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Patient Price Information List

Disclaimer: Salina Surgical Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, Salina Surgical Hospital has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2020. Salina Surgical Hospital's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Manhattan Surgical Center

Manhattan

KS

McPherson Hospital

McPherson

KS

Memorial Hospital

Abilene

KS

Salina Regional Health Center

Salina

KS

Summit Surgical

Hutchinson

KS

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$1,105
$1,739

36% lower than market

CMS SHOPPABLE SERVICE

Description

Our Charge
Market Charge

Variance

Biopsy of the Esophagus, Stomach, Using an Endoscope

$1,264
$1,397

10% lower than market

Biopsy of Large Bowel, Using an Endoscope

$1,615
$2,378

32% lower than market

CT Head Brain without Contrast

$1,674
$1,833

9% lower than market

CT Abdomen & Pelvis with Contrast

$1,191
$2,860

58% lower than market

CT Pelvis with Contrast

$1,674
$1,975

15% lower than market

Diagnostic Examination of Esophagus, Stomach, and/or Upper Small Bowel with Endoscope

$1,264
$1,240

2% higher than market

Colonscopy

$2,150
$2,089

3% higher than market

Removal of 1 or more breast growth, open procedure

$8,526
$4,870

75% higher than market

Gallbladder Removal Using an Endoscope

$13,604
$8,508

60% higher than market

Removal of one knee cartilage using an endoscope

$7,704
$7,350

5% higher than market

Colonoscopy with removal of polyp(s)

$2,826
$1,959

44% higher than market

Removal of recurring cataract in lens capsule using laser

$1,427
$1,086

31% higher than market

Repair of groin hernia patient age 5 years or older

$8,751
$6,250

40% higher than market

Shaving of shoulder bone using an endoscope

$2,855
$5,453

48% lower than market

Spinal fusion other than the neck without major complications

$32,441
$94,303

66% lower than market

Total Knee or Hip Replacement

$27,854
$47,014

41% lower than market

Uterus or Ovary Surgery Not Related to Cancer without complications

$17,844
$34,147

48% lower than market

OUTPATIENT CLINIC

Description

Our Charge
Market Charge

Variance

Established patient office visit, complex

$100
$151

34% lower than market

OUTPATIENT MEDICINE SERVICES

Description

Our Charge
Market Charge

Variance

Electronic analysis and programming of implanted complex spinal cord or peripheral neurostimulator

$319
$1,000

68% lower than market

Hydration Infusion into a Vein

$107
$178

40% lower than market

Infusion into a Vein for Therapy, Diagnosis, or Prevention

$107
$176

39% lower than market

Injection of Same Drug into Vein for Therapy or Diagnosis

$112
$145

23% lower than market

Measurement of esophageal swallowing movement

$1,367
$1,448

6% lower than market

Monitoring and recording of gastroesophageal reflux through nose including analysis and interpretati

$1,001
$1,448

31% lower than market

Monitoring and recording of gastroesophageal reflux with pH electrode insertion including analysis a

