Home › Hospitals › Weston County Health Services Posts prices for 29 of the 66 common shoppable procedures we track. Price file retrieved 2026-06-27.
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Procedure Cash price Gross charge × Medicare
CT head/brain without contrast (70450) $1,905
$1,905
17.8×
MRI brain without contrast (70551) $2,858
$2,858
11.7×
MRI brain with contrast (70552) $2,751
$2,751
7.7×
MRI brain without and with contrast (70553) $3,929
$3,929
11.0×
X-ray lower spine, 4+ views (72110) $617
$617
5.8×
MRI lumbar spine without contrast (72148) $2,858
$2,858
11.7×
CT pelvis with contrast (72193) $2,292
$2,292
12.8×
MRI lower-extremity joint without contrast (73721) $2,620
$2,620
10.7×
CT abdomen and pelvis with contrast (74177) $4,716
$4,716
13.2×
Ultrasound, abdomen complete (76700) $1,072
$1,072
10.0×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $755
$755
7.1×
Ultrasound, transvaginal (76830) $595
$595
5.6×
Mammography, screening (bilateral) (77067) $650
$650
7.1×
Basic metabolic panel (80048) $165
$165
19.5×
Comprehensive metabolic panel (80053) $195
$195
18.5×
Obstetric panel (80055) $411
$411
8.6×
Lipid panel (80061) $165
$165
12.3×
Renal function panel (80069) $156
$156
18.0×
Hepatic function panel (80076) $144
$144
17.6×
Urinalysis, non-automated, with microscopy (81000) $80
$80
19.9×
Urinalysis, non-automated, without microscopy (81002) $37
$37
10.6×
PSA, total (84153) $209
$209
11.4×
Thyroid stimulating hormone (TSH) (84443) $211.50
$211.50
12.6×
CBC with automated differential (85025) $133
$133
17.1×
CBC, automated (85027) $99
$99
15.3×
Prothrombin time (PT) (85610) $85
$85
19.8×
Partial thromboplastin time (PTT) (85730) $101
$101
16.8×
Sleep study (attended polysomnography) (95810) $3,994
$3,994
4.6×
Physical therapy, therapeutic exercise (per 15 min) (97110) $125
$125
4.3×
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.