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Patient Price Information List

Disclaimer: Wagoner Community Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, Wagoner Community Hospital has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2021. Wagoner Community Hospital's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Hillcrest Hospital Pryor

Pryor

OK

Hillcrest Hospital South

Tulsa

OK

Northeastern Health System

Tahlequah

OK

Saint Francis Hospital

Tulsa

OK

Saint Francis Hospital Muskogee

Muskogee

OK

Saint John Broken Arrow

Broken Arrow

OK

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$675
$1,102

39% lower than market

Semi-Private Room

$675
$1,249

46% lower than market

Intensive Care Unit

$1,750
$1,733

1% higher than market

CMS SHOPPABLE SERVICE

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]

$2,440
$4,811

49% lower than market

Abdominal ultrasound (complete) [HCPCS 76700]

$472
$1,109

57% lower than market

Colon (large bowel) examination and biopsy with endoscope [HCPCS 45380]

$4,013
$7,562

47% lower than market

Colon (large bowel) examination and polyps or tumors removal by snare technique with endoscope [HCPCS 45385]

$297
$7,883

96% lower than market

Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]

$3,509
$6,277

44% lower than market

Esophagus, stomach, and/or upper small bowel examination and biopsy with endoscope [HCPCS 43239]

$3,428
$7,268

53% lower than market

Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]

$780
$2,311

66% lower than market

Imaging of brain by MRI without contrast, followed by contrast [HCPCS 70553]

$3,139
$3,596

13% lower than market

Imaging of leg joint by MRI without contrast [HCPCS 73721]

$1,861
$2,759

33% lower than market

Imaging of lower spinal canal by MRI without contrast [HCPCS 72148]

$1,861
$2,838

34% lower than market

Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]

$22
$94

77% lower than market

Lab analysis of urine specimen by dipstick without microscope (automated) [HCPCS 81003]

$15
$61

75% lower than market

Lab analysis to evaluate kidney function via a blood test panel [HCPCS 80069]

$119
$151

21% lower than market

Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]

$71
$89

20% lower than market

Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]

$114
$254

55% lower than market

Lab analysis to measure coagulation in plasma or whole blood specimen [HCPCS 85730]

$65
$91

29% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test [HCPCS 85027]

$44
$102

56% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]

$53
$133

60% lower than market

Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 800

$100
$140

28% lower than market

Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]

$91
$186

51% lower than market

Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]

$58
$132

56% lower than market

Lab analysis to measure the amount of total PSA (prostate specific antigen) in serum specimen [HCPCS 84153]

$125
$173

27% lower than market

Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]

$72
$145

50% lower than market

Mammography of both breasts (screening exam) [HCPCS 77067]

$584
$446

31% higher than market

Mammography of both breasts for diagnosis [HCPCS 77066]

$270
$507

47% lower than market

Mammography of one breast for diagnosis [HCPCS 77065]

$245
$380

36% lower than market

Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]

$54
$86

38% lower than market

Sleep pattern monitoring of patient in sleep lab, sleep staging with 4 or more parameters of sleep (6 years of age or older) [HCPCS 95810]

$2,500
$5,305

53% lower than market

Spinal fusion other than the neck without major complications

$46,822
$84,675

45% lower than market

Spinal x-ray of lower and sacral spine (minimum of 4 views) [HCPCS 72110]

$285
$698

59% lower than market

OUTPATIENT CLINIC

Description

Our Charge
Market Charge

Variance

Hospital outpt clinic visit [HCPCS G0463]

$164
$380

57% lower than market

OUTPATIENT EMERGENCY DEPARTMENT

Description

Our Charge
Market Charge

Variance

Emergency department visit for minor problem [HCPCS 99281]

$172
$383

55% lower than market

Emergency department visit for problem of high severity [HCPCS 99284]

$800
$1,570

49% lower than market

Emergency department visit for problem of low to moderate severity [HCPCS 99282]