$1,210
$1,236

2% lower than market

Debridement, open wound; each additional 20cm2 or part thereof

$100
$291

66% lower than market

Debridement, open wound; first 20 cm2 or less

$492
$457

8% higher than market

OUTPATIENT OBSERVATION

Description

Our Charge
Market Charge

Variance

Hospital Observation per Hour

$39
$93

59% lower than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION

Description

Our Charge
Market Charge

Variance

Injection, atropine sulfate, 0.01 mg

$10
$16

41% lower than market

Injection, Cefazolin Sodium, 500 mg

$21
$21

3% higher than market

Injection, Dexamethasone Sodium Phosphate, 1 mg

$1
$3

58% lower than market

Injection, Diphenhydramine HCL, up to 50 mg

$6
$20

68% lower than market

Injection, Fentanyl Citrate, 0.1 mg

$5
$21

73% lower than market

Injection, garamycin, gentamicin, up to 80 mg

$8
$22

65% lower than market

Injection, Enoxaparin Sodium, 10 mg

$3
$6

42% lower than market

Injection, Heparin Sodium, per 1000 Units

$2
$5

63% lower than market

Injection, Midazolam Hydrochloride, per 1 mg

$2
$10

77% lower than market

Injection, propofol, 10 mg

$1
$2

34% lower than market

Injection, Levofloxacin, 250 mg

$36
$34

6% higher than market

Injection, Metoclopramide HCL, Up to 10mg

$10
$31

68% lower than market

Injection, neostigmine methylsulfate, up to 0.5 mg

$8
$39

79% lower than market

Injection, Ondansetron Hydrochloride, per 1 mg

$1
$5

75% lower than market

Injection, Promethazine HCL, up to 50 mg

$7
$26

73% lower than market

Injection, Vancomycin HCL, 500 mg

$18
$24

24% lower than market

OUTPATIENT PROSTHETIC PROCEDURES

Description

Our Charge
Market Charge

Variance

Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies

$1,540
$1,299

19% higher than market

OUTPATIENT SUPPLIES

Description

Our Charge
Market Charge

Variance

Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)

$743
$770

4% lower than market

Ocular implant, aqueous drainage assist device

$5,125
$5,125

Approximately equal to market

Prosthesis, urinary sphincter (implantable)

$11,764
$33,226

65% lower than market

Prosthesis, penile, inflatable

$19,410
$28,481

32% lower than market

Stent, non-coronary, temporary, with delivery system

$470
$482

2% lower than market

OUTPATIENT SURGICAL SERVICES

Description

Our Charge
Market Charge

Variance

Amputation, toe; interphalangeal joint

$7,704
$6,906

12% higher than market

Anus procedure

$2,150
$2,943

27% lower than market

Application of Short Leg Splint (Calf to Foot)

$376
$320

18% higher than market

Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee

$583
$825

29% lower than market

Aspiration and/or injection: large joint/bursa

$737
$847

13% lower than market

Balloon dilation of large bowel using an endoscope

$2,826
$2,942

4% lower than market

Dilation of large bowel stricture using an endoscope

$1,615
$1,477

9% higher than market

Balloon dilation of pancreatic or bile duct using an endoscope

$4,578
$3,960

16% higher than market

Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)

$1,615
$1,477

9% higher than market

Biopsy of rectum and large bowel using an endoscope

$1,615
$2,509

36% lower than market

Biopsy and/or removal of polyp of the uterus using an endoscope

$7,031
$5,941

18% higher than market

Biopsy of breast accessed throught the skin with ultrasound guidance; each additional lesion

$1,490
$2,326

36% lower than market

Biopsy of breast, open procedure

$8,526
$8,752

3% lower than market

Biopsy of cervix or excision of local growths

$1,583
$2,507

37% lower than market

Biopsy of vagina and cervix using an endoscope

$1,797
$2,461

27% lower than market

Biopsy or removal of lymph nodes of under the arm, open procedure

$8,526
$7,205

18% higher than market

Blood vessel procedure

$1,775
$7,192

75% lower than market

Closed treatment of dislocated hip prosthesis under anesthesia

$3,815
$5,654

33% lower than market

Closed treatment of finger tendon

$3,815
$5,404

29% lower than market

Colorectal Cancer Screening; Colonoscopy on Non-High Risk Patient

$1,229
$1,798

32% lower than market

Colonoscopy on High Cancer Risk Patient

$1,229
$1,907

36% lower than market

Complex control of nose bleed

$321
$1,222

74% lower than market

Bunionectomy

$7,704
$8,963

14% lower than market

Crushing, fragmenting, and removal of bladder stones, complicated or larger than 2.5 centimeters

$8,495
$15,054

44% lower than market

Colonoscopy, flexible; with ablation of tumor(s), polyp(s) or other lesion(s)

$1,615
$1,499

8% higher than market

Destruction of tissue in the bladder, bladder canal (urethra) or surrounding glands using an endosco

