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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 April 1, 2009. Room and Board -- Per Day Charges | |
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| Charges | | Critical Care Unit |
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| $1,124.00 | |
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| | Medical/Surgical |
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| Telemetry Semi-Private/Private |
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| $802.00 | |
| Med/Surg Semi-Private/Private |
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| $612.00 | | Pediatrics |
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| Semi-Private |
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| $532.00 | |
| Private |
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| $569.00 | | Birth Center |
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| Obstetrics |
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| $647.00 | |
| Nursery |
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| $520.00 | |
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| | 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.
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| Charges | | Normal Delivery |
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| $2,900.00 | | Cesarean Section Delivery |
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| $4,882.70 | |
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| 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. The patient can expect to receive a separate bill from the Emergency department physician. | | | | | |
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| Charges | | Level 1 |
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| $98.65 | | Level 2 |
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| $115.45 | | Level 3 |
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| $202.10 | | Level 4 |
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| $349.60 | | Level 5 |
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| $699.05 | | Level 6 |
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| $758.40 | | | 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.
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| | | Colonoscopy |
| $2,100.00 | | Upper GI Endoscopy |
| $2,100.00 | | Hysteroscopy, Diagnostic, Separate Procedure
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| $3,540.35
| | Dilation and Curettage |
| $2,898.50 | | Carpal Tunnel Surgery |
| $2,976.35
| | Endometrial Ablation, Thermal
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| $4,619.60 | | Laparoscopic Appendectomy |
| $5,891.95 | | Knee Arthroscopy
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| $4,922.25 | | Laparoscopic Cholecystectomy
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| $7,336.35 | | Bilateral Tubal Occlusion with Filshie Clip
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| $3,434.55
| | Laparoscopy, Excise Lesions
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| $7,650.26 | | Laparoscopy, Tubal Block
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| $7,540.30
| | Care of Miscarriage
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| $3,032.35
| | Laparoscopic Supracervical Hysterectomy (Uterus <250G)
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| $7,307.90
| | Repair Bladder Defect
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| $7,008.30
| | Repair of Wound or Lesion
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| $303.10 | | Hysteroscopy, Biopsy
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| $3,636.98
| | Hysteroscopy, Sterilization
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| $7,214.05
| | Total Knee Replacement
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| $20,168.00
| | Laparoscopic Supracervical Hysterectomy (Uterus >250G)
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| $7,540.30
| | Diagnostic Laparoscopy
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| $5,891.95
| | Lysis of Adhesions
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| $2,965.65
| | Excision Lesion, Face
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| $1,273.70
| | Closed Biopsy of Bronchus
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| $3,822.40
| | Laparoscopic Assisted Vaginal Hysterectomy
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| $10,284.35
| | Inguinal Hernia Repair
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| $4,847.70
| | Excision Lesion Face, Suspected Malignancy
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| $1,273.70
| | Thoracentesis
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| $552.35 | | Hysteroscopy, Ablation
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| $5,060.60
| | Repair Wound/Lesion 2.6-7.5 cm
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| $933.35 | |
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| 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. | | | |
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| | | | | Self Care/Home Mgmt Training | $64.10 |
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| Massage |
| $60.00 |
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| | Ultrasound | $65.00 |
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| Gait Training
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| $60.00 |
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| | Therapeutic Exercises
| $75.00 |
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| Manual Therapy Techniques
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| $65.35 |
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| | Swimex | $75.00 |
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| Electrical Stimulation
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| $70.00 |
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| | Initial Evaluation
| $115.00 |
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| Traction
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| $64.10 |
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| | | Occupational Therapy Charges | | | | The following charges reflect the most common services offered by our Occpational Therapy department. Patients may have additional charges, depending on the services performed.
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| | | Initial Evaluation
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| $113.15 | | Therapeutic Procedure - 15 min.
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| $70.00 | | Ultrasound
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| $52.95
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| Speech Therapy Charges
| | | | The following charges reflect the most common services offered by our Speech Therapy department. Patients may have additional charges, depending on the services performed.
