Aultman Orrville Hospital
Aultman Orrville Hospital in Orrville, OH publishes cash prices for 36 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
832 South Main Street, Orrville, OH 44667 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Abdomen/Pelvis W/Contrast | $1,413.90 | $3,142.00 | 55% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Abdomen/Pelvis W/Contrast | $1,413.90 | $3,142.00 | 55% |
| CT scan of the head or brain, no contrast dye CPT 70450 Ct - Head/Brain Wo Contrast | $623.70 | $1,386.00 | 55% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct - Head/Brain Wo Contrast | $623.70 | $1,386.00 | 55% |
| CT scan of the pelvis, with contrast dye CPT 72193 Ct Pelvis W/Dye | $821.70 | $1,826.00 | 55% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Ct Pelvis W/Dye | $821.70 | $1,826.00 | 55% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Mammogram Dx W/Cad Bilateral | $145.80 | $324.00 | 55% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mammogram Dx W/Cad Bilateral | $145.80 | $324.00 | 55% |
| Diagnostic mammogram, one breast one side CPT 77065 Mammogram Dx W/Cad Unilateral | $129.60 | $288.00 | 55% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammogram Dx W/Cad Unilateral | $129.60 | $288.00 | 55% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Mri Lower Extrem/Joint | $1,850.40 | $4,112.00 | 55% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Mri Lower Extremity/Joint | $1,850.40 | $4,112.00 | 55% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Mri Lower Extremity/Joint | $1,850.40 | $4,112.00 | 55% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Mri Lower Extrem/Joint | $1,850.40 | $4,112.00 | 55% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Mri Lwr Extrem/Joint W&Wo Dye | $2,125.80 | $4,724.00 | 55% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Mri Lwr Extrem/Joint W&Wo Dye | $2,125.80 | $4,724.00 | 55% |
| MRI of the brain, no contrast dye CPT 70551 Mri Brain W/O Contrast | $1,405.80 | $3,124.00 | 55% |
| MRI of the brain, no contrast dye inpatient CPT 70551 Mri Brain W/O Contrast | $1,405.80 | $3,124.00 | 55% |
| MRI of the brain, with and without contrast dye CPT 70553 Mri Brain W & W/O Contrast | $2,757.15 | $6,127.00 | 55% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Brain W & W/O Contrast | $2,757.15 | $6,127.00 | 55% |
| MRI of the lower back, no contrast dye CPT 72148 Mri Lumbar Spine W/O Contrast | $1,682.55 | $3,739.00 | 55% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 Mri Lumbar Spine W/O Contrast | $1,682.55 | $3,739.00 | 55% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ob Us >= 14 Wks Single Fetus | $216.45 | $481.00 | 55% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ob Us >= 14 Wks Single Fetus | $216.45 | $481.00 | 55% |
| Screening mammogram, both breasts CPT 77067 Mammogram Screening W/Cad | $155.70 | $346.00 | 55% |
| Screening mammogram, both breasts inpatient CPT 77067 Mammogram Screening W/Cad | $155.70 | $346.00 | 55% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysominography 4+ Attended | $3,456.90 | $7,682.00 | 55% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysominography 4+ Attended | $3,456.90 | $7,682.00 | 55% |
| Transvaginal pelvic ultrasound CPT 76830 Non-Ob Transvag Us | $364.50 | $810.00 | 55% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Non-Ob Transvag Us | $364.50 | $810.00 | 55% |
| Ultrasound of the abdomen, complete CPT 76700 Us Abdomen Complete | $505.35 | $1,123.00 | 55% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Us Abdomen Complete | $505.35 | $1,123.00 | 55% |
| X-ray of the lower back, 4 or more views CPT 72110 Xray Of Lower Spine 4+ Views | $378.45 | $841.00 | 55% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Xray Of Lower Spine 4+ Views | $378.45 | $841.00 | 55% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $56.25 | $125.00 | 55% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $56.25 | $125.00 | 55% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lab-Lipid Panel | $90.45 | $201.00 | 55% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lab-Lipid Panel | $90.45 | $201.00 | 55% |
| Complete blood count (CBC) with differential CPT 85025 Lab-Cbc W Plt W Autom Diff | $27.90 | $62.00 | 55% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Lab-Cbc W Plt W Autom Diff | $27.90 | $62.00 | 55% |