$4,986
$10,905

54% lower than market

Diagnostic examination of rectum and large bowel using an endoscope

$1,229
$1,986

38% lower than market

Diagnostic examination of small bowel using an endoscope

$2,505
$2,942

15% lower than market

Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope

$1,566
$3,081

49% lower than market

Drainage of Abscess

$492
$410

20% higher than market

Drainage of blood or fluid accumulation

$3,863
$4,462

13% lower than market

Drainage of rectal abscess, perianal

$2,150
$3,088

30% lower than market

Insertion of Breathing Tube Using an Endoscope

$314
$729

57% lower than market

Exploration of the scrotal sac of testicle

$4,809
$5,357

10% lower than market

Extensive repair of turning-outward eyelid defect

$5,446
$5,096

7% higher than market

Arthrodesis, great toe; metatarsophalangeal joint

$14,430
$12,505

15% higher than market

Incision and drainage of abscess in scrotal sac of testicle

$3,863
$5,146

25% lower than market

Incision of bladder with drainage

$4,986
$5,887

15% lower than market

Incision of engorged external hemorrhoid

$378
$638

41% lower than market

Trigger Finger Release

$3,815
$4,598

17% lower than market

Incision of the bladder canal (urethra) using an endoscope

$4,986
$4,343

15% higher than market

Incision to repair tendon covering at wrist; deQuervains disease

$3,815
$4,674

18% lower than market

Injection of anesthetic agent, collar bone nerve

$1,759
$1,914

8% lower than market

Injection procedure into sacroiliac joint for anesthetic or steroid

$352
$716

51% lower than market

Injections of large bowel using an endoscope

$1,615
$1,502

8% higher than market

Injections into large bowel using an endoscope

$1,229
$1,507

18% lower than market

Injections of esophagus, stomach, and/or upper small bowel using an endoscope

$1,264
$1,396

9% lower than market

Insertion of arterial catheter for blood sampling or infusion, accessed through the skin

$100
$259

61% lower than market

Cystourethroscopy, with ureteral catheterization

$4,986
$5,404

8% lower than market

Insertion of drug delivery implant into tissue

$307
$278

10% higher than market

Insertion of eye fluid drainage device

$10,746
$9,367

15% higher than market

Insertion of guide wire with dilation of esophagus using an endoscope

$2,212
$2,010

10% higher than market

Insertion of Needle into Vein to Collect Blood

$8
$28

70% lower than market

Bladder instillation of cancer preventive, inhibiting, or suppressive agent

$661
$1,095

40% lower than market

Multiple incisions for removal of varicose veins of arm or leg, more than 20 incisions

$7,799
$17,370

55% lower than market

Nervous system procedure

$737
$2,817

74% lower than market

Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or

$14,430
$12,711

14% higher than market

Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial

$7,704
$6,995

10% higher than market

Partial removal of collar bone

$7,704
$8,299

7% lower than market

Partial removal of knee joint lining using an endoscope

$7,704
$7,349

5% higher than market

Laminectomy

$14,430
$26,248

45% lower than market

Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body are of infants and children)

$4,567
$5,887

22% lower than market

Placement of mesh to repair incisional or abdominal hernia, open procedure

$2,132
$4,391

51% lower than market

Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))

$10,554
$15,277

31% lower than market

Reconstruction of knee joint ligaments

$14,430
$12,646

14% higher than market

Rectal procedure

$2,150
$2,085

3% higher than market

Carpal Tunnel Release

$4,839
$4,585

6% higher than market

Ulnar Nerve Release

$4,839
$5,383

10% lower than market

Release of nerve between tissue and bone of foot

$4,839
$8,752

45% lower than market

Release of wrist ligament using an endoscope

$3,815
$6,659

43% lower than market

Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure)

$7,799
$7,515

4% higher than market

Relocation of mouth tissue to gum surface

$1,036
$4,747

78% lower than market

Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands; 20 sq cm or less

$4,567
$7,812

42% lower than market

Relocation of tendon of forearm and/or wrist

$7,704
$8,009

4% lower than market

Removal (3 centimeters or greater) tissue growth beneath the skin of back or flank

$3,863
$4,595

16% lower than market

Removal (3 centimeters or greater) tissue growth beneath the skin of shoulder area

$3,863
$7,903

51% lower than market

Removal (5 centimeters or greater) muscle growth of shoulder area

$6,526
$7,624

14% lower than market

Removal (5 centimeters or greater) muscle growth of thigh or knee

$6,526
$6,248

4% higher than market

Removal (less than 1.5 centimeters) tissue growth beneath the skin of foot or toe

$3,863
$3,581

8% higher than market

Removal (less than 3 centimeters) tissue growth beneath the skin of back or flank

$3,863
$7,624

49% lower than market

Removal of (less than 2 centimeter) tissue growth beneath the skin of face and scalp

