ProMedica Defiance Regional Hospital — price list

← Hospital overviewVerified from ProMedica Defiance Regional Hospital’s published price file

Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

286 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Intravenous infusion casirivimabimdevimab Inpatient	M0243 HCPCS	$1,661	$1,080	$864 – $1,661	—
Intravenous infusion casirivimabimdevimab Outpatient	M0243 HCPCS	$1,661	$1,080	$303 – $1,661	—
IV inf hydrate 1st hr Inpatient	96360 CPT	$515	$335	$268 – $515	—
IV inf hydrate 1st hr Outpatient	96360 CPT	$515	$335	$93.87 – $505	—
IV inf hydrate add hr Inpatient	96361 CPT	$326	$212	$170 – $326	—
IV inf hydrate add hr Outpatient	96361 CPT	$326	$212	$59.42 – $319	—
IV inf txprodx 1st hr Inpatient	96365 CPT	$515	$335	$268 – $515	—
IV inf txprodx 1st hr Outpatient	96365 CPT	$515	$335	$93.87 – $505	—
IV inf txprodx add hr Inpatient	96366 CPT	$338	$220	$176 – $338	—
IV inf txprodx add hr Outpatient	96366 CPT	$338	$220	$61.61 – $331	—
IV infusion etesevimabbamianivimab Inpatient	M0245 HCPCS	$1,661	$1,080	$864 – $1,661	—
IV infusion etesevimabbamianivimab Outpatient	M0245 HCPCS	$1,661	$1,080	$303 – $1,661	—
IV infusion sotrovimab Inpatient	M0247 HCPCS	$1,661	$1,080	$864 – $1,661	—
IV infusion sotrovimab Outpatient	M0247 HCPCS	$1,661	$1,080	$303 – $1,661	—
Nonchemo initiate infusion 8hrs Inpatient	C8957 HCPCS	$1,384	$900	$720 – $1,384	—
Nonchemo initiate infusion 8hrs Outpatient	C8957 HCPCS	$1,384	$900	$252 – $1,384	—
Rb ach intermediate Inpatient	20600005 CDM	$4,910	$3,192	$1,600 – $5,836	—
Rb ach private med surg Inpatient	11100002 CDM	$2,827	$1,838	$1,470 – $5,836	—
Rb emergency Inpatient	12100002 CDM	$2,827	$1,838	$1,470 – $5,836	—
Rb intermediate Inpatient	20600000 CDM	$4,910	$3,192	$1,600 – $5,836	—
Rb nursery Inpatient	17100000 CDM	$2,596	$1,687	$1,350 – $5,836	—
Rb nursery level 2 Inpatient	17200002 CDM	$2,827	$1,838	$1,470 – $5,836	—
Rb private ICU Inpatient	20000000 CDM	$5,655	$3,676	$1,600 – $5,836	—
Rb private med surg Inpatient	11100000 CDM	$2,827	$1,838	$1,470 – $5,836	—
Rb private peds Inpatient	11300000 CDM	$2,827	$1,838	$1,470 – $5,836	—
Rb private psych Inpatient	11400000 CDM	$2,827	$1,838	$1,132 – $3,128	—
Rb private psych ICU Inpatient	20400000 CDM	$4,893	$3,180	$1,132 – $4,893	—
Rb semi private ob Inpatient	12200000 CDM	$2,827	$1,838	$1,470 – $5,836	—
Rb semiprivate swing bed Inpatient	12000002 CDM	$1,345	$874	$699 – $5,836	—
Txprodg addl seq IV inf Inpatient	96367 CPT	$176	$114	$91.52 – $176	—