WAYNE COUNTY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer
70553	MRI scan of brain before and after contrast - outside service	$2,982	—	$774	$2,786
72148	MRI scan of lower spinal canal - outside service	$1,758	—	$400	$1,642
73721	MRI scan of leg joint - outside service	$1,758	—	$345	$1,642
74177	CT scan of abdomen and pelvis with contrast	$1,060	—	$297	$990
88188	FLOW CYTOMETRY 9-15	$941	—	$358	$879
88261	CHROMOSOME ANA COUNT	$866	—	$329	$809
87902	HEP C GENOTYPE	$693	—	$263	$647
86023	PLATELET ASSOC IGG	$618	—	$235	$577
84445	THYROID STIM IMMUNOG	$602	—	$229	$562
87497	CMV PCR QN 138610	$560	—	$213	$523
88262	CHROMOSOME ANA 15-20	$555	—	$211	$519
85301	ANTITHROMBIN AG	$555	—	$211	$518
88230	TISSUE CULTURE	$519	—	$197	$485
87798	EHRLICHIA CHAFFEENSE	$505	—	$192	$472
85300	ANTITHROMBIN ACTIV	$504	—	$192	$471
87522	HEP C VIRAL LOAD	$498	—	$189	$465
88237	TISSUE CULTURE NEO	$495	—	$188	$463
87536	HIV RNA BY PCA QUAN	$494	—	$188	$461
87521	HEP C VIRAL RNA QL	$491	—	$35.09	$459
87517	HEP B DNA VIRAL TAGM	$480	—	$182	$448
87556	MYCOBACTERIUM BY PCR	$477	—	$181	$445
84233	ESTROGEN RECEPTORS	$472	—	$179	$441
88309	PATH VI 88309	$467	—	$177	$436
88377	MULTIPLEX PROBE STAI	$463	—	$160	$432
77066	Mammography of both breasts	$449	—	$128	$419
86800	LUPUS PROFILE	$445	—	$169	$416
88239	TISSUE CULT SOLID TU	$422	—	$160	$394
86812	HLA-B27 ANTIGEN	$403	—	$153	$377
86352	IMMUKNOW 284529	$403	—	$153	$377
77067	Mammography, screening, bilateral	$402	—	$103	$376
86148	PHOSPHOLIPID AB PANE	$372	—	$141	$348
84597	VITAMIN K	$368	—	$140	$343
72193	CT scan, pelvis, with contrast	$352	—	$134	$329
85732	PTT SUBSTITUTION EAC	$342	—	$130	$320
88307	PATH V 88307	$337	—	$128	$315
84206	PRO INSULIN	$335	—	$127	$313
86480	QUANTIFERON-TB GOLD	$334	—	$127	$312
84080	ALKA PHOSP ISOENZYME	$326	—	$124	$304
86713	LEGIONELLA TITER AB	$323	—	$123	$302
70450	CT scan, head or brain, without contrast	$311	—	$118	$291
93975	US DOPPLER COMPLETE	$311	—	$118	$291
86870	CKBC AB PANEL	$310	—	$118	$290
77065	Mammography of one breast	$307	—	$101	$287
84252	VITAMIN B2	$303	—	$115	$283
85302	PROTEIN C ANTIGEN	$296	—	$112	$276
86255	SMOOTH MUSC ABS 263	$286	—	$109	$267
86666	EHRLICHIA CHAFFEENSI	$284	—	$108	$265
86021	ANTIBODY ID	$283	—	$107	$264
86335	IMMUNOFIXATION OTHER	$280	—	$106	$262
99205	New patient office of other outpatient visit, typically 60 min	$280	—	$106	$261

Showing top 50 of 412 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.