$3,863
$4,411

12% lower than market

Removal of (less than 5 centimeters) muscle growth of neck or front of chest

$6,526
$7,289

10% lower than market

Removal of bone joints between wrist and fingers

$7,704
$8,165

6% lower than market

Removal of central venous catheter for infusion

$1,775
$1,834

3% lower than market

Removal of cyst at wrist (dorsal or volar); primary

$3,815
$6,482

41% lower than market

Removal of deep bone implant

$6,526
$6,121

7% higher than market

Removal of drain device from anus

$2,826
$3,641

22% lower than market

Removal of excessive skin and fat of upper eyelid

$4,567
$5,630

19% lower than market

Removal of excessive skin of lower eyelid and fat around eye

$4,567
$5,628

19% lower than market

Removal of external bone fixation under anesthesia

$3,815
$6,176

38% lower than market

Removal of fluid accumulation in sperm reservoir

$4,986
$5,942

16% lower than market

Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); extensors

$7,704
$6,576

17% higher than market

Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors

$3,815
$3,322

15% higher than market

Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope

$4,986
$4,400

13% higher than market

Removal of growth (0.5 centimeters or less) of the trunk, arms or legs

$1,717
$2,300

25% lower than market

Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth

$1,717
$3,227

47% lower than market

Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs

$1,717
$3,090

44% lower than market

Removal of growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs

$1,717
$4,273

60% lower than market

Removal of growth of tendon covering or joint capsule of foot

$3,815
$5,372

29% lower than market

Removal of growth of tendon finger or hand

$3,815
$5,150

26% lower than market

Removal of heel bone spur

$7,704
$8,641

11% lower than market

Removal of impact ear wax, one ear

$155
$176

12% lower than market

Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar

$7,886
$11,291

30% lower than market

Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips

$1,717
$1,674

3% higher than market

Removal of malignant growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals

$1,717
$2,226

23% lower than market

Removal of malignant growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs

$899
$757

19% higher than market

Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips

$3,863
$5,853

34% lower than market

Removal of malignant growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs

$1,717
$3,571

52% lower than market

Removal of malignant growth (over 4.0 centimeters) of the trunk, arms, or legs

$3,863
$3,306

17% higher than market

Removal of multiple internal and external hemorrhoids

$6,597
$5,597

18% higher than market

Removal of peripheral venous catheter for infusion

$1,775
$2,871

38% lower than market

Removal of anal growth

$2,826
$2,910

3% lower than market

Removal of skin and tissue

$220
$464

53% lower than market

Removal of skin and tissue first 20 sq cm or less

$899
$1,723

48% lower than market

Removal of skin and/or muscle first 20 sq cm or less

$1,399
$2,079

33% lower than market

Removal of stomach reduction device using an endoscope

$8,441
$8,630

2% lower than market

Removal of sutures under anesthesia by same surgeon

$1,399
$2,575

46% lower than market

Excision of pilonidal cyst or sinus; complicated

$6,526
$9,374

30% lower than market

Removal of thyroid; total

$13,604
$26,189

48% lower than market

Removal of tissue of palm; with release of single digit or skin grafting

$7,704
$12,642

39% lower than market

Removal of wrist bone cyst or growth

$7,704
$7,530

2% higher than market

Repair non-healed fracture of forearm bone with patient-derived bone graft

$13,857
$11,620

19% higher than market

Repair of anterior cruciate ligament of knee with assistance of an endoscope

$14,430
$12,646

14% higher than market

Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon

$7,704
$7,124

8% higher than market

Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon

$3,815
$4,799

21% lower than market

Repair of finger tendon using tissue

$7,704
$6,589

17% higher than market

Repair of fluid accumulation in testicle and sperm reservoir

$4,935
$4,873

1% higher than market

Repair recurrent inguinal hernia, any age; reducible

$8,751
$7,625

15% higher than market

Repair of hernia using an endoscope

$13,604
$11,966

14% higher than market

Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible

$20,295
$22,099

8% lower than market

Repair of knee joint using an endoscope, with meniscus repair (medial or lateral)

