Hospital Pricing

In compliance with state law, Twin City Hospital is providing this price list containing our charges for room and board, emergency department, operating room, 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 billing staff to determine whether they qualify for discounts. These prices are correct as of 10/15/2009.

Room and Board -- Per Day Charges
Intensive care
	Level 1	(Stepdown)		$597.00
	Level 2			$882.00
SemiPrivate				$422.00
Skilled Swing Bed Unit				$260.00
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. The physician charge associated with each level is listed separately and will be billed separately from the hospital charge.
Facility Charge				Physician Charge
Level 1		$93.00		Evaluation/Management 1			$35.00
Level 2		$108.00		Evaluation/Management 2			$63.00
Level 3		$220.50		Evaluation/Management 3			$113.00
Level 4		$333.50		Evaluation/Management 4			$204.50
Level 5		$451.50		Evaluation/Management 5			$373.50
Operating Room Charges
Operating Room charges are based on the complexity level, with level 1 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.
		Set-Up Charge		Additional 15-Minute Charge
Level 1		$1,704.00		$444.00
Physical Therapy Charges
The following charges reflect the most common services offered by our Physical Therapy department. Patients may have additional charges, depending on the services performed.
Evaluation				$134.50
Balance & Coordination Exercise				$69.50
Manual Electrical Stimulation				$41.00
Gait Training/Stair Climbing				$60.00
Therapeutic Activities/Functional Improvement				$52.00
Ultrasound each 15 min				$38.00
Occupational Therapy Charges
The following charges reflect the most common services offered by our Occupational Therapy department. Patients may have additional charges, depending on the services performed.
Evaluation				$134.50
Self Care Management Training				$60.00
Therapeutic Activities/Functional Improvement				$60.00
Therapeutic Procedure				$60.00
Ultrasound each 15 min				$28.50
Pulmonary Therapy Charges
The following charges reflect the most common services offered by our Pulmonary Therapy department. Patients may have additional charges, depending on the services performed.
Cardiac Rehab Evaluation				$32.00
Pulmonary Rehab Initial Eval				$224.50
Aerosal Initial				$104.50
Pulse Oximetry (Single Determination)				$53.50
Pulse Oximetry (Multiple Determination)				$110.00
Diffusion Studies				$255.50
Incentive Spirometry Treatment				$159.50
Lung Volume Studies				$255.50
Postural Drainage and Percussion				$104.50
X-Ray and Radiological Charges
The following charges reflect the hospital's 30 most common x-ray and radiological procedures.
Chest (2 views)					$194.50
Chest (1 view)					$194.50
Spine Lumbosacral (2-3 views)					$194.50
Bilateral Mammogram Screening					$105.00
Foot Complete					$173.50
Abdomen Series Acute					$322.00
Spine Cervical Complete					$322.00
Ankle Complete					$173.50
Abdomen Single View					$194.50
Knee					$184.00
Hand Complete					$173.50
Shoulder Complete					$184.00
Doppler Echo Color Flow Mapping					$389.50
Ultrasound Echo 2D Complete					$1,763.50
Ultrasound Echo Doppler					$206.50
CT Brain without Contrast					$660.50
CT Abdomen with & without Contrast					$1,428.00
CT Pelvis with contrast					$1,217.00
CT Abdomen without Contrast					$842.50
CT Chest/Thorax with Contrast					$1,217.00
CT Pelvis without Contrast					$842.50
CT Brain with & without Contrast					$1,428.00
Ultrasound Pelvis Non-Obstetric					$429.00
Ultrasound -Duplex Extracranial Arteries Bilateral					$715.00
Ultrasound Renal					$419.00
Ultrasound -Duplex Extremities Veins Unilateral					$499.00
Ultrasound Abdomen Complete					$419.00
Myocardial Perfusion Imaging SPECT Multi Study					$3,215.50
Myocardial Perfusion Study with ejection fraction					$314.00
Bone Densitometry Imaging (DEXA)					$395.00
Laboratory Charges
The following charges reflect the hospital's 30 most common laboratory procedures.
Activated Partial Thromboplastin Time (APTT)					$35.50
ALT					$31.50
Amylase, Serum					$38.50
AST (SGOT)					$30.50
Basic Metabolic Panel					$103.00
CBC with Diff					$46.00
CKMB					$75.50
Comprehensive Metabolic Panel					$166.50
CPK					$38.50
Creatinine					$30.50
Blood Culture					$61.00
Throat Culture					$53.50
Urine Culture					$48.00
Glucose					$23.00
Hemoglobin A1C					$57.00
Lipase					$4.50
Lipid Panel					$75.00
Hepatic Function Panel					$91.50
Magnesium					$34.00
Microalbumin, Random Urine					$34.00
NT - proBNP					$199.00
Phosphorous					$28.50
Prothombin Time					$27.00
t4 Free					$53.00
Troponin I					$80.50
TSH					$98.50
Urinalysis					$28.00
Surgical Path Level IV					$153.00
Fecal Occult Blood					$23.00
Renal Function Panel					$132.50
Pap Test (Thin Prep)					$116.50
HOSPITAL BILLING POLICIES
It is the policy of Twin City Hospital that quality care is administered regardless of race, creed, income, social status, national origin, handicap, or sex. Twin City Hospital is happy to file all verified insurance on the patient's behalf for payment of the bill(s). Please be advised, however, that the insurance policy is a contract between the subscriber and the insurance company.  Those patients holding a PPO, HMO, or other individual policy are ultimately responsible for the total bill or the portion of the bill the insurance plan does not pay. While we will make every effort to collect payment on the account from the insurance company, it is common that a situation arises in which we require assistance or information from the patient or guarantor to resolve an account. Not all services are a covered benefit by all insurance companies.  It is the responsibility of the insurance plan subscriber to be aware of the benefits allowed by his/her specific plan. Coverage issues can only be addressed by your employer, group administrator, or caseworker.  Those patients that are uninsured or simply unable to pay can reach a Financial Counselor to discuss financial assistance options Monday-Friday 8:00am to 4:00pm at 740-922-7450 ext. 2254. We can assist you in filling out a Medicaid application or review your financial situation to assess if you qualify for the Hospital Care Assurance Program (HCAP) or other available discount or payment programs. We understand the high cost of health care can be overwhelming and are dedicated to helping every patient in their individual situations. We cannot, however, help those that do not make us aware of their situations. In the case that we have had no payment or personal response to our inquiries for payment we have no choice but to assume that the patient/guarantor is not willing to resolve the account.  We do send unpaid, delinquent accounts to an outside collection agency for additional attempts at payment. Those outside agencies do report to credit bureaus and in some instances even pursue legal action against the patient/ guarantor.  This action can typically be avoided with your cooperation. We are available to answer any additional billing questions at our business office. The following is a list of contact information should you have questions regarding billing for specific services: Twin City Hospital              Twin City Hospital           Tri County Radiology      Modern Pathology Patient Accounts               Anesthesia Services        Billing Office                  1320 Mercy Drive 819 N First Street              740-922-7450 ext. 2189    819 N First Street          Canton, Ohio 44709 Dennison, Ohio 44621                                             Dennison, Ohio 44621     800-288-8325 740-922-2800                                                          740-922-7450 ext. 2217