$280
$630

56% lower than market

Emergency department visit for problem of moderate severity [HCPCS 99283]

$493
$1,021

52% lower than market

Emergency department visit for problem with significant threat to life [HCPCS 99285]

$1,172
$2,279

49% lower than market

OUTPATIENT LABORATORY AND PATHOLOGY

Description

Our Charge
Market Charge

Variance

Lab analysis by nucleic acid (DNA or RNA) to identify antigen of severe acute respiratory syndrome coronavirus 2 (Covid-19) [HCPCS 87635]

$180
$140

28% higher than market

Lab analysis of blood culture to identify bacteria [HCPCS 87040]

$119
$203

41% lower than market

Lab analysis of special gram or Giemsa stain to idenitfy microorganisms [HCPCS 87205]

$89
$117

24% lower than market

Lab analysis of specimen from fine needle aspirate with interpretation and report [HCPCS 88173]

$188
$246

23% lower than market

Lab analysis of urine culture to identify bacteria [HCPCS 87088]

$64
$143

55% lower than market

Lab analysis of urine culture to measure the amount of bacteria [HCPCS 87086]

$55
$169

67% lower than market

Lab analysis to evaluate an antimicrobial drug (antibiotic, antifungal, antiviral) by microdilution or agar dilution (each multi-antimicrobial, per plate) [HCPCS 87186]

$51
$166

69% lower than market

Lab analysis to measure free thyroxine (thyroid chemical) in serum specimen [HCPCS 84439]

$61
$188

67% lower than market

Lab analysis to measure the albumin (protein) level in blood, serum, or plasma specimen [HCPCS 82040]

$34
$96

65% lower than market

Lab analysis to measure the amount of blood in stool specimen by peroxidase activity [HCPCS 82272]

$17
$60

72% lower than market

Lab analysis to measure the amount of C-reactive protein in serum to identify infection or inflammation [HCPCS 86140]

$38
$109

65% lower than market

Lab analysis to measure the amount of immune system protein (complement) antigens (each component) [HCPCS 86160]

$82
$108

24% lower than market

Lab analysis to measure the amount of troponin (protein) in serum specimen [HCPCS 84484]

$105
$195

46% lower than market

Lab analysis to measure the creatine kinase (cardiac enzyme) level (MB fraction only) [HCPCS 82553]

$105
$182

42% lower than market

Lab analysis to measure the creatinine level in blood specimen to test for kidney function or muscle injury [HCPCS 82565]

$35
$106

67% lower than market

Lab analysis to measure the creatinine level to test for kidney function or muscle injury (other than blood specimen) [HCPCS 82570]

$78
$108

28% lower than market

Lab analysis to measure the cyanocobalamin (vitamin b-12) level [HCPCS 82607]

$103
$164

37% lower than market

Lab analysis to measure the ferritin (blood protein) level [HCPCS 82728]

$93
$164

43% lower than market

Lab analysis to measure the folic acid level in serum specimen [HCPCS 82746]

$100
$172

42% lower than market

Lab analysis to measure the hemoglobin A1C level in blood specimen [HCPCS 83036]

$66
$119

45% lower than market

Lab analysis to measure the iron binding capacity [HCPCS 83550]

$60
$78

24% lower than market

Lab analysis to measure the iron level [HCPCS 83540]

$44
$119

63% lower than market

Lab analysis to measure the lactic acid level in blood, plasma, or cerbrospinal fluid specimen [HCPCS 83605]

$136
$219

38% lower than market

Lab analysis to measure the lipase (fat enzyme) level [HCPCS 83690]

$47
$148

68% lower than market

Lab analysis to measure the magnesium level in body fluids and cells [HCPCS 83735]

$46
$148

69% lower than market

Lab analysis to measure the microalbumin (protein) level in urine specimen [HCPCS 82043]

$38
$144

74% lower than market

Lab analysis to measure the parathormone (parathyroid hormone) level [HCPCS 83970]

