Summit CountyMedicineHPV VaccineVaccine 2/3 Dose Im90651$172.00 Per Service
Summit CountyMedicinePneumonia 13 VaccinePcv13 Vaccine Im90670$283.64 Per Service
Summit CountyMedicineFlu Vaccine - preservative freeFlu Vacinne 0.5 Ml Intramuscular90686$24.00 Per Service
Summit CountyMedicineFlu VaccineFlu Vaccine Split 0.5 Ml Intramuscular90688$22.50 Per Service
Summit CountyMedicineTetanus Diptheria Vaccine administered to individuals 7 years or olderTetanus Diptheria Vaccine 7 Yrs/> Intramuscular90715$53.00 Per Service
Summit CountyMedicinePsychotherapy Evalutation - 30 MinutesPsychotherapy Evalutation with E/M 30 Min90833$122.00 Per Service
Summit CountyMedicinePsychotherapy Evaluation - 45 MinutesPsychotherapy Evaluation with E/M 45 Minutes90834$156.00 Per Service
Summit CountyMedicineElectroconvulsive TherapyElectroconvulsive Therapy90870$205.37 Per Service
Summit CountyMedicineComprehensive Hearing TestComprehensive Hearing Test92557$68.00 Per Service
Summit CountyMedicineElectrocardiogram (EKG) CompleteElectrocardiogram Complete93000$31.00 Per Service
Summit CountyMedicineElectrocardiogram (EKG) ReportElectrocardiogram Report93010$15.50 Per Service
Summit CountyMedicineEchocardiogram with Doppler StudyTransthoracic Echo w/Doppler Complete93306$379.50 Per Service
Summit CountyMedicineHeart Stress Test CompleteStress Test Complete93351$424.00 Per Service
Summit CountyMedicineHeart Angiogram including Left Heart Catherization L Hrt Artery/Ventricle Angio93458$1,841.50 Per Service
Summit CountyMedicineAbdominal/Pelvic ultrasound study -arteries/veins - LimitedVascular Study93976$276.00 Per Service
Summit CountyMedicineTherapeutic Exercises, each 15 minutesTherapeutic Exercises97110$55.50 Per Service
Summit CountyMedicineManual therapy for 1 or more regions, each 15 minutesManual Therapy 1/> Regions97140$50.50 Per Service
Summit CountyMedicinePhysical therapy evaluation - low complexity (about 20 Minutes)Physical therapy Evaluation Low Complex 20 Min97161$151.50 Per Service
Summit CountyEvaluation and MgmtLevel 2 office visit for a new patient Office/Outpatient Visit New Patient99202$135.50 Per Service
Summit CountyEvaluation and MgmtLevel 3 office visit for a new patient Office/Outpatient Visit New Patient99203$194.50 Per Service
Summit CountyEvaluation and MgmtLevel 4 office visit for a new patient Office/Outpatient Visit New Patient99204$296.00 Per Service
Summit CountyEvaluation and MgmtLevel 5 office visit for a new patient Office/Outpatient Visit New Patient99205$372.50 Per Service
Summit CountyEvaluation and MgmtLevel 2 office visit for an established patientOffice/Outpatient Visit Established Patient99212$79.50 Per Service
Summit CountyEvaluation and MgmtLevel 3 office visit for an established patientOffice/Outpatient Visit Established Patient99213$131.50 Per Service
Summit CountyEvaluation and MgmtLevel 4 office visit for an established patientOffice/Outpatient Visit Established Patient99214$193.50 Per Service
Summit CountyEvaluation and MgmtLevel 5 office visit for an established patientOffice/Outpatient Visit Established Patient99215$261.00 Per Service
Summit CountyEvaluation and MgmtInitial preventative visit for a newpatient less than one year oldInit Preventative E/M New Patient Infant99381$199.50 Per Service
Summit CountyEvaluation and MgmtInitial preventative visit for a new patient between the ages 1-4Init Preventative E/M New Patient 1-4 Yrs99382$208.50 Per Service
Summit CountyEvaluation and MgmtInitial preventative visit for a new patient between the ages 5-11Previous Visit New Age 5-1199383$216.50 Per Service
Summit CountyEvaluation and MgmtInitial preventative visit for a new patient between the ages 12-17Previous Visit New Age 12-1799384$244.50 Per Service
Summit CountyEvaluation and MgmtInitial preventative visit for a new patient between the ages 18-39Prev Visit New Patient Age 18-3999385$237.00 Per Service
Summit CountyEvaluation and MgmtInitial preventative visit for a new patient between the ages 40-64Prev Visit New Patient Age 40-6499386$275.00 Per Service
Summit CountyEvaluation and MgmtPreventive visit for an established infant patient less than one year oldPreventive Visit Reevaluation Established Pat Infant99391$179.00 Per Service
Summit CountyEvaluation and MgmtPreventive visit for an established patient between the ages of 1-4Preventive Visit Established Patient Age 1-499392$191.00 Per Service
Summit CountyEvaluation and MgmtPreventive visit for an established patient between the ages of 5-11Preventive Med Visit Established Pateint Age 5-1199393$190.50 Per Service
Summit CountyEvaluation and MgmtPreventive visit for an established patient between the ages of 12-17Preventive Visit Established Patient Age 12-1799394$209.00 Per Service
Summit CountyEvaluation and MgmtPreventive visit for an established patient between the ages of 18-39Prev Visit Established Patient Age 18-3999395$213.50 Per Service
Summit CountyEvaluation and MgmtPreventive visit for an established patient between the ages of 40-64Prev Visit Est Age 40-6499396$227.00 Per Service
Summit CountyEvaluation and MgmtPreventive visit for an established patients ages 65 and overEstablished Patient Reevaluation65+ Yr99397$245.00 Per Service

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Our goal is to provide meaningful and reliable information to help you understand prices in advance of your visit. We have put together the top outpatient visits and procedure costs by region for self-pay individuals to give you an estimate of the expected pricing for commonly provided health care services at a Centura Health practice or clinic.

Actual prices on the final bill may vary from this information based on the provider providing the services, the patient’s medical condition, unknown circumstances or complications, final diagnosis, and recommended treatment ordered.  Please be advised that while Centura Health attempts to estimate the prices of care as accurately as possible, there may be significant variations between the prices listed and the actual price reflected on your final bill.

These are physician fees only. You may incur other charges from the entity where services were rendered. 

If you do not see the procedure or service you are looking for, or wish to receive a customized estimate on a specific procedure, please request a custom estimate.