▸ Hospital · OH · CCN 360013

Wilson Memorial Hospital

915 WEST MICHIGAN STREET, SIDNEY, OH, 45365-

44 bedsAcute Care Hospitals2

Compliance grade

86/100

Rates published

940

last crawl 2026-05-24

Procedures tracked

129

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All OH hospitals JSON

Source MRF: https://8589329.fs1.hubspotusercontent-na1.net/hubfs/8589329/Wilson%20Health%20CMS%20Price%20Transparency%2012.6.24%20-%20CSV%20CD-1.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
emergency
ED visit level 1	CPT	99281	0	$286.65	$143.33	—	—	—
ED visit level 2	CPT	99282	0	$487.2	$243.6	—	—	—
ED visit level 3	CPT	99283	0	$812.7	$406.35	—	—	—
ED visit level 4	CPT	99284	0	$1,134	$567	—	—	—
ED visit level 5	CPT	99285	0	$1,579.2	$789.6	—	—	—
Critical care, first hour	CPT	99291	0	$2,345.7	$1,172.85	—	—	—
imaging
CT head without contrast	CPT	70450	0	$1,920.45	$960.23	—	—	—
CT head with contrast	CPT	70460	0	$2,268	$1,134	—	—	—
CT head with and without contrast	CPT	70470	0	$2,615.55	$1,307.78	—	—	—
CT neck with contrast	CPT	70491	0	$2,268	$1,134	—	—	—
MRI brain without contrast	CPT	70551	0	$3,487.05	$1,743.53	—	—	—
MRI brain with contrast	CPT	70552	0	$3,920.7	$1,960.35	—	—	—
MRI brain with and without contrast	CPT	70553	0	$4,357.5	$2,178.75	—	—	—
Chest X-ray single view	CPT	71045	0	$305.55	$152.78	—	—	—
Chest X-ray 2 views	CPT	71046	0	$451.5	$225.75	—	—	—
Chest X-ray 3 views	CPT	71047	0	$504	$252	—	—	—
CT chest without contrast	CPT	71250	0	$1,920.45	$960.23	—	—	—
CT chest with contrast	CPT	71260	0	$2,268	$1,134	—	—	—
CT chest with and without contrast	CPT	71270	0	$2,615.55	$1,307.78	—	—	—
MRI chest without contrast	CPT	71550	0	$3,168.9	$1,584.45	—	—	—
MRI chest with and without contrast	CPT	71552	0	$3,958.5	$1,979.25	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$510.3	$255.15	—	—	—
CT cervical spine without contrast	CPT	72125	0	$1,920.45	$960.23	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$2,615.55	$1,307.78	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$1,920.45	$960.23	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$3,487.05	$1,743.53	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$3,487.05	$1,743.53	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$3,487.05	$1,743.53	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$4,357.5	$2,178.75	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$4,357.5	$2,178.75	—	—	—
CT pelvis without contrast	CPT	72192	0	$1,920.45	$960.23	—	—	—
CT pelvis with contrast	CPT	72193	0	$2,268	$1,134	—	—	—
Shoulder X-ray	CPT	73030	0	$655.2	$327.6	—	—	—
Humerus X-ray	CPT	73060	0	$355.95	$177.98	—	—	—
Hand X-ray 3 views	CPT	73130	0	$355.95	$177.98	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$3,487.05	$1,743.53	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$4,357.5	$2,178.75	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$339.15	$169.58	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$539.7	$269.85	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$3,487.05	$1,743.53	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$4,357.5	$2,178.75	—	—	—
CT abdomen without contrast	CPT	74150	0	$1,920.45	$960.23	—	—	—
CT abdomen with contrast	CPT	74160	0	$2,268	$1,134	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$2,615.55	$1,307.78	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$3,834.6	$1,917.3	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$4,532.85	$2,266.43	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$5,225.85	$2,612.93	—	—	—
MRI abdomen without contrast	CPT	74181	0	$3,487.05	$1,743.53	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$4,357.5	$2,178.75	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$1,400.7	$700.35	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$1,400.7	$700.35	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$1,282.05	$641.03	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$1,024.8	$512.4	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$1,078.35	$539.18	—	—	—
Transvaginal ultrasound	CPT	76830	0	$1,180.2	$590.1	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$1,638	$819	—	—	—
Scrotal ultrasound	CPT	76870	0	$1,078.35	$539.18	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$388.5	$194.25	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$739.2	$369.6	—	—	—
Screening mammography bilateral	CPT	77067	0	$321.3	$160.65	—	—	—
EKG complete	CPT	93000	0	$237.3	$118.65	—	—	—
EKG tracing only	CPT	93005	0	$266.7	$133.35	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$3,834.6	$1,917.3	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$3,834.6	$1,917.3	—	—	—