$282
$341

17% lower than market

Lab analysis to measure the phosphate level [HCPCS 84100]

$32
$113

71% lower than market

Lab analysis to measure the total creatine kinase (cardiac enzyme) level in blood specimen [HCPCS 82550]

$59
$139

58% lower than market

Lab analysis to measure the total protein level in urine specimen [HCPCS 84156]

$55
$135

59% lower than market

Lab analysis to measure the uric acid level in blood specimen [HCPCS 84550]

$31
$99

69% lower than market

Lab analysis to measure the vitamin D-3 level in serum or plasma specimen [HCPCS 82306]

$202
$379

47% lower than market

Lab analysis to measure total testosterone (hormone) level in serum specimen [HCPCS 84403]

$176
$342

48% lower than market

Lab analysis to measure urea nitrogen level in serum or plasma specimen to assess kidney function (quantitative) [HCPCS 84520]

$27
$70

62% lower than market

Lab analysis to screen for autoimmune disorders [HCPCS 86038]

$189
$186

2% higher than market

Lab analysis to screen for autoimmune disorders by titer [HCPCS 86039]

$132
$156

16% lower than market

Lab analysis to screen for pathogenic organisms [HCPCS 87081]

$75
$154

51% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's blood group type (ABO) [HCPCS 86900]

$64
$179

64% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's Rh (D) type (Rh positive or Rh negative) [HCPCS 86901]

$32
$141

77% lower than market

Pathology lab analysis of special stained specimen slides to identify organisms with interpretation and report [HCPCS 88312]

$152
$250

39% lower than market

Pathology lab analysis of tissue with microscope (intermediate complexity) [HCPCS 88305]

$235
$557

58% lower than market

Pathology lab analysis of tissue with microscope (moderately low complexity) [HCPCS 88304]

$135
$391

65% lower than market

Psa screening [HCPCS G0103]

$125
$120

4% higher than market

OUTPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Drug administration beneath the skin or into muscle by injection for therapy, diagnosis, or prevention [HCPCS 96372]

$145
$144

1% higher than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (each additional hour) [HCPCS 96366]

$104
$216

52% lower than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96365]

$430
$567

24% lower than market

Drug administration into vein by infusion of additional sequential infusion of new drug for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96367]

$145
$192

24% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of same drug) [HCPCS 96376]

$73
$194

62% lower than market

Hbot, full body chamber, 30m [HCPCS G0277]

$62
$133

54% lower than market

Heart and lungs restart (attempt) [HCPCS 92950]

$560
$1,118

50% lower than market

Hydration administration into vein by infusion (31 minutes to 1 hour) [HCPCS 96360]

$430
$442

3% lower than market

Hydration administration into vein by infusion (each additional hour) [HCPCS 96361]

$93
$190

51% lower than market

Implanted venous access drug delivery device irrigation [HCPCS 96523]

$197
$189

4% higher than market

Influenza vaccine for injection into muscle (preservation free) [HCPCS 90662]

$123
$263

53% lower than market

Moderate conscious sedation services by physician also performing a procedure, first 15 minutes (patient 5 years of age or older) [HCPCS 99152]

$182
$352

48% lower than market

Pneumococcal polysaccharide vaccine for injection beneath the skin or into muscle (2 years of age or older) [HCPCS 90732]

$131
$421

69% lower than market

Sleep pattern monitoring of patient in sleep lab with continued pressured respiratory assistance by mask or breathing tube (6 years of age or older) [HCPCS 95811]

$2,500
$5,928

58% lower than market

Tetanus and diphtheria toxoids vaccine for injection into muscle (7 years of age or older) [HCPCS 90714]

$57
$121

53% lower than market

Tissue removal from wounds per session (each additional 20 sq cm) [HCPCS 97598]

$238
$498

52% lower than market

Tissue removal from wounds per session (first 20 sq cm or less) [HCPCS 97597]

