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Pricing Information
In compliance with state law, Knox Community Hospital is providing this price list containing our charges for room and board, emergency department, operating room, delivery, physical therapy and other procedures. 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. Uninsured or underinsured patients should consult with our admitting and billing staff to determine whether they qualify for discounts. To obtain pricing information for services not listed below, please contact our Chargemaster Coordinator at 740.393.9636.
These prices are correct as of January 1, 2010.

Charges for physician, radiologist, pathologist, and anesthesiologist services
are not included in the prices below.
Room and Board - Per Day Charges

          Intensive Care Unit

          Step Down
          Progressive Care Unit
          Routine Nursery
          Routine Care

$1,442.01

$1,155.33
$950.58
$513.26
$544.00
Labor & Delivery Charges Charges
The following list does not include charges for anesthesia, drugs, or supplies required for a particular delivery room procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.

          Cesarean Section Delivery
          Circumcision
          Fetal Monitor
          Fetal Non-Stress Test
          Normal Vaginal Delivery
$4,277.01
$167.73
$139.21
$131.17
$1,066.40
Emergency Department Charges
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. They also do not include fees for Emergency Department physicians, who will bill separately for their services.

          Level 1
          Level 2
          Level 3
          Level 4
          Level 5
          Critical Care 1-74 Minutes
$109.00
$162.05
$252.53
$364.30
$524.59
$881.43
Operating Room Charges
Surgery prices are based upon one primary procedure. Below is a list of the most common surgeries by specialty group. The following list does not include charges for anesthesia, drugs, or supplies required for a particular procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.

          Endoscopy

          Flexible Colonoscopy
          Gallbladder, Removal by Laparoscope

          Ear/Nose/Throat
          Ear Tubes (one side) Tympanostomy
          Repair of nasal septum (Septoplasty)

          General/Other
          Appendix, Removal by laparoscope
          Critical Care 1-74 Minutes

          Urology
          Vasectomy
          Vasectomy Reversal

          GYN
          D&C (Dilatation and curettage)
          Non OB Total abdominal hysterectomy

          Orthopedics
          Arthroscopic knee
          Open Carpel Tunnel Release


$1,087.28

$5,405.61


$1,934.70
$2,990.28


$5,405.61
$3,448.47


$2,831.93
$2,950.97


$2,520.32
$4,139.10


$3,543.50
$2,124.46
Physical Therapy Charges
The following charges reflect the most common services offered by our Physical Therapy department. Patients may have additional charges, depending on the services and or supplies that are used.

          Aquatic Therapy-pool

          Manual Therapy
          Physical Therapy Evaluation
          Therapeutic Exercise
          Therapeutic Neurologic Re-education
          Work Conditioning

$76.49

$67.57
$168.42
$80.28
$66.88
$130.00
Occupational Therapy Charges
The following charges reflect the most common services offered by our Occupational Therapy department. Patients may have additional charges, depending on the services and/or supplies that are used.

          Occupational Therapy Evaluation

          OT Activities of Daily Living
          OT Manual Therapy
          OT Neurological Re-education
          OT Paraffin Bath
          OT Therapeutic Exercise

$165.28

$64.17
$67.57
$66.88
$60.00
$80.28
Pulmonary Therapy Charges
The following charges reflect the most common services offered by our Pulmonary Therapy department. Patients may have additional charges, depending on the services performed.

          Arterial Blood Gas

          Breathing Treatment
          EKG
          PFT Study-Pulmonary Function Test
          Polysomnogram

$135.00

$50.00
$105.53
$223.97
$2,448.06
X-Rays and Radiological Charges
The following charges reflect the hospital’s 30 most common x-ray and radiological procedures. The following list does not include charges for drugs. Additionally, there may be charges for supplies specific to your treatment. Fees for the radiologist readings are also not reflected, and will be billed separately.
          Abdomen
          Abdominal Series
          Ankle
          Cervical Spine
          Chest-1 view
          Chest-2 views
          Elbow
          Foot
          Hand
          Hip
          Humerus
          Knee
          Lumbar Spine
          Pelvis
          Sacrum
          Shoulder

          CAT Scans
          CT Abdomen (with & without contrast)
          CT Abdomen (without contrast)
          CT Chest (with contrast)
          CT Head (without contrast)
          CT Head (with & without contrast)
          CT Pelvis (with contrast)
          CT Pelvis (without contrast)
          CT Sinuses

