ProMedica Fostoria Community Hospital — price list
← Hospital overviewVerified from ProMedica Fostoria Community 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.
264 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Rb semiprivate Inpatient | 12000000 CDM | $2,552 | $1,659 | $1,353 – $5,495 | — | |
| Rb semiprivate swing bed Inpatient | 12000002 CDM | $1,359 | $883 | $720 – $5,495 | — | |
| Pbb albuterol inhal Inpatient | J7613 HCPCS | $9.00 | $5.85 | $4.77 – $7.18 | — | |
| Pbb albuterol inhal Outpatient | J7613 HCPCS | $9.00 | $5.85 | $0.03 – $7.18 | — | |
| Pbb albuterol noncompounded Inpatient | J7620 HCPCS | $9.00 | $5.85 | $4.77 – $7.18 | — | |
| Pbb albuterol noncompounded Outpatient | J7620 HCPCS | $9.00 | $5.85 | $0.13 – $7.18 | — | |
| Pbb albuterolinhal solcompo Inpatient | J7610 HCPCS | $9.00 | $5.85 | $4.77 – $7.18 | — | |
| Pbb albuterolinhal solcompo Outpatient | J7610 HCPCS | $9.00 | $5.85 | $1.90 – $8.24 | — | |
| Pbb arthrocnt aspirinj interm jtburs no US Inpatient | 20605 CPT | $1,143 | $743 | $606 – $912 | — | |
| Pbb arthrocnt aspirinj interm jtburs no US Outpatient | 20605 CPT | $1,143 | $743 | $241 – $912 | — | |
| Pbb arthrocnt aspirinj major jtbursa no US Inpatient | 20610 CPT | $750 | $488 | $398 – $599 | — | |
| Pbb arthrocnt aspirinj major jtbursa no US Outpatient | 20610 CPT | $750 | $488 | $158 – $599 | — | |
| Pbb arthrocnt aspirinj small jtbursa no US Inpatient | 20600 CPT | $993 | $645 | $526 – $792 | — | |
| Pbb arthrocnt aspirinj small jtbursa no US Outpatient | 20600 CPT | $993 | $645 | $210 – $792 | — | |
| Pbb blood occult by peroxidase qualitative feces Inpatient | 82272 CPT | $59.00 | $38.35 | $31.27 – $47.08 | — | |
| Pbb blood occult by peroxidase qualitative feces Outpatient | 82272 CPT | $59.00 | $38.35 | $2.27 – $47.08 | — | |
| Pbb boniva ibandronate sodium 1 mg Inpatient | J1740 HCPCS | $398 | $259 | $211 – $318 | — | |
| Pbb boniva ibandronate sodium 1 mg Outpatient | J1740 HCPCS | $398 | $259 | $29.31 – $318 | — | |
| Pbb brief emotionalbehav assmt Inpatient | 96127 CPT | $142 | $92.30 | $75.26 – $113 | — | |
| Pbb brief emotionalbehav assmt Outpatient | 96127 CPT | $142 | $92.30 | $29.97 – $113 | — | |
| Pbb chemodenverv musc migraine Inpatient | 64615 CPT | $750 | $488 | $398 – $599 | — | |
| Pbb chemodenverv musc migraine Outpatient | 64615 CPT | $750 | $488 | $158 – $599 | — | |
| Pbb collection capillary blood specimen Inpatient | 36416 CPT | $22.00 | $14.30 | $11.66 – $17.56 | — | |
| Pbb collection capillary blood specimen Outpatient | 36416 CPT | $22.00 | $14.30 | $4.63 – $17.56 | — | |
| Pbb consultation oplevel 1 Inpatient | 99211 CPT | $154 | $100 | $81.62 – $123 | — | |
| Pbb consultation oplevel 1 Outpatient | 99211 CPT | $154 | $100 | $32.50 – $123 | — | |
| Pbb consultation oplevel 2 Inpatient | 99212 CPT | $154 | $100 | $81.62 – $123 | — | |
| Pbb consultation oplevel 2 Outpatient | 99212 CPT | $154 | $100 | $32.50 – $123 | — | |
| Pbb consultation oplevel 3 Inpatientapprox. match | 99213 CPT | $154 | $100 | $81.62 – $123 | — | |
| Pbb consultation oplevel 3 Outpatientapprox. match | 99213 CPT | $154 | $100 | $32.50 – $123 | — |