Clinton Memorial Hospital
Clinton Memorial Hospital in Wilmington, OH publishes cash prices for 34 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
610 West Main Street, Wilmington, OH 45177 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W/CONT | $1,376.76 | $2,753.52 | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W | $1,376.76 | $2,753.52 | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W/CONT | $1,376.76 | $2,753.52 | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W | $1,376.76 | $2,753.52 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO | $800.47 | $1,600.94 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O | $800.47 | $1,600.94 | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO | $800.47 | $1,600.94 | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O | $800.47 | $1,600.94 | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W | $998.05 | $1,996.11 | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W | $998.05 | $1,996.11 | 50% |
| Diagnostic mammogram, both breasts CPT 77066 MAMMO DIAG BIL | $203.38 | $406.77 | 50% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMO DIAG BIL | $203.38 | $406.77 | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI LT | $155.00 | $310.00 | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI RT | $155.00 | $310.00 | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNI LT | $155.00 | $310.00 | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNI RT | $155.00 | $310.00 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LOW EXT JT WO BLT | $1,904.62 | $3,809.23 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JT L-EXT W/O BL | $1,904.93 | $3,809.86 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JT L-EXT W/O LT | $1,707.35 | $3,414.69 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE JNT WO RT | $1,707.35 | $3,414.69 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI JT L-EXT W/O RT | $1,707.35 | $3,414.69 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE JNT WO LT | $1,707.35 | $3,414.69 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LOW EXT JT WO BLT | $1,904.62 | $3,809.23 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JT L-EXT W/O BL | $1,904.93 | $3,809.86 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JT L-EXT W/O LT | $1,707.35 | $3,414.69 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE JNT WO RT | $1,707.35 | $3,414.69 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE JNT WO LT | $1,707.35 | $3,414.69 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI JT L-EXT W/O RT | $1,707.35 | $3,414.69 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JT L-EXT WO/W RT | $1,729.50 | $3,459.00 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI JT L-EXT WO/W LT | $1,729.50 | $3,459.00 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE JNT W/WO RT | $1,729.50 | $3,459.00 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LE JNT W/WO LT | $1,729.50 | $3,459.00 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE JNT W/WO LT | $1,729.50 | $3,459.00 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI JT L-EXT WO/W LT | $1,729.50 | $3,459.00 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LE JNT W/WO RT | $1,729.50 | $3,459.00 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI JT L-EXT WO/W RT | $1,729.50 | $3,459.00 | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O | $1,554.72 | $3,109.45 | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO | $1,554.72 | $3,109.45 | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O | $1,554.72 | $3,109.45 | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO | $1,554.72 | $3,109.45 | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W | $2,240.56 | $4,481.12 | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/W/O | $2,240.56 | $4,481.12 | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/W | $2,240.56 | $4,481.12 | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/W/O | $2,240.56 | $4,481.12 | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O | $1,666.80 | $3,333.60 | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE W/O | $1,666.80 | $3,333.60 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PREG UTERUS COMPLETE | $476.24 | $952.47 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 PREG UTERUS COMPLETE | $476.24 | $952.47 | 50% |
| Screening mammogram, both breasts both sides CPT 77067 MAMM SCRN BILAT CAD | $196.07 | $392.14 | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMM SCRN BILAT CAD | $196.07 | $392.14 | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4 + | $2,557.84 | $5,115.69 | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4 + | $2,557.84 | $5,115.69 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $577.57 | $1,155.14 | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $577.57 | $1,155.14 | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $538.28 | $1,076.56 | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE | $538.28 | $1,076.56 | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 LS SPINE 4VW > | $227.34 | $454.68 | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LS SPINE 4VW > | $227.34 | $454.68 | 50% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANE | $56.35 | $112.70 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANE | $56.35 | $112.70 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $38.77 | $77.55 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIO IQ ADV. LIPID | $76.97 | $153.95 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $38.77 | $77.55 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ ADV. LIPID | $76.97 | $153.95 | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF | $37.27 | $74.55 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF | $37.27 | $74.55 | 50% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTO W/PLT WO/DF | $22.73 | $45.45 | 50% |
| Complete blood count (CBC), no differential CPT 85027 CWMDP CBC W/O DIFF | $23.35 | $46.70 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTO W/PLT WO/DF | $22.73 | $45.45 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CWMDP CBC W/O DIFF | $23.35 | $46.70 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL | $111.50 | $223.00 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL | $111.50 | $223.00 | 50% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $90.30 | $180.60 | 50% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $90.30 | $180.60 | 50% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCT PANEL | $72.10 | $144.20 | 50% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCT PANEL | $72.10 | $144.20 | 50% |
| Obstetric blood test panel CPT 80055 OB PANEL W/BB ID | $75.75 | $151.50 | 50% |
| Obstetric blood test panel inpatient CPT 80055 OB PANEL W/BB ID | $75.75 | $151.50 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $45.85 | $91.70 | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $45.85 | $91.70 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $54.08 | $108.15 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL | $54.08 | $108.15 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $30.95 | $61.90 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $30.95 | $61.90 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME INR | $18.32 | $36.65 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $18.32 | $36.65 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT | $18.32 | $36.65 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME INR | $18.32 | $36.65 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $60.60 | $121.20 | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $60.60 | $121.20 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 UA AUTO W MICRO | $20.65 | $41.30 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA AUTO W MICRO | $20.65 | $41.30 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 UA DIPSTICK | $4.03 | $8.05 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO M | $18.00 | $36.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIPSTICK | $4.03 | $8.05 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO M | $18.00 | $36.00 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK | $24.02 | $48.05 | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK | $24.02 | $48.05 | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ST EXERCISE TX 15" | $89.92 | $179.84 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA THER EXER/15 MIN | $107.66 | $215.32 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXER/15 MIN | $107.66 | $215.32 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 ST EXERCISE TX 15" | $89.92 | $179.84 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA THER EXER/15 MIN | $107.66 | $215.32 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXER/15 MIN | $107.66 | $215.32 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OP CONSULTS | $999.73 | $1,999.45 | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OP CONSULTS | $999.73 | $1,999.45 | 50% |
Source file: https://apps.trihealth.com/static/pricing/273633811_clinton-memorial-hospital_standardcharges.json