$7,704
$8,396

8% lower than market

Repair of knee joint and removal of scar tissue using an endoscope

$7,704
$6,825

13% higher than market

Total knee repair

$12,604
$17,193

27% lower than market

Repair of trapped groin hernia patient age 5 years or older

$8,751
$10,196

14% lower than market

Repair of trapped hernia at navel patient age 5 years or older

$8,751
$11,431

23% lower than market

Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals

$899
$1,400

36% lower than market

Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs

$899
$997

10% lower than market

Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs

$899
$2,378

62% lower than market

Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals

$1,399
$1,440

3% lower than market

Repair of Wound (2.6 to 7.5 centimeters)

$492
$462

6% higher than market

Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs

$899
$1,428

37% lower than market

Repair of Wound (7.6 to 12.5 cm)

$492
$459

7% higher than market

Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs

$899
$1,171

23% lower than market

Repair initial femoral hernia, any age; reducible

$8,751
$8,047

9% higher than market

Repair initial femoral hernia, any age; incarcerated or strangulated

$8,751
$7,334

19% higher than market

Repositioning of recurrent groin hernia using an endoscope

$13,604
$13,414

1% higher than market

Reshaping of nasal cartilage

$6,329
$6,173

3% higher than market

Revision of dialysis graft, open procedure

$12,935
$18,432

30% lower than market

Shoulder procedure

$607
$2,964

80% lower than market

Control Nose Bleed - Simple Case

$307
$503

39% lower than market

Skin, mucus membrane and beneath the skin procedure

$492
$2,557

81% lower than market

Bowel procedure

$1,264
$1,566

19% lower than market

Thigh or knee procedure

$607
$2,737

78% lower than market

Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, ne

$4,567
$8,462

46% lower than market

Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the trunk

$4,567
$9,361

51% lower than market

Transfusion of Blood or Blood Products

$1,092
$1,122

3% lower than market

Transplant of tendon of hand, without free graft

$7,704
$7,124

8% higher than market

Tying or biopsy of temporal artery (side of skull)

$3,863
$3,788

2% higher than market

Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries with repair of herniated bowel

$12,022
$14,420

17% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL

Description

Our Charge
Market Charge

Variance

CT Abdomen without Contrast

$1,674
$1,840

9% lower than market

CT Abdomen with Contrast

$2,016
$2,048

2% lower than market

CT Pelvis without Contrast

$1,674
$1,870

10% lower than market

CT Chest with and without Contrast

$2,016
$2,344

14% lower than market

CT Chest with Contrast

$1,674
$2,038

18% lower than market

Fluoroscopic guidance for insertion of needle

$100
$524

81% lower than market

Fluoroscopic guidance for insertion, replacement or removal of central venous access device

$242
$543

55% lower than market

Imaging of urinary tract

$1,191
$1,157

3% higher than market

Radiological supervision and interpretation X-ray of bile and/or pancreatic ducts during surgery

