Home › Hospitals › Weisbrod Memorial County Hospital Posts prices for 30 of the 66 common shoppable procedures we track. Price file retrieved 2026-06-28.
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Procedure Cash price Gross charge × Medicare
CT head/brain without contrast (70450) $293.40
$489
2.7×
X-ray lower spine, 4+ views (72110) $349.20
$582
3.2×
MRI lumbar spine without contrast (72148) $1,830.60
$3,051
7.3×
CT pelvis with contrast (72193) $525.60
$876
2.8×
CT abdomen and pelvis with contrast (74177) $1,001.40
$1,669
2.7×
Ultrasound, abdomen complete (76700) $293.40
$489
2.7×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $293.40
$489
2.7×
Ultrasound, transvaginal (76830) $293.40
$489
2.7×
Basic metabolic panel (80048) $82.80
$138
9.8×
Comprehensive metabolic panel (80053) $119.40
$199
11.3×
Lipid panel (80061) $102
$170
7.6×
Renal function panel (80069) $97.80
$163
11.3×
Hepatic function panel (80076) $90.60
$151
11.1×
Urinalysis, non-automated, with microscopy (81000) $25.80
$43
6.4×
Urinalysis, non-automated, without microscopy (81002) $20.70
$34.50
5.9×
PSA, total (84153) $57.60
$96
3.1×
Thyroid stimulating hormone (TSH) (84443) $55.80
$93
3.3×
CBC with automated differential (85025) $54.60
$91
7.0×
CBC, automated (85027) $43.20
$72
6.7×
Prothrombin time (PT) (85610) $39.60
$66
9.2×
Partial thromboplastin time (PTT) (85730) $54.60
$91
9.1×
Sleep study (attended polysomnography) (95810) $1,693.20
$2,822
1.9×
Physical therapy, therapeutic exercise (per 15 min) (97110) $49.20
$82
1.7×
Office visit, new patient (low complexity, ~30 min) (99203) $96
$160
0.7×
Office visit, new patient (moderate complexity, ~45 min) (99204) $130.20
$217
0.9×
Office visit, new patient (high complexity, ~60 min) (99205) $157.20
$262
1.1×
Office consultation (low complexity, ~30 min) (99243) $15.60
$26
0.1×
Office consultation (moderate complexity, ~40 min) (99244) $15.60
$26
0.1×
Preventive visit, new patient (age 18–39) (99385) $157.20
$262
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Preventive visit, new patient (age 40–64) (99386) $157.20
$262
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As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs — the × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.