Patient Price Information List

In compliance with state law, Wilson Health 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, 2017.

Room and Board, Per Day Charges

 

 

   

Charges

Critical Care Unit

   

$1,254.00

Medical/Surgical

   

 

 

Telemetry Semi-Private/Private

   

$896.00

 

Med/Surg Semi-Private/Private

   

$684.00

Birth Center

   

 

 

Obstetrics

   

$941.00

 

Nursery

   

$848.00

 

Neonatal

         

$1,842.00

          

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

   

$4,288.00

Cesarean Section Delivery

   

$7,169.00

 

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.

 

 

 

 

   

Charges

Level 1

   

$208.00

Level 2

   

$355.00

Level 3

   

$592.00

Level 4

   

$828.00

Level 5

   

$1,153.00

Critical Care - 1st 30 minutes

   

$1,713.00

 

Operating Room Charges

Operating Room Services charges are based upon a complexity level for a particular operation. There is a per minute charge in addition to the charge for the complexity level. The patient can expect to receive a separate bill from the Anesthesiologist, Surgeon, and/or Pathologist. 

    Charges

Per minute charge

 

$114.00

Level 1

 

$2,317.00

Level 2

 

$3,969.00

Level 3

 

$5,623.00 

 

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.

  Charges           Charges

Therapeutic Exercises - 15 mins.

$138.00

   

Massage - 15 mins.

$124.00

Ultrasound - 15 mins.

$124.00

   

Gait Training  - 15 mins.

$124.00

Therapeutic Activities - 15 mins.

$124.00

   

Manual Therapy Techniques  - 15 mins.

$174.00

Aquatic Therapy - 15 mins.

$124.00

   

Electrical Stimulation (Unattended) 

$124.00

Initial Evaluation

$380.00

   

Traction 

$124.00

Work / Physical Conditioning

$393.00

       
 

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.  

    Charges

Initial Evaluation

 

$380.00

Therapeutic Procedure - 15 min.

 

$138.00

Ultrasound- 15 mins.

 

$124.00

Self Care/Home Mgmt Training

 

$124.00

Therapeutic Exercise - 15 mins.

 

$138.00

 

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.

    Charges

Speech Therapy

 

$240.00

Dysphagia Therapy

 

$240.00

Modified Barium Swallow

 

$355.00

Dysphagia Clinical Evaluation

 

$355.00

Evaluation - Speech/Language

 

$334.00

 

Cardiopulmonary Charges

The following charges reflect the most common services offered by our Cardiopulmonary department. Patients may have additional charges, depending on the services performed.

  Charges         Charges

Medicated Dose Inhaler Subsequent

$152.00

   

Initial Respiratory Treatment Education

 

$152.00

Medicated Nebulizer Subsequent

$152.00

   

EKG 

 

$186.00

Oxygen Charge for 12 Hours

$65.00

   

Oximetry Single Determination

 

$74.00

Arterial Puncture Collection

$56.00

   

Aterial Blood Gases 

 

$132.00

Cardio Stress Test - Treadmill

$710.00

     

 

 

 

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.

  Charges       Charges

Chest Two View

$324.00

   

CT Abdomen With Pelvis With Contrast

$3,221.00

Mammogram Screening (including CAD reading)

$281.00

   

Pelvis, CT With Contrast

$1,611.00

Chest, Portable 1 View

$218.00

   

Dexa Bone Density

$656.00

Head, CT Without Contrast

$1,364.00

   

Abdomen, KUB Flat Plate 1 View

$243.00

Echo, 2-D (including Color Dopplar Mapping and Pulse Wave)

$2,265.00

   

CT Abdomen Withoout Pelvis Without Contrast  

$2,600.00

Knee X-Ray, 3 views      

$246.00

   

Shoulder X-Ray         

$255.00

Ultrasound, Pelvis (including Transvaginal Ultrasound other than OB)

$1,775.00

   

Ultrasound, Venous Duplex Unilateral

$953.00

Hand X-Ray        

$255.00

   

Pelvis, CT Without Contrast         

$1,301.00

Acute Abdomen Series        

$463.00

   

Mammogram Diagnostic, Bilateral (including CAD reading)  

$404.48

Cardiac Stress/Rest (including Myocardial Wall Motion and Ejection Fraction)

$3,930.00

   

Ultrasound, Carotid Bilateral         

$1,112.00

Ultrasound, Abdominal Aorta  

$775.00

   

Wrist X-Ray         

$255.00

Foot X-Ray

$255.00

   

Lumbar Spine, 2 or 3 views

$367.92

Ankle X-Ray        

$255.00

   

Abdomen, CT With and Without Contrast

$1,772.00

Chest, CT With Contrast        

$1,536.00

   

Ultrasound, Breast

$662.00

Mammogram Unilateral (Including CAD reading)

$391.00

   

MRI Lumbar Spine Without Contrast  

$2,477.00

Knee Complete, Minimum 4 views $222.00     MRI Knee Without Contrast $2,477.00
 

Laboratory Charges

The following charges reflect the hospital's 30 most common laboratory procedures.

Complete blood count (CBC)

$80.00

   

Glucose        

$41.00

Comprehensive metabolic panel

$210.00

   

Surgical Pathology Level 4        

$226.00

Basic metabolic panel

$122.00

   

Electrolytes Panel        

$65.00

Prothrombin Time

$42.00

   

Free Thyroxine         

$90.00

Lipid Panel        

$155.00

   

CKMB Z      

$102.00

Urinalysis

$57.00

   

Urine Pregnancy Test

$102.00

TSH

$166.00

   

Biochemical Profile Negative Organism   

$82.00

Magnesium

$60.00

   

Blood Culture        

$103.00

Troponin        

$99.00

   

Sedimentation Rate   

$36.00

Creatinine        

$66.00

   

Hemoglobin        

$25.00

Throat Culture        

$87.00

   

Lipase        

$69.00

Partial Thromboplastin Time

$61.00

   

Hematocrit        

$25.00

Urine Culture        

$82.00

   

Amylase        

$65.00

Hepatic Function Panel

$114.00

   

Creatine Kinase (CK)

$66.00

Hemoglobin A1C        

$97.00

   

Urea Nitrogen   

$42.00

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.ohiohealthcareguide.org/.