Room & Board Per Day
Medical/Surgical	774.00
Medical/Surgical Telemetry	919.00
Medical/Surgical Isolation	1,103.00
Medical/Surgical Telemetry & Isolation	1,247.00
Pediatric Unit	774.00
Obstetrics Birthing Room	774.00
Nursery	774.00
Coronary Care Unit	1,667.00
Psychiatric Unit	989.00
Psychiatric Unit Special Care	1,098.00
Physical Rehabilitation Unit	774.00

Operating Room
Operating Room charges are based on the complexity level, with level 1 being the most basic for a particular operation. There is an initial 15 minute charge, as well as an additional charge for each minute while the operation is being performed. This charge includes the use of some supplies, nursing time, room time, and other items to perform the surgery.
OR Time Charge Class I - Initial 15 minute	1,182.00
OR Time Charge Class I - Each additional minute	25.00
OR Time Charge Class II - Initial 15 minute	1,775.00
OR Time Charge Class II - Each additional minute	36.00
OR Time Charge Class III - Initial 15 minute	2,367.00
OR Time Charge Class III - Each additional minute	47.00
OR Time Charge Class IV - Initial 15 minute	2,601.00
OR Time Charge Class IV - Each additional minute	59.00
OR Time Charge Class V - Initial 15 minute	2,972.00
OR Time Charge Class V - Each additional minute	71.00

Recovery Room
Recovery Room Phase I Level 2	10.00
Recovery Room Phase I Level 3	12.00
Recovery Room Phase I Level 4	14.00

Anesthesia
Physician fees for anesthesiologists as applicable are not included in the these charges and will be billed separately by the Anesthesiologist.
Anesthesia Gen IV/Per Minute	12.00

Emergency Room
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. Emergency Room Physician fees as applicable are not included in the these charges and will be billed separately by the emergency room physician.
Emergency Room Level I	114.00
Emergency Room Level II	151.00
Emergency Room Level III	255.00
Emergency Room Level IV	481.00
Emergency Room Level V	672.00
Critical Care	1,224.00

Laboratory
The following charges reflect the hospital's 30 most common scheduled outpatient laboratory procedures. Physician fees for the Pathologist as applicable are not included in the these charges and will be billed separately by the pathologist.
Alt Transaminase (SGPT)	56.90
Amylase, Blood	60.00
AST SGOT	52.50
Basic Metabolic	55.90
Blood Drawing Charge	13.20
BNP	73.60
BUN	33.50
CBC	52.00
CBC w/o Diff	49.00
CKMB Quantative	73.20
Comp Metabolic	71.10
CPK Total	46.90
Creatinine Blood	33.50
Electrolytes	45.50
Glucose Fasting	33.50
Glucose Random	33.50
Hematocrit	24.20
Hemoglobin	24.20
Hemoglobin A1C	62.50
Hepatic Function Panel	53.60
LDL (Low Density Lipoproteins)	79.60
Lipase	57.50
Lipid	83.80
Magnesium	37.00
PT (Prothrombin Time)	27.30
PTT/APTT	33.00
Sedimentation Rate	32.70
Sensitivity, MIC	62.50
T-3 Uptake	40.30
T4, Thyroxine	82.00
Troponin I	48.80
TSH - Thyroid Stimulating Hormone	82.00
Urinalysis Rout (No Micro)	24.10
Urine Culture	40.90

Cardiology
Physician fees for the cardiologist as applicable are not included in these charges and will be billed separately by the cardiologist.
Electrocardiogram	114.00
Doppler Color Flow Mapping	452.00
Echocardiogram (2D/M-Mode)	619.00
Echocardiogram (Doppler)	452.00
Cardiac Rehab Entrance Membership per month	40.00
Cardiac Rehab Exercise Therapy	133.00

Radiology
The following charges reflect the hospital's 30 most common scheduled outpatient x-ray and radiological procedures. Physician Fees for the radiologist as applicable are not included in the these charges and will be billed separately by the radiologist.
Abdomen Acute Series	166.00
Ankle, 3 Views	104.00
Chest, 2 Views, P-A & L	108.00
Chest, Portable 1 View AP	173.00
Foot, 3 Views	104.00
Hand Min 3 Views	104.00
Hip Min 2 Views	104.00
Knee, 4 Views	104.00
KUB, 1 View	102.00
Lumbar, Routine, 6 Views	209.00
Mammography, Screen	152.00
Mammography, Bilat DX	210.00
Mammography, CAD, DX	33.00
Pelvis, 1 or 2 Views	100.00
Shoulder, 2 or More Views	104.00
Spine, Cervical Min 4 Views	209.00
CT Scan Abdomen With Contrast	996.00
CT Scan Head W/O Contrast	653.00
CT Scan Head With & W/O Contrast	930.00
CT Scan chest w contrast	996.00
CT Pelvis w/contrast	940.00
MRI, Brain w&wo contrast	2,950.00
MRI, Spine Lumb w/o contrast	2,258.00
MRI, Spine Cervical w/o contrast	2,258.00
MRI Lower Extremity w/o contrast	1,930.00
PET Lung, SPN SB - MT	4,406.00
Radiopharmaceutical FDG < 45mci	2,570.00
Carotid Duplex Dopscan Bilateral	684.00
Gallbladder Ultra Sound	340.00
Venous Duplex, Unilateral	646.00
Breast, Unilateral Ultrasound	199.00
Pelvic Ultrasound	358.00
Bone Imaging, Whole Body	1,021.00

Heart Catheterization/Angiography
Physician fees for hearth catheterizations as applicable are not included in the these charges and will be billed separately by the physician.
Left Heart Cath	3,331.00
LHC & Cor Angio w/Graphs	8,325.00
Cor Angio	5,363.00

Respiratory care
Physician fees as applicable are not included in the these charges and will be billed separately by the physician.
Aerosol Treatment Initial	75.00
Arterial Blood Gases	135.00
IPPB Initial	68.00
Pulse Oximetry - Single Determination	59.00

Physical Therapy
The following charges reflect the most common services offered by our physical therapy department. Patients may have additional charges, depending on the services performed.
Aquatic Therapy each 15 minute	63.00
ES unattended	77.00
ES unattended with hp or cp	147.00
Gait Training per 15 minute	50.00
Manual therapy each 15 minute	65.00
Neuromuscular re-education each 15 minute	59.00
Self Care/Home Mgmt each 15 minute	38.00
Therapeutic Exercise each 15 minute	63.00
Ultrasound each 15 minute	109.00
Whirlpool	101.00

Occupational Therapy
The following charges reflect the most common services offered by our occupational therapy department. Patients may have additional charges, depending on the services performed.
Neuromuscular Re-education each 15 minute	59.00
Self-care/Home Mgmt each 15 minute	38.00
Therapeutic Activities each 15 minute	59.00
Therapeutic Exercise each 15 minute	63.00
Therapy Group	59.00

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. Firleands Regional Medical Center does not charge interest on current remaining balances with our facility. Any patient uninsured or underinsured should consult with our Financial Counseling staff at 419-557-7879, or apply online at www.firelands.com (Pay Bills Online), to determine whether they qualify for discounts, or extended payment arrangements.

Consumers can access a number of government and private websites, which provide additional information on hospitals' charges and quality. For a complete listing of available online resources, visit the Consumer Guide to Quality Health Care in Ohio.