Adena Pike Medical Center

100 Dawn Lane, Waverly, OH 45690

Critical Access HospitalsVoluntary non-profit - Private

82% transparent

Price transparency

Meets 9 of the 11 rules we can check.

It gives a cash price for its shoppable servicesThe rule requires a discounted cash price for each service. Many files list only insurer prices for a procedure; we expect a cash price for at least 90% of the shoppable services the file prices.
It gives a list price for its shoppable servicesThe rule also requires the gross charge, the hospital's full list price. We expect one for at least 90% of the shoppable services the file prices.

Meets the other 9.

The hospital's own price file

Common services

74 of CMS's shoppable services. The insurer price is the median across every plan the hospital lists.

Service	Insurer median	Cash price	Plans
Psychotherapy, 30 min	$404	$281	34
Psychotherapy, 45 min	$404	$281	34
Psychotherapy, 60 min	$404	$281	34
Family psychotherapy, not including patient, 50 min	$285	$197	34
Family psychotherapy, including patient, 50 min	$404	$281	34
Group psychotherapy	$274	$191	34
New patient office or other outpatient visit, typically 30 min	$137	$95	34
New patient office or other outpatient visit, typically 45 min	$167	$115	34
New patient office or other outpatient visit, typically 60 min	$187	$129	34
Patient office consultation, typically 40 min	$104	$72	34
Patient office consultation, typically 60 min	$152	$105	34
Initial new patient preventive medicine evaluation (18-39 years)	$258	Unpublished	2
Initial new patient preventive medicine evaluation (40-64 years)	$299	Unpublished	2
Basic metabolic panel	$29	$20	34
Blood test, comprehensive group of blood chemicals	$42	$29	34
Obstetric blood test panel	$220	Unpublished	4
Blood test, lipids (cholesterol and triglycerides)	$50	$35	34
Kidney function panel test	$34	$24	34
Liver function blood test panel	$25	$17	34
Manual urinalysis test with examination using microscope	$19	Unpublished	4
Manual urinalysis test with examination using microscope	$12	$9	34
Automated urinalysis test	$9	$6	34
Automated urinalysis test	$9	$6	34
PSA (prostate specific antigen)	$63	$44	34
PSA (prostate specific antigen)	$63	$44	34
Blood test, thyroid stimulating hormone (TSH)	$58	$40	34
Complete blood cell count, with differential white blood cells, automated	$31	$21	34
Complete blood count, automated	$25	$18	34
Blood test, clotting time	$16	$11	34
Coagulation assessment blood test	$24	$16	34
CT scan, head or brain, without contrast	$1,097	$764	34
MRI scan of brain before and after contrast	$2,146	$1,495	34
X-Ray, lower back, minimum four views	$437	$304	34
MRI scan of lower spinal canal	$1,642	$1,144	34
CT scan, pelvis, with contrast	$1,447	$1,008	34
MRI scan of leg joint	$3,037	$2,116	34
CT scan of abdomen and pelvis with contrast	$2,894	$2,016	34
Ultrasound of abdomen	$587	$409	34
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus	$255	$178	34
Ultrasound pelvis through vagina	$587	$409	34
Mammography of one breast	$468	$326	34
Mammography of both breasts	$538	$375	34
Mammography, screening, bilateral	$208	$144	34
Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities	$94,091	Unpublished	1
Spinal fusion except cervical without major comorbid conditions or complications (MCC)	$35,665	Unpublished	1
Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications (MCC)	$18,384	Unpublished	1
Cervical spinal fusion without comorbid conditions (CC) or major comorbid conditions or complications (MCC)	$23,080	Unpublished	1
Uterine and adnexa procedures for non-malignancy without comorbid conditions (CC) or major comorbid conditions or complications (MCC)	$11,686	Unpublished	1
Removal of 1 or more breast growth, open procedure	$8,000	Unpublished	3
Shaving of shoulder bone using an endoscope	$290	Unpublished	3
Removal of one knee cartilage using an endoscope	$6,686	Unpublished	3
Removal of tonsils and adenoid glands patient younger than age 12	$12,096	Unpublished	3
Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope	$3,725	$2,595	34
Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope	$4,139	$2,883	34
Diagnostic examination of large bowel using an endoscope	$4,292	$2,990	34
Biopsy of large bowel using an endoscope	$4,789	$3,336	34
Removal of polyps or growths of large bowel using an endoscope	$4,622	$3,220	34
Ultrasound examination of lower large bowel using an endoscope	$2,445	Unpublished	3
Removal of gallbladder using an endoscope	$12,353	Unpublished	3
Repair of groin hernia patient age 5 years or older	$7,316	Unpublished	3
Biopsy of prostate gland	$2,665	Unpublished	1
Surgical removal of prostate and surrounding lymph nodes using an endoscope	$21,720	Unpublished	3
Routine obstetric care for vaginal delivery, including pre-and post-delivery care	$4,326	Unpublished	2
Routine obstetric care for cesarean delivery, including pre-and post-delivery care	$4,837	Unpublished	2
Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care	$4,560	Unpublished	2
Injection of substance into spinal canal of lower back or sacrum using imaging guidance	$2,348	$1,636	34
Injection of substance into spinal canal of lower back or sacrum using imaging guidance	$3,353	$2,336	34
Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance	$7,867	$5,549	34
Removal of recurring cataract in lens capsule using laser	$1,124	Unpublished	3
Removal of cataract with insertion of lens	$4,716	Unpublished	3
Electrocardiogram, routine, with interpretation and report	$29	Unpublished	2
Insertion of catheter into left heart for diagnosis	$6,624	Unpublished	3
Sleep study	$3,873	$2,698	34
Physical therapy, therapeutic exercise	$160	$112	34

Published hospital standard charges, not a quote. Check with your insurer and hospital.