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Patient Price Information List In compliance with state law, Wilson Memorial 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. These prices are correct as of January 1, 2007. Room and Board -- Per Day Charges | | | Charges | Critical Care Unit | $1,030.00 | | | | Medical/Surgical | | | Telemetry Semi-Private | $ 734.00 | | Telemetry Private | $ 767.00 | | Med/Surg Semi-Private | $ 488.00 | | Med/Surg Private | $ 521.00 | Pediatrics | | | Semi-Private | $ 488.00 | | Private | $ 521.00 | Birth Center | | | Obstetrics | $ 560.00 | | Nursery | $ 451.00 | | | | | | | | 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. | | | Charges | Normal Delivery | $ 2,510.00 | Cesarean Section Delivery | $ 4,227.40 | | | | | | | | | 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. | | | | | | | | | | | Charges | Level 1 | $ 90.30 | Level 2 | $ 105.70 | Level 3 | $ 185.05 | Level 4 | $ 320.10 | Level 5 | $ 640.10 | Level 6 | $ 735.50 | Level 1 Doctor charge | $ 51.90 | Level 2 Doctor charge | $ 98.05 | Level 3 Doctor charge | $ 138.90 | Level 4 Doctor charge | $ 329.40 | Level 5 Doctor Charge | $ 658.55 | Critical Care Doctor Charge | $ 781.05 | | | Operating Room Charges | | | Operating Room Services are charged based on each procedure performed. Listed below are the top 30 procedures and their price. The patient can expect to receive a separate bill from Anesthesiologist, Pathologist, and Surgeon in relation to the surgery. | | | | Colonoscopy | $1,365.85 | Diagnostic Upper GI Endoscopy, with/without biopsy | $1,287.55 | Dilatation and Curettage (D & C) | $2,654.25 | Diagnostic Hysteroscopy, With or Without Biopsy | $3,242.05 | Laparoscopy, Tubal Block | $6,718.20 | Care of Miscarriage | $2,776.85 | Total Abdominal Hysterectomy | $5,431.45 | Create Eardrum Opening | $3,834.30 | Carpal Tunnel Surgery | $2,725.55 | Knee Arthroscopy | $4,507.50 | Lysis of Adhesions | $2,715.75 | Cataract Removal with Insertion of Intraocular Lens | $3,782.65 | Laparoscopic Cholecystectomy with Cholangiography | $6,718.20 | Removal of Both Ovaries and Tubes | $2,715.75 | Laparoscopy With Lysis of Adhesions | $6,718.20 | Repair of Wound or Lesion | $277.50 | Repair Initial Inguinal Hernia, Age 5 or over, Reducible | $4,439.25 | Urinary Incontinence Repair | $2,595.05 | Closed Endoscopic Biopsy of Large Intestine | $2,896.75 | After Cataract Laser Surgery | $814.75 | Endometrial Thermal Ablation | $4,230.35 | Laparoscopic Vaginal Hysterectomy | $9,417.90 | Laparoscopic, Excise Lesions | $6,718.20 | Excision of Skin Lesion - Face - 1.1-2cm Diameter | $1,166.35 | Repair Bladder Defect | $6,417.85 | Bilateral Tubal Occlusion | $3,034.05 | Vaginal Hysterectomy | $4,043.40 | Insertion of Tunneled Central Venous Catheter | $4,221.95 | Cystocele/Rectocele Repair | $4,508.15 | Thoracentesis | $505.85 | | | 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 performed. | | | | | | | | Self Care/Home Mgmt Training | $58.65 | Ice Packs | $36.40 | | | Ultrasound | $48.45 | Massage | $42.10 | | | Hot Packs | $36.40 | | | | | Respiratory Therapy Charges | | | The following charges reflect the most common services offered by our Respiratory Therapy department. Patients may have additional charges, depending on the services performed. | | | | | | Medicated Nebulizer Initial | $113.45 | Oxygen charge for 12 hours | $83.40 | IPPB Initial | $84.30 | | | | | | | | | | | X-Ray and Imaging Charges | | | The following charges reflect the hospital's 30 most common x-ray and radiological procedures. Fees for physician interpretation services are not reflected, and will be billed separately by your physician. | | | | | | Chest Two View | $154.00 | Unilateral mammogram | $121.00 | Screening Mammogram | $101.00 | Diagnostic mammogram | $183.00 | Portable Chest | $211.00 | Ultrasound breast | $377.00 | CT Head without contrast | $993.00 | Dexa Bone Density | $299.00 | CT Abdomen with contrast | $1,165.00 | CT Abdomen without contrast | $957.00 | Echocardiogram | $787.00 | Knee x-ray | $143.00 | Myocardial Perfusion | $900.00 | Ultrasound carotid | $851.00 | CT Pelvis with contrast | $1,125.00 | Foot x-ray | $128.00 | Ultrasound abdominal aorta | $496.00 | Ankle x-ray | $128.00 | Acute abdomen x-ray | $122.00 | MRI Lumbar Spine with contrast | $1,736.00 | CT Chest with contrast | $1,230.00 | MRI Lumbar Spine without contrast | $1,512.00 | Ultrasound pelvis | $406.00 | Kidneys, Ureters, & Bladder x-ray | $77.80 | Ultrasound transvaginal | $201.00 | Whole body bone scan | $619.00 | Lumbar spine x-ray | $217.00 | MRI Brain with contrast | $1,736.00 | Hand x-ray | $128.00 | MRI Brain without contrast | $1,512.00 | | | Laboratory Charges | | | The following charges reflect the hospital's 30 most common laboratory procedures. | Complete blood count (CBC) | $42.25 | Electrolytes | $50.25 | Differential | $36.70 | Blood urea nitrogen (BUN) | $31.15 | Basic metabolic profile | $101.20 | SGPT | $31.15 | Protime | $21.85 | Glucose | $31.15 | Lipid | $99.20 | CK-CKMB | $88.25 | Comprehensive metabolic profile | $177.10 | Renal profile | $126.15 | Urinalysis | $34.90 | Lipase | $63.15 | Troponin | $66.30 | Amylase | $67.60 | Magnesium | $53.20 | SGOT | $31.50 | Liver profile | $75.90 | Free thyroxine 4 | $58.25 | Partial thromboplastin time | $40.55 | Hemoglobin & Hematocrit | $25.00 | Microscopic urine | $11.80 | Sed rate | $27.00 | Thyroid stimulating hormone | $79.25 | D-Dimer | $108.35 | Creatinine | $35.90 | HCG Urine | $79.10 | Hemoglobin A1C | $93.65 | PSA | $102.50 |
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/portal.
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