Plain Church: disclosed hospital rates

iDirect answer

Based on the published hospital price files, Plain Church appears in disclosed negotiated rates across 4 hospitals and 1785 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

1,785 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
83021 HEMOGLOBIN FRACTJ/QUANT CHROMOTOGRAPHY Inpatient	Elkhart General Hospital	83021 CPT	$60.00	$39.00	$12.00 – $78.00	—
83704 LIPOPROTEIN BLD QUAN PART Inpatient	Elkhart General Hospital	83704 CPT	$113	$73.45	$22.60 – $147	—
84140 PREGNENOLONE LAB Inpatient	Memorial Hospital of South Bend	84140 CPT	$268	$174	$53.60 – $220	—
84154 ASSAY OF PSA FREE Inpatient	Memorial Hospital of South Bend	84154 CPT	$387	$252	$77.40 – $317	—
84155 ASSAY OF PROTEIN SERUM Inpatient	Memorial Hospital of South Bend	84155 CPT	$79.00	$51.35	$15.80 – $64.78	—
84156 ASSAY OF PROTEIN URINE Inpatient	Memorial Hospital of South Bend	84156 CPT	$354	$230	$70.80 – $290	—
84202 ASSAY RBC PROTOPORPHYRIN Inpatient	Memorial Hospital of South Bend	84202 CPT	$294	$191	$58.80 – $241	—
84244 ASSAY OF RENIN Inpatient	Memorial Hospital of South Bend	84244 CPT	$462	$300	$92.40 – $379	—
84392 ASSAY OF URINE SULFATE Inpatient	Memorial Hospital of South Bend	84392 CPT	$100	$65.00	$20.00 – $82.00	—
84394 Test for total Tau protein Inpatient	Memorial Hospital of South Bend	84394 CPT	$648	$421	$130 – $531	—
84402 ASSAY OF FREE TESTOSTERONE Inpatient	Memorial Hospital of South Bend	84402 CPT	$539	$350	$108 – $442	—
84403 ASSAY OF TOTAL TESTOSTERONE Inpatient	Memorial Hospital of South Bend	84403 CPT	$513	$333	$103 – $421	—
84478 ASSAY OF TRIGLYCERIDES Inpatient	Memorial Hospital of South Bend	84478 CPT	$133	$86.45	$26.60 – $109	—
84479 THYROID HORM (T3/T4) UPTK OR THBR Inpatient	Elkhart General Hospital	84479 CPT	$87.00	$56.55	$17.40 – $113	—
84560 ASSAY OF URINE/URIC ACID Inpatient	Memorial Hospital of South Bend	84560 CPT	$105	$68.25	$21.00 – $86.10	—
84702 CHORIONIC GONADOTROPIN TEST Inpatient	Memorial Hospital of South Bend	84702 CPT	$130	$84.50	$26.00 – $107	—
84999 CLINICAL CHEMISTRY TEST Inpatient	Memorial Hospital of South Bend	84999 CPT	$76.00	$49.40	$15.20 – $62.32	—
85014 HEMATOCRIT Inpatient	Memorial Hospital of South Bend	85014 CPT	$59.00	$38.35	$11.80 – $48.38	—
85018 IH HEMOGLOBIN Inpatient	Memorial Hospital of South Bend	85018 CPT	$124	$80.60	$24.80 – $102	—
85018 IH HEMOGLOBIN Inpatient	Elkhart General Hospital	85018 CPT	$26.00	$16.90	$5.20 – $33.80	—
85360 EUGLOBULIN LYSIS Inpatient	Memorial Hospital of South Bend	85360 CPT	$111	$72.15	$22.20 – $91.02	—
85384 Fibrinogen Activity Inpatient	Memorial Hospital of South Bend	85384 CPT	$171	$111	$34.20 – $140	—
85385 FIBRINOGEN ANTIGEN Inpatient	Community Hospital of Bremen	85385 CPT	$62.00	$40.30	$31.00 – $80.60	—
85390 Fibrinolysis Inpatient	Memorial Hospital of South Bend	85390 CPT	$75.00	$48.75	$15.00 – $61.50	—
85410 FIBRINOLYTIC ANTIPLASMIN Inpatient	Elkhart General Hospital	85410 CPT	$129	$83.85	$25.80 – $168	—