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| | | Speech Therapy
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| $185.43 | | Dysphagia Therapy
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| $185.43 | | Modified Barium Swallow
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| $277.46
| | Dysphagia Clinical Evaluation
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| $277.46 | |
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| Cardiopumonary Charges | | | | The following charges reflect the most common services offered by our Cardiopulmonary department. Patients may have additional charges, depending on the services performed.
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| | | | | Medicated Nebulizer Initial
| $123.95 |
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| Metered Dose Inhaler, Initial
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| $50.45 |
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| | Medicated Nebulizer Subsequent
| $100.05 |
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| EKG
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| $132.10 |
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| | Oxygen Charge for 12 Hours
| $91.15 |
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| Oximeter Analysis
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| $58.15 |
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| | Subsequent Oxygen Charge
| $23.15 |
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| Aterial Blood Gases
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| $188.90 |
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| | | 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.
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| | | | Chest Two View | $169.00 |
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| Abdomen, CT With Contrast
| $1,273.00 | | Mammogram Screening (including CAD reading)
| $165.00 |
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| Pelvis, CT With Contrast | $1,230.00 | | Chest, Portable 1 View
| $231.00 |
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| Dexa Bone Density
| $327.00 | | Head, CT Without Contrast
| $1,085.00 |
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| Abdomen, KUB Flat Plate 1 View
| $135.00 | | Echo, 2-D (including Color Dopplar Mapping and Pulse Wave)
| $1,294.00 |
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| Abdomen, CT Without Contrast | $1,046.00 | | Knee X-Ray
| $158.00 |
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| Shoulder X-Ray
| $141.00 | | Ultrasound, Pelvis
(including Transvaginal Ultrasound other than OB) | $666.00 |
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| Ultrasound, Breast
| $412.00 | | Hand X-Ray
| $141.00 |
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| Pelvis, CT Without Contrast
| $1,046.00 | | Acute Abdomen Series
| $274.00 |
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| Mammogram Diagnostic
(including CAD reading)
| $260.00 | | Cardiac Stress/Rest
(including Myocardial Wall Motion and Ejection Fraction)
| $1,513.00 |
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| Ultrasound, Carotid Bilateral
| $930.00 | | Ultrasound, Abdominal Aorta
| $542.00 |
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| Wrist X-Ray | $141.00 | | Foot X-Ray
| $141.00 |
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| Lumbar Spine, With Obliques
| $303.00 | | Ankle X-Ray
| $141.00 |
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| Abdomen, CT With and Without Contrast
| $1,284.00 | | Chest, CT With Contrast
| $1,344.00 |
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| Pelvis, CT With and Without Contrast
| $1,284.00 | | Mammogram Unilateral
| $134.00 |
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| MRI L-Spine Without Contrast
| $1,652.00 | | | Laboratory Charges | | | | The following charges reflect the hospital's 30 most common laboratory procedures. | | Complete blood count (CBC) | $62.15 |
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| Glucose
| $31.35 | | Comprehensive metabolic profile
| $99.85 |
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| Surgical Pathology Level 4
| $183.25 | | Basic metabolic profile | $58.65 |
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| Electrolytes Panel
| $36.25 | | Prothrombin Time
| $31.45 |
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| Free Thyroxine
| $72.10 | | Lipid Panel
| $101.65 |
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| Prostate Specific Antigen
| $147.00 | | Urinalysis | $18.90 |
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| Urine Pregnancy Test
| $82.30 | | TSH | $134.25 |
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| Blood Urea Nitrogen (BUN)
| $31.55 | | Magnesium | $46.10 |
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| Blood Culture
| $82.50 | | Troponin
| $78.70 |
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| Sedimentation Rate
| $28.40 | | Creatinine
| $41.00 |
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| Hemoglobin
| $18.95 | | Urine Microscopic
| $24.25 |
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| Lipase
| $55.05 | | Partial Thromboplastin Time
| $47.95 |
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| Hematocrit
| $18.95 | | Urine Culture
| $64.70 |
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| Amylase
| $51.85 | | Hepatic Function Panel | $50.55 |
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| Creatine Kinase (CK)
| $52.05 | | Hemoglobin A1C
| $77.60 |
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| RH Type
| $42.75 | 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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