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	0	$32,797	$16,399	—	—	—
COPD w MCC	MS-DRG	190	0	$21,621	$10,810	—	—	—
COPD w CC	MS-DRG	191	0	$23,336	$11,668	—	—	—
COPD w/o CC/MCC	MS-DRG	192	0	$11,929	$5,964.4	—	—	—
Simple pneumonia & pleurisy w CC	MS-DRG	194	0	$24,044	$12,022	—	—	—
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	0	$17,549	$8,774.45	—	—	—
AMI discharged alive w MCC	MS-DRG	280	0	$43,130	$21,565	—	—	—
AMI discharged alive w CC	MS-DRG	281	0	$38,646	$19,323	—	—	—
AMI discharged alive w/o CC/MCC	MS-DRG	282	0	$35,463	$17,732	—	—	—
Heart failure & shock w MCC	MS-DRG	291	0	$21,011	$10,505	—	—	—
Heart failure & shock w CC	MS-DRG	292	0	$16,451	$8,225.73	—	—	—
Cardiac arrhythmia w MCC	MS-DRG	308	0	$30,589	$15,295	—	—	—
Cardiac arrhythmia w CC	MS-DRG	309	0	$28,844	$14,422	—	—	—
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	0	$12,955	$6,477.63	—	—	—
GI hemorrhage w CC	MS-DRG	378	0	$28,983	$14,491	—	—	—
GI hemorrhage w/o CC/MCC	MS-DRG	379	0	$17,079	$8,539.51	—	—	—
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	0	$20,664	$10,332	—	—	—
Kidney/UTI w MCC	MS-DRG	689	0	$22,002	$11,001	—	—	—
Kidney/UTI w/o MCC	MS-DRG	690	0	$22,712	$11,356	—	—	—
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	0	$30,540	$15,270	—	—	—
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	0	$22,958	$11,479	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$161.7	$80.85	—	—	—
Electrolyte panel	CPT	80051	0	$88.2	$44.1	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$276.15	$138.08	—	—	—
Lipid panel	CPT	80061	0	$205.8	$102.9	—	—	—
Renal function panel	CPT	80069	0	$447.3	$223.65	—	—	—
Hepatic function panel	CPT	80076	0	$152.25	$76.13	—	—	—
Urinalysis non-automated	CPT	81002	0	$44.1	$22.05	—	—	—
Urinalysis automated	CPT	81003	0	$36.75	$18.38	—	—	—
Glucose quantitative	CPT	82947	0	$56.7	$28.35	—	—	—
Hemoglobin A1c	CPT	83036	0	$128.1	$64.05	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$218.4	$109.2	—	—	—
Complete blood count with automated differential	CPT	85025	0	$107.1	$53.55	—	—	—
Complete blood count without differential	CPT	85027	0	$88.2	$44.1	—	—	—
Urine culture bacterial	CPT	87086	0	$109.2	$54.6	—	—	—
Urine culture identification	CPT	87088	0	$57.75	$28.88	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$297.15	$148.58	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$563.85	$281.93	—	—	—
Vaginal delivery only	CPT	59409	0	$6,142.5	$3,071.25	—	—	—
C-section delivery only	CPT	59514	0	$10,269	$5,134.5	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$354.9	$177.45	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$354.9	$177.45	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$354.9	$177.45	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$455.7	$227.85	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$354.9	$177.45	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$354.9	$177.45	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$428.4	$214.2	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$598.5	$299.25	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$850.5	$425.25	—	—	—
surgery
Major small/large bowel procedures w MCC	MS-DRG	329	0	$132,253	$66,127	—	—	—
Major small/large bowel procedures w CC	MS-DRG	330	0	$92,323	$46,161	—	—	—
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	0	$59,630	$29,815	—	—	—
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	0	$72,016	$36,008	—	—	—
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	0	$43,992	$21,996	—	—	—
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	0	$10,904	$5,451.93	—	—	—
Major joint replacement w/o MCC	MS-DRG	470	0	$82,619	$41,310	—	—	—
Hip & femur procedures except major joint w CC	MS-DRG	481	0	$46,024	$23,012	—	—	—
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	0	$42,766	$21,383	—	—	—
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	0	$49,266	$24,633	—	—	—
PCI single major coronary artery	CPT	92920	0	$15,056	$7,527.98	—	—	—
PCI with drug-eluting stent	CPT	92928	0	$30,110	$15,055	—	—	—
PCI bypass graft	CPT	92937	0	$30,110	$15,055	—	—	—
Left heart catheterization	CPT	93452	0	$18,233	$9,116.63	—	—	—
Coronary angiography with cath	CPT	93455	0	$21,641	$10,820	—	—	—
Coronary angiography with bypass cath	CPT	93458	0	$21,641	$10,820	—	—	—

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Related data on other Healthparse brands

Explore this hospital across cost reports, quality ratings, and non-profit filings.

HCRIS.io

Medicare cost reports, margins, utilization

Stetho.io

SNF, HHA, hospice, dialysis cost reports + ownership

990Health

IRS Form 990 financials, executive compensation

CareLens

CMS quality ratings, inspections, staffing