Wilson Memorial Hospital

Sidney, OH · CMS ID: 360013

This hospital has pricing data for 32 procedures.

Procedures (32)

Chest X-Ray 1 View

71045

Cash Price

(No Insurance)

—

Gross Charge

$155

No payer-negotiated rates available

Chest X-Ray 2 Views

71046

Cash Price

(No Insurance)

—

Gross Charge

$389

No payer-negotiated rates available

Complete Blood Count (CBC)

85025

Cash Price

(No Insurance)

—

Gross Charge

$94

No payer-negotiated rates available

Comprehensive Metabolic Panel

80053

Cash Price

(No Insurance)

—

Gross Charge

$30

No payer-negotiated rates available

CT Abdomen/Pelvis with Contrast

74177

Cash Price

(No Insurance)

—

Gross Charge

$4,111

No payer-negotiated rates available

CT Abdomen/Pelvis without Contrast

74176

Cash Price

(No Insurance)

—

Gross Charge

$3,478

No payer-negotiated rates available

CT Chest Low Dose

71271

Cash Price

(No Insurance)

—

Gross Charge

$1,741

No payer-negotiated rates available

CT Chest with Contrast

71260

Cash Price

(No Insurance)

—

Gross Charge

$2,057

No payer-negotiated rates available

ER Visit Level 3

99283

Cash Price

(No Insurance)

—

Gross Charge

$737

No payer-negotiated rates available

ER Visit Level 4

99284

Cash Price

(No Insurance)

—

Gross Charge

$1,028

No payer-negotiated rates available

ER Visit Level 5

99285

Cash Price

(No Insurance)

—

Gross Charge

$1,432

No payer-negotiated rates available

Fetal Non-Stress Test

59025

Cash Price

(No Insurance)

—

Gross Charge

$511

No payer-negotiated rates available

Hemoglobin A1C

83036

Cash Price

(No Insurance)

—

Gross Charge

$116

No payer-negotiated rates available

Hip Replacement

27130

Cash Price

(No Insurance)

—

Gross Charge

$5,375

No payer-negotiated rates available

Knee X-Ray

73560

Cash Price

(No Insurance)

—

Gross Charge

$307

No payer-negotiated rates available

Lipid Panel

80061

Cash Price

(No Insurance)

—

Gross Charge

$56

No payer-negotiated rates available

Mammogram Diagnostic

77066

Cash Price

(No Insurance)

—

Gross Charge

$390

No payer-negotiated rates available

Mammogram Screening

77067

Cash Price

(No Insurance)

—

Gross Charge

$291

No payer-negotiated rates available

MRI Brain

70551

Cash Price

(No Insurance)

—

Gross Charge

$3,162

No payer-negotiated rates available

MRI Brain with Contrast

70553

Cash Price

(No Insurance)

—

Gross Charge

$3,952

No payer-negotiated rates available

MRI Cervical Spine

72141

Cash Price

(No Insurance)

—

Gross Charge

$3,162

No payer-negotiated rates available

MRI Knee

73721

Cash Price

(No Insurance)

—

Gross Charge

$3,162

No payer-negotiated rates available

MRI Lumbar Spine

72148

Cash Price

(No Insurance)

—

Gross Charge

$3,162

No payer-negotiated rates available

MRI Shoulder

73221

Cash Price

(No Insurance)

—

Gross Charge

$3,162

No payer-negotiated rates available

Office Visit Level 3

99213

Cash Price

(No Insurance)

—

Gross Charge

$250

No payer-negotiated rates available

Office Visit Level 4

99214

Cash Price

(No Insurance)

—

Gross Charge

$333

No payer-negotiated rates available

Shoulder X-Ray

73030

Cash Price

(No Insurance)

—

Gross Charge

$173

No payer-negotiated rates available

TSH (Thyroid)

84443

Cash Price

(No Insurance)

—

Gross Charge

$198

No payer-negotiated rates available

Ultrasound Abdomen

76700

Cash Price

(No Insurance)

—

Gross Charge

$1,270

No payer-negotiated rates available

Ultrasound Pelvis

76856

Cash Price

(No Insurance)

—

Gross Charge

$1,485

No payer-negotiated rates available

Ultrasound Transvaginal

76830

Cash Price

(No Insurance)

—

Gross Charge

$1,070

No payer-negotiated rates available

Urinalysis

81001

Cash Price

(No Insurance)

—

Gross Charge

$71

No payer-negotiated rates available