$155
$772

80% lower than market

Ultrasound Guidance for Insertion of Needle

$219
$727

70% lower than market

Ultrasound Heart

$2,902
$2,554

14% higher than market

Ultrasound guidance for accessing into blood vessel

$170
$190

11% lower than market

Breast Ultrasound - Limited

$200
$633

68% lower than market

Ultrasound Veins of Both Arms or Legs

$1,024
$1,171

13% lower than market

Imaging of Abdomen; Single View

$196
$276

29% lower than market

X-Ray Ankle, 2 Views

$202
$327

38% lower than market

X-Ray Both Hips and Pelvis, 2 Views

$347
$594

41% lower than market

Chest X-Ray; Single View

$202
$238

15% lower than market

Chest X-Ray; 2 Views

$233
$319

27% lower than market

X-Ray Collar Bone

$202
$292

31% lower than market

X-Ray Foot, 2 Views

$202
$262

23% lower than market

X-Ray Hand, 3 Views

$202
$284

29% lower than market

X-Ray Hip and Pelvis, 2 Views

$202
$277

27% lower than market

X-Ray Knee, 1-2 Views

$196
$193

2% higher than market

X-Ray Knee, 3 Views

$202
$308

34% lower than market

X-Ray Colon with Air Contrast and High Density Barium

$1,051
$1,409

25% lower than market

X-Ray Pelvis, 1-2 Views

$347
$287

21% higher than market

X-Ray Shoulder, 1 View

$202
$295

32% lower than market

X-Ray Shoulder, 2 Views

$202
$291

31% lower than market

X-ray of spine, 1 view

$202
$423

52% lower than market

X-Ray Upper Arm, 2 Views

$202
$248

19% lower than market

X-ray of upper digestive tract with contrast

$772
$854

10% lower than market

X-Ray Wrist, 3 Views

$202
$284

29% lower than market

INPATIENT VASCULAR SURGERY CHARGES

Description

Our Charge
Market Charge

Variance

Extracranial procedures without complications

$17,880
$29,979

40% lower than market

INPATIENT CARDIOLOGY

Description

Our Charge
Market Charge

Variance

Peripheral vascular disorders with complications

$14,291
$16,634

14% lower than market

INPATIENT GENERAL SURGERY

Description

Our Charge
Market Charge

Variance

Major small & large bowel procedures with complications

$28,159
$63,355

56% lower than market

Major small & large bowel procedures with major complications

$35,460
$112,988

69% lower than market

Major small & large bowel procedures without complications

$25,733
$43,261

41% lower than market

Stomach, esophageal & duodenal proc without complications

$23,343
$30,240

23% lower than market

Wnd debrid & skn grft exc hand, for musculo-conn tiss dis with complications

$32,979
$55,478

41% lower than market

Wnd debrid & skn grft exc hand, for musculo-conn tiss dis without complications

$23,797
$45,110

47% lower than market

INPATIENT ORTHOPEDIC SURGERY

Description

Our Charge
Market Charge

Variance

Hip & femur procedures except major joint with complications

$17,088
$54,212

68% lower than market

Hip & femur procedures except major joint with major complications

$38,322
$73,442

48% lower than market

Hip & femur procedures except major joint without complications

$22,498
$26,476

15% lower than market

Knee procedures w pdx of infection without complications

$15,525
$56,429

72% lower than market

Knee procedures without pdx of infection with major complications

$21,551
$36,470

41% lower than market

Knee procedures without pdx of infection without complications

$13,955
$40,763

66% lower than market

Lower extrem & humer proc except hip,foot,femur without complications

$23,200
$49,467

53% lower than market

Other musculoskelet system & connective tissue O.R. procedure without complications

$21,097
$40,406

48% lower than market

Revision of hip or knee replacement with complications

$40,037
$62,572

36% lower than market

Total Knee or Hip Revision

$41,082
$38,123

8% higher than market

Total Shoulder Replacement

$35,012
$39,444

11% lower than market

INPATIENT ORTHOPEDICS

Description

Our Charge
Market Charge

Variance

Aftercare for muscle and connective tissue injuries with complications

$12,977
$25,285

49% lower than market

Bone diseases & arthropathies without major complications

$12,157
$19,711

38% lower than market

INPATIENT SURGERY FOR MALIGNANCY

Description

Our Charge
Market Charge

Variance

Kidney & ureter procedures for neoplasm without complications

$25,920
$35,135

26% lower than market

Major male pelvic procedures with major complications

$27,297
$60,027

55% lower than market

INPATIENT UROLOGY

Description

Our Charge
Market Charge

Variance

Kidney & ureter procedures for non-neoplasm without complications

$10,026
$31,772

68% lower than market

Transurethral prostatectomy without complications

$12,586
$23,251

46% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Salina Surgical Hospital for your healthcare needs. We want to make understanding and paying your bill as easy as possible. Here are some ways you can help us as we work to make the billing process go smoothly.

• Please give us complete health insurance information.

In addition to your health insurance card, we may ask for a photo ID. If you have been seen at Salina Surgical Hospital, let us know if your personal information or insurance information has changed since your last visit.

• Please understand and follow the requirements of your health plan.

Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and Salina Surgical Hospital is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.

• Please respond promptly to any requests from your insurance provider.

You may receive multiple bills from your hospital visit, including your family doctor, specialists, physicians that read x-rays, providers that give anesthesia, or physicians that interpret blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from Salina Surgical Hospital indicating the bill is now your responsibility. All bills sent to you are due upon receipt.

Questions about Price and Billing Information

Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.

To ask questions or get more information about a bill for services you've received, please contact our Billing Department at 785-827-0610.

If you need more information about the price of a future service, please contact our Customer Service at 785-827-0610. A physician’s order or CPT code is strongly encouraged when you call to assist us in providing you with the most accurate estimate. You can obtain the CPT code from the ordering physician.