Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp
Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp in Wellsville, NY publishes cash prices for 59 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
191 North Main Street, Wellsville, NY 14895 Collected Sep 23, 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 HB CT Abdomen & Pelvis W/Contrast Material | $680.00 | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HB CT Head/Brain W/O Contrast Material | $202.00 | — | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HB CT Pelvis W/Contrast Material | $339.00 | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 HB Diagnostic Mammography Computer-Aided Detcj Bi | $136.00 | — | — |
| Diagnostic mammogram, one breast CPT 77065 HB Diagnostic Mammography Computer-Aided Detcj Uni | $106.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HB MRI Any Jt Lower Extrem W/O Contrast Matrl | $459.00 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HB MRI Any Jt Lower Extrem W/O & W/Contrast Matrl | $680.00 | — | — |
| MRI of the brain, no contrast dye CPT 70551 HB MRI Brain Brain Stem W/O Contrast Material | $459.00 | — | — |
| MRI of the brain, with and without contrast dye CPT 70553 HB MRI Brain Brain Stem W/O W/Contrast Material | $680.00 | — | — |
| MRI of the lower back, no contrast dye CPT 72148 HB MRI Spinal Canal Lumbar W/O Contrast Material | $459.00 | — | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $126.42 | $212.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HB US Preg Uterus After 1st Trimest 1/1st Gestation | $202.00 | — | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $126.42 | $212.00 | 40% |
| Screening mammogram, both breasts both sides CPT 77067 HB Screening Mammography Bi 2-View Breast Inc Cad | $112.00 | — | — |
| Sleep study in a lab (polysomnography) CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $587.95 | $986.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 HB Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $1,934.00 | — | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $587.95 | $986.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 HB Ultrasound Transvaginal (Pro) | $93.00 | — | — |
| Transvaginal pelvic ultrasound CPT 76830 CHG US TRANSVAGINAL | $110.91 | $186.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 HB Ultrasound Transvaginal | $202.00 | — | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 CHG US TRANSVAGINAL | $110.91 | $186.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 HB US Abdominal Real Time W/Image Documentation | $202.00 | — | — |
| X-ray of the lower back, 4 or more views CPT 72110 HB Radex Spine Lumbosacral Minimum 4 Views | $202.00 | — | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HB Basic Metabolic Panel Calcium Total | $58.00 | — | — |
| Basic metabolic panel (blood test) CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL | $66.79 | $112.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL | $66.79 | $112.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HB Lipid Panel | $44.00 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHG LIPID PANEL | $51.88 | $87.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHG LIPID PANEL | $51.88 | $87.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 HB Blood Count Complete Auto&Auto Difrntl Wbc | $24.00 | — | — |
| Complete blood count (CBC) with differential CPT 85025 CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $27.43 | $46.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CHG BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $27.43 | $46.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 HB Blood Count Complete Automated | $24.00 | — | — |
| Complete blood count (CBC), no differential CPT 85027 CHG BLOOD COUNT COMPLETE AUTOMATED | $28.62 | $48.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CHG BLOOD COUNT COMPLETE AUTOMATED | $28.62 | $48.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 HB Comprehensive Metabolic Panel | $34.00 | — | — |
| Comprehensive metabolic panel (blood test) CPT 80053 CHG COMPREHENSIVE METABOLIC PANEL | $41.74 | $70.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CHG COMPREHENSIVE METABOLIC PANEL | $41.74 | $70.00 | 40% |
| Kidney function blood test panel CPT 80069 HB Renal Function Panel | $10.00 | — | — |
| Liver function blood test panel CPT 80076 HB Hepatic Function Panel | $22.00 | — | — |
| Liver function blood test panel CPT 80076 CHG HEPATIC FUNCTION PANEL | $23.85 | $40.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 CHG HEPATIC FUNCTION PANEL | $23.85 | $40.00 | 40% |
| Obstetric blood test panel CPT 80055 CHG OBSTETRIC PANEL | $146.09 | $245.00 | 40% |
| Obstetric blood test panel inpatient CPT 80055 CHG OBSTETRIC PANEL | $146.09 | $245.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HB Assay of Prostate Specific Antigen Free | $58.00 | — | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $66.79 | $112.00 | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $66.79 | $112.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HB Assay of Prostate Specific Antigen Total | $58.00 | — | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $69.77 | $117.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $69.77 | $117.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HB Thromboplastin Time Partial Plasma/Whole Blood | $21.00 | — | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $22.66 | $38.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $22.66 | $38.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $14.00 | — | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 CHG PROTHROMBIN TIME | $16.70 | $28.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHG PROTHROMBIN TIME | $16.70 | $28.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HB Assay of Thyroid Stimulating Hormone Tsh | $54.00 | — | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH | $65.00 | $109.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH | $65.00 | $109.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 HB Urnls Dip Stick/Tablet Reagent Auto Microscopy | $12.00 | — | — |