          Nuclear Medicine
          Cardiolite Stress Test (Total Facility Charge)

          Ultrasound

          Ultrasound Pelvis
          Ultrasound Right Upper Quadrant

          MRI
          MRI Lumbar spine (without contrast)

          Other
          DEXA (Bone Density Scan)
          Digital Mammogram (Screening-both sides)
          Digital Mammogram (Diagnostic-one side)
$193.58
$353.87
$263.67
$225.81
$194.70
$228.45
$244.08
$251.90
$245.52
$231.08
$213.93
$230.53
$333.46
$207.03
$228.31
$255.50


$1,881.57
$1,304.40
$1,567.70
$1,226.48
$1,505.50
$1,570.86
$1,379.30
$1,066.82


$4,950.00


$555.57
$549.53


$2,350.74


$250.99
$173.27
$200.48
Laboratory Charges
The following charges reflect the hospital’s 30 most common laboratory procedures. These prices are based on specimens drawn in our facility or by our staff. * Please be informed that blood tests will have one additional charge of $13.82 per visit for the blood collection.

          A1C– Glycated Hemoglobin

          Amylase*
          APTT-Activated Pro-Thrombin time
          B12*
          Blood Culture*
          BMP-Basic metabolic panel
          BNP–Brain Natriuretic Peptide
          CBC–Complete blood count
          CMP–Comprehensive metabolic panel
          CRP–C-Reactive Protein
          Creatinine*
          D Dimer*
          Electrolyte panel*
          ESR* – Sedimentation rate
          Free T4*
          Glucose*
          HCG* – Blood pregnancy
          HFP* – Liver function panel
          Lipid Panel*
          Lipase*
          Myoglobin*
          Pro Time*
          PSA* – Prostatic Acid Phosphatase (Screening)
          Rapid Strep
          Thera PT* – Pro Time (Coumadin level)
          Thyroxine*
          Troponin I*
          TSH* – Thyroid Stimulating Hormone
          Urinalysis (complete)
          Urine culture
          (if positive test, additional charges may apply)

$60.42

$43.16
$47.26
$56.07
$105.45
$125.00
$137.42
$63.58
$165.00
$81.52
$35.37
$116.30
$96.36
$36.05
$108.42
$32.65
$47.26
$96.41
$98.15
$51.29
$95.70
$29.66
$91.92

$36.42
$29.66
$54.25
$78.38
$109.24
$48.56

$63.48


Hospital Billing Policies

Knox Community Hospital has a trained staff of professionals here to help you with your billing and collection needs. After receiving your services at Knox Community Hospital, a summary of charges will be sent to your home indicating the insurance company that will be billed. As a courtesy to our patients, Knox Community Hospital submits claims to all applicable insurances provided at the time of registration.

Once all applicable insurances have paid their obligated portion, Knox Community Hospital will send a statement to the listed responsible party. If you are unable to pay the amount due, please call one of our customer service representatives immediately to make other arrangements. You can contact a customer service representative by calling 1.866.576.1236 between the hours 8:00 am to 9:00 pm Monday thru Friday and 9:00 am to 1:00 pm on Saturday. Knox Community Hospital payment plans are interest free and have no service fees.

Alternate payment options and financial aid are available to qualified uninsured and underinsured patients. Financial assistance applications can be found on the back of your statement, obtained by contacting a customer service representative at the above phone numbers, and are also available on our website, www.KnoxCommHosp.org. If you have questions concerning the financial assistance program, please contact a financial counselor at 740.393.9630.

We invite you to share your comments and concerns with us by submitting them to:

Patient Financial Services
Customer Relations
1330 Coshocton Road
Mount Vernon, Ohio 43050

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, please visit the Consumer’s Guide to Quality Health Care in Ohio at www.ohanet.org.

1330 Coshocton Road, Mount Vernon, Ohio 43050 | 740.393.9636 | www.KnoxCommHosp.org

Click below for a printable version of the information above. (Rev.28Jan2010)

2010 Knox Community Hospital Pricing


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The Joint Commission Knox Community Hospital is accredited by the Joint Commission on Accreditation of Health Care Organizations

1330 Coshocton Rd Mt Vernon OH 43050 p: 740.393.9000
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