WAYNE MEMORIAL HOSPITAL
Acute Care Hospitals
Procedure Prices at WAYNE MEMORIAL HOSPITAL
HC COLLECTION BLOOD VENIPUNCTURE
CPT 36415
$2.88
HC CBC W DIFFERENTIAL AUTO
CPT 85025
$7.46
EKG Interpretation
CPT 93010
$7.77
HC COMPREHENSIVE METABOLIC PANEL
CPT 80053
$10.14
Mechanical Traction
CPT 97012
$14.35
Therapeutic Exercises
CPT 97110
$28.06
Therapeutic Activities
CPT 97530
$29.63
Chest X-Ray (1 view)
CPT 71045
$44.89
EKG Tracing
CPT 93005
$55.39
Chest X-Ray (2 views)
CPT 71046
$55.75
Abdominal Ultrasound
CPT 76700
$73.65
Echocardiogram
CPT 93307
$80.69
Diagnostic Mammogram (unilateral)
CPT 77065
$80.74
Screening Mammogram (bilateral)
CPT 77067
$85.06
HC ESTABLISHED PATIENT LEVEL 3
CPT 99213
$98
OB Ultrasound
CPT 76805
$101.16
Diagnostic Mammogram (bilateral)
CPT 77066
$102.93
CT Chest
CPT 71250
$108.34
Thoracic Spine X-Ray
CPT 72072
$108.34
Abdominal Ultrasound — Limited
CPT 76705
$108.34
Retroperitoneal Ultrasound
CPT 76770
$108.34
MRI Brain w/o Contrast
CPT 70551
$228.97
MRI Joint of Lower Extremity
CPT 73721
$228.97
ER Visit — Low-Moderate Complexity
CPT 99283
$230.29
Echocardiogram w/ Doppler
CPT 93306
$269.93
MRI Brain w/ Contrast
CPT 70553
$366.44
CT Abdomen & Pelvis
CPT 74177
$366.44
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Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.