| Complete blood count (CBC), no differential CPT 85027 Lab-Complete Cbc Automated | $40.05 | $89.00 | 55% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Lab-Complete Cbc Automated | $40.05 | $89.00 | 55% |
| Comprehensive metabolic panel (blood test) CPT 80053 Lab-Comp Metabolic Panel | $77.40 | $172.00 | 55% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Lab-Comp Metabolic Panel | $77.40 | $172.00 | 55% |
| Kidney function blood test panel CPT 80069 Lab-Renal Function Panel | $68.40 | $152.00 | 55% |
| Kidney function blood test panel inpatient CPT 80069 Lab-Renal Function Panel | $68.40 | $152.00 | 55% |
| Liver function blood test panel CPT 80076 Lab-Hepatic Function Panel | $58.95 | $131.00 | 55% |
| Liver function blood test panel inpatient CPT 80076 Lab-Hepatic Function Panel | $58.95 | $131.00 | 55% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Lab-Psa Free | $61.65 | $137.00 | 55% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Lab-Psa Free | $61.65 | $137.00 | 55% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Lab-Ptt | $39.60 | $88.00 | 55% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lab-Ptt | $39.60 | $88.00 | 55% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $27.45 | $61.00 | 55% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Lab-Prothrombin Time | $27.45 | $61.00 | 55% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lab-Prothrombin Time | $27.45 | $61.00 | 55% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $27.45 | $61.00 | 55% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Lab-Thyroid Stim Hormoneone | $80.55 | $179.00 | 55% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Lab-Thyroid Stim Hormoneone | $80.55 | $179.00 | 55% |
| Urinalysis with microscope exam, automated CPT 81001 Autom Urine Dip W/Micro | $31.05 | $69.00 | 55% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Autom Urine Dip W/Micro | $31.05 | $69.00 | 55% |
| Urinalysis without microscope exam, automated CPT 81003 Lab-Urine Scrn Auto W/O Micro | $14.85 | $33.00 | 55% |
| Urinalysis without microscope exam, automated CPT 81003 Lab-Bilirubin Urine | $27.90 | $62.00 | 55% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Lab-Urine Scrn Auto W/O Micro | $14.85 | $33.00 | 55% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Lab-Bilirubin Urine | $27.90 | $62.00 | 55% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Lower-back epidural injection, with imaging guidance CPT 62323 Inj Spine L/S With Imaging | $2,125.80 | $4,724.00 | 55% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inj Spine L/S With Imaging | $2,125.80 | $4,724.00 | 55% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Inj Spine L/S W/O Imaging | $1,619.10 | $3,598.00 | 55% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inj Spine L/S W/O Imaging | $1,619.10 | $3,598.00 | 55% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Foramen Epidural L/S | $1,395.90 | $3,102.00 | 55% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Foramen Epidural L/S | $1,395.90 | $3,102.00 | 55% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 Off/Oupt Visit New Pt Lev 3 | $239.40 | $532.00 | 55% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Off/Oupt Visit New Pt Lev 3 | $239.40 | $532.00 | 55% |
| New patient office visit, about 45 minutes CPT 99204 Off/Oupt Visit New Pt Lev 4 | $289.80 | $644.00 | 55% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Off/Oupt Visit New Pt Lev 4 | $289.80 | $644.00 | 55% |
| New patient office visit, about 60 minutes CPT 99205 Off/Oupt Visit New Pt Lev 5 | $318.60 | $708.00 | 55% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Off/Oupt Visit New Pt Lev 5 | $318.60 | $708.00 | 55% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ot Therapeutic Exer Per 15 Min | $72.90 | $162.00 | 55% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pt Therapeutic Exer Per 15 Min | $72.90 | $162.00 | 55% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Pt Therapeutic Exer Per 15 Min | $72.90 | $162.00 | 55% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ot Therapeutic Exer Per 15 Min | $72.90 | $162.00 | 55% |
Source file: https://aultman.org/pricing-transparency/2026/1891718375_aultman-orrville-hospital_standardcharges.json