Room and Board, Per Day Charges
| Charge description | Cost |
|---|---|
| Critical Care Unit | $ 1,331.20 |
| Med/Surg Telemetry | $ 950.56 |
| Med/Surg Medical | $ 725.92 |
| Birth Center - Obstetrics | $ 1,056.00 |
| Birth Center - Nursery | $ 999.90 |
| Birth Center - Neonatal | $ 2,066.90 |
OB
| Charge description | Cost |
|---|---|
| Normal Delivery | $ 4,811.40 |
| Cesarean Section Delivery | $ 8,044.30 |
ED
| Charge description | Cost |
|---|---|
| Level 1 | $ 223.60 |
| Level 2 | $ 380.64 |
| Level 3 | $ 634.40 |
| Level 4 | $ 887.12 |
| Level 5 | $ 1,235.52 |
| Critical Care - 1st 30 min | $ 1,835.60 |
Operating Room
| Charge description | Cost |
|---|---|
| Level 1 | $ 2,678.40 |
| Level 2 | $ 4,586.40 |
| Level 3 | $ 6,498.36 |
| First 15 minute charge | $ 1,955.88 |
| Per Minute | $ 131.76 |
Physical Therapy
| Charge description | Cost |
|---|---|
| Therapeutic Exercises - 15 mins. | $ 154.35 |
| Ultrasound - 15 mins. | $ 138.60 |
| Therapeutic Activities - 15 mins. | $ 138.60 |
| Massage - 15 mins. | $ 138.60 |
| Gait Training - 15 mins. | $ 138.60 |
| Manual Therapy techniques - 15 mins. | $ 194.25 |
| Aquatic Therapy - 15 mins. | $ 138.60 |
| Initial Evaluation | $ 423.15 |
| Work/Physical Conditioning | $ 437.85 |
| Electrical Stimulation (Unattended) | $ 138.60 |
| Traction | $ 138.60 |
Occupational Therapy
| Charge description | Cost |
|---|---|
| Initial Evaluation | $ 423.15 |
| Theraputic Procedure - 15 mins. | $ 154.35 |
| Ultrasound - 15 mins. | $ 138.60 |
| Self Care/Home Mgmt Training | $ 138.60 |
| Therapeutic Exercises - 15 mins. | $ 154.35 |
Speech Therapy
| Charge description | Cost |
|---|---|
| Speech Therapy | $ 252.35 |
| Dysphagia Therapy | $ 252.35 |
| Modified Barium Swallow | $ 373.89 |
| Dysphagia Clinical Evaluation | $ 373.89 |
| Evaluation - Speech/Language | $ 351.23 |
Cardiopulmonary
| Charge description | Cost |
|---|---|
| Medicated Dose Inhaler Subsequent | $ 160.68 |
| Medicated Nebulizer Subsequent | $ 160.68 |
| Oxygen Charge for 12 Hours | $ 66.95 |
| Arterial Puncture Collection | $ 59.74 |
| Arterial Blood Gas | $ 139.05 |
| Cardio Stress Test - Treadmill | $ 769.00 |
| Initial Respiratory Treatment Education | $ 160.68 |
| EKG | $ 206.85 |
| Oximetry Single Determination | $ 78.20 |
X-Ray and Imaging
| Charge description | Cost |
|---|---|
| Chest Two View | $ 351.75 |
| Mammogram Screening | $ 249.90 |
| CT Abdomen With Pelvis With Contrast | $ 3,550.05 |
| Pelvis, CT With Contrast | $ 1,775.55 |
| Chest, Portable 1 View | $ 237.30 |
| Head, CT without Contrast | $ 1,775.55 |
| Echo, 2-D | $ 2,741.20 |
| Knee X-ray, 3 Viewes | $ 277.20 |
| Ultrasound, Pelvis (including Transvaginal) | $ 2,202.20 |
| Hand X-Ray | $ 277.20 |
| Acute Abdomen Series | $ 501.90 |
| Cardiac Stress/Rest | $ 4,714.25 |
| Ultrasound, Abdominal Aorta | $ 521.40 |
| Foot X-Ray | $ 277.20 |
| Ankle X-Ray | $ 277.20 |
| Chest, CT with Contrast | $ 1,775.55 |
| Dexa Bone Density | $ 710.85 |
| Abdomen, KUB Flat Plate 1 View | $ 263.55 |
| CT Abdomen without Pelvis without Contrast | $ 3,007.20 |
| Shoulder X-Ray | $ 277.20 |
| Ultrasound, Venous Duplex Unilateral | $ 1,155.00 |
| Pelvis, CT without Contrast | $ 1,503.60 |
| Mammogram Diagnostic, Bilateral | $ 336.00 |
| Ultrasound, Carotid Bilateral | $ 1,346.40 |
| Wrist X-Ray | $ 277.20 |
| Lumbar Spine, 2 or 3 view | $ 399.00 |
| Abdomen, CT with and without Contrast | $ 2,048.55 |
| Ultrasound, Breast | $ 801.90 |
| Mammogram Diagnostic, Unilateral | $ 303.45 |
| Knee Complete, Minimum 4 Views | $ 240.45 |
| MRI Lumbar Spine without Contrast | $ 2,730.00 |
| MRI Knee without Contrast | $ 2,730.00 |
Laboratory
| Charge description | Cost |
|---|---|
| Complete blood count (CBC) | $ 82.00 |
| Comprehensive Metabolic Panel | $ 215.00 |
| Basic Metabolic Panel | $ 125.00 |
| Prothrombin Time | $ 43.00 |
| Lipid Panel | $ 169.00 |
| Urinalysis | $ 59.00 |
| TSH | $ 170.00 |
| Magnesium | $ 62.00 |
| Troponin | $ 101.00 |
| Creatinine | $ 55.00 |
| Throat Culture | $ 90.00 |
| Glucose | $ 42.00 |
| Surgical Pathology Level 4 | $ 231.00 |
| Electrolytes Panel | $ 67.00 |
| Free Thyroxine | $ 93.00 |
| CKMB | $ 94.00 |
| Urine Pregnancy Test | $ 105.00 |
| Biochemical Profile Negative Organism | $ 84.00 |
| Blood Culture | $ 106.00 |
| Sedimentation Rate | $ 37.00 |
| Hemoglobin | $ 27.00 |
| Lipase | $ 72.00 |
| Partial Thromboplastin Time | $ 63.00 |
| Urine Culture | $ 84.00 |
| Hepatic Function Panel | $ 118.00 |
| Hemoglobin A1C | $ 99.00 |
| Hematocrit | $ 27.00 |
| Amylase | $ 68.00 |
| Creatine Kinase (CK) | $ 69.00 |
| Urea Nitrogen | $ 43.00 |
The information provided in the below link is a comprehensive list of charges for each inpatient and outpatient service or item provided by Wilson Hospital, also known as a chargemaster. It is not a helpful tool for patients to comparison shop between hospitals or to estimate what health care services are going to cost them out of their own pocket. For more information about the cost of your care, please contact our patient financial services staff at (937) 498-5331 or 1-800-589-9641 ext: 5331. These prices are effective as of January 1, 2020.
Chargemaster 2020 - Wilson Hospital
Helpful Resources:
Consumer Guide to Healthcare Prices
Chargemaster FAQ
Avoiding Surprises in Medical Bills
Financial Assistance