| Urinalysis with microscope exam, automated CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $13.71 | $23.00 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $13.71 | $23.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 HB Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy | $4.00 | — | — |
| Urinalysis with microscope exam, manual CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $11.93 | $20.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $11.93 | $20.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 HB Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy | $12.00 | — | — |
| Urinalysis without microscope exam, automated CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $16.10 | $27.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $16.10 | $27.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 HB Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp | $12.00 | — | — |
| Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $16.10 | $27.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $16.10 | $27.00 | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $2,498.50 | $4,190.00 | 40% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $2,498.50 | $4,190.00 | 40% |
| Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $422.78 | $709.00 | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $422.78 | $709.00 | 40% |
| Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $401.31 | $673.00 | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $401.31 | $673.00 | 40% |
| Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $317.83 | $533.00 | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $317.83 | $533.00 | 40% |
| Gallbladder removal, laparoscopic CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY | $623.13 | $1,045.00 | 40% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY | $623.13 | $1,045.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HB Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible (Pro) | $415.00 | — | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $494.93 | $830.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HB Repair Ing Hernia,5+Y/O,Reducibl | $6,710.00 | — | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $494.93 | $830.00 | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 HB Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg (Pro) | $436.00 | — | — |
| Knee arthroscopy with meniscus trim CPT 29881 PR ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG | $519.38 | $871.00 | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 HB PR Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg | $6,168.00 | — | — |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 PR ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG | $519.38 | $871.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $239.12 | $401.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $239.12 | $401.00 | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $124.63 | $209.00 | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $124.63 | $209.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $228.98 | $384.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $228.98 | $384.00 | 40% |
| Prostate biopsy CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH | $226.59 | $380.00 | 40% |
| Prostate biopsy inpatient CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH | $226.59 | $380.00 | 40% |
| Removal of a breast lump, open surgery CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $490.75 | $823.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $490.75 | $823.00 | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HB Shoulder Scope Bone Shaving | $2,474.00 | — | — |
| Total hip replacement CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $1,215.86 | $2,039.00 | 40% |
| Total hip replacement inpatient CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $1,215.86 | $2,039.00 | 40% |
| Total knee replacement CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $1,214.07 | $2,036.00 | 40% |
| Total knee replacement inpatient CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $1,214.07 | $2,036.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $345.26 | $579.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Edg Transoral Biopsy Single/Multiple | $1,782.00 | — | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $345.26 | $579.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $267.14 | $448.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic | $1,782.00 | — | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $267.14 | $448.00 | 40% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $2,354.79 | $3,949.00 | 40% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $2,354.79 | $3,949.00 | 40% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $2,256.40 | $3,784.00 | 40% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $2,256.40 | $3,784.00 | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $13.71 | $23.00 | 40% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $13.71 | $23.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $106.14 | $178.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $106.14 | $178.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $159.81 | $268.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $159.81 | $268.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $211.09 | $354.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $211.09 | $354.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $28.62 | $48.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB Therapeutic Px 1/> Areas Each 15 Min Exercises | $62.00 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES | $28.62 | $48.00 | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HB Initial Preventive Medicine New Pt Age 18-39yrs | $118.00 | — | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $253.43 | $425.00 | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $253.43 | $425.00 | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HB Initial Preventive Medicine New Patient 40-64yrs | $118.00 | — | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $268.34 | $450.00 | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $268.34 | $450.00 | 40% |