$329
$1,154

71% lower than market

Whole blood removal by needle to correct blood level imbalance [HCPCS 99195]

$150
$197

24% lower than market

Wound vac therapy (negative pressure wound therapy) with DME (durable medical equipment) per session (surface area greater than 50 square cm) [HCPCS 97606]

$329
$1,336

75% lower than market

OUTPATIENT OBSERVATION

Description

Our Charge
Market Charge

Variance

Hospital observation per hr [HCPCS G0378]

$1
$13

89% lower than market

OUTPATIENT OTHER

Description

Our Charge
Market Charge

Variance

Locm 200-299mg/ml iodine,1ml [HCPCS Q9966]

$21
$3

716% higher than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION

Description

Our Charge
Market Charge

Variance

Aminophyllin 250 mg inj [HCPCS J0280]

$42
$50

16% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of new drug) [HCPCS 96375]

$93
$201

54% lower than market

Drugs unclassified injection [HCPCS J3490]

$16
$7,969

100% lower than market

Fentanyl citrate injection [HCPCS J3010]

$17
$41

58% lower than market

Furosemide injection [HCPCS J1940]

$17
$29

41% lower than market

Glucagon hydrochloride/1 mg [HCPCS J1610]

$329
$774

58% lower than market

Inj midazolam hydrochloride [HCPCS J2250]

$17
$7

148% higher than market

Ketorolac tromethamine inj [HCPCS J1885]

$31
$26

18% higher than market

Methylprednisolone injection [HCPCS J2920]

$31
$45

32% lower than market

Na ferric gluconate complex [HCPCS J2916]

$25
$17

44% higher than market

Promethazine hcl injection [HCPCS J2550]

$31
$26

20% higher than market

Tc99m tetrofosmin [HCPCS A9502]

$198
$471

58% lower than market

OUTPATIENT PULMONARY THERAPY

Description

Our Charge
Market Charge

Variance

Amount and speed of breathed air measurement and graphic recording before and after medication administration [HCPCS 94060]

$560
$590

5% lower than market

Routine EKG (electrocardiogram) tracing using at least 12 wires [HCPCS 93005]

$197
$299

34% lower than market

OUTPATIENT SURGICAL SERVICES

Description

Our Charge
Market Charge

Variance

Abdominal cavity fluid drainage with imaging guidance [HCPCS 49083]

$1,101
$2,046

46% lower than market

Blood or blood products transfusion [HCPCS 36430]

$1,356
$6,730

80% lower than market

Burn tissue dressing change and/or removal (small: less than 5% of total body surface area) [HCPCS 16020]

$380
$319

19% higher than market

Drainage of dental bone abscess, cyst, or blood accumulation [HCPCS 41800]

$365
$751

51% lower than market

Fluid removal from chest cavity with imaging guidance [HCPCS 32555]

$1,101
$3,874

72% lower than market

Implanted central venous access device or catheter infusion for declotting [HCPCS 36593]

$1,877
$1,630

15% higher than market

Indwelling bladder catheter insertion (simple) [HCPCS 51702]

$2,858
$5,906

52% lower than market

Liver needle biopsy through the skin [HCPCS 47000]

$2,105
$3,300

36% lower than market

Needle biopsy of lung or chest tissue, accessed through the skin

$2,105
$4,540

54% lower than market

Needle insertion into vein for collection of blood sample [HCPCS 36415]

$14
$36

61% lower than market

Simple repair of wound of scalp, neck, underarms, genitalia, trunk, arms, and/or legs (2.5 cm or less) [HCPCS 12001]

$1,402
$4,483

69% lower than market

Skin substitute graft application to trunk, arms, and legs for wound up to 100 sq cm (first 25 sq cm) [HCPCS 15271]

$3,168
$4,791

34% lower than market

Vein wound compression system application to lower leg below knee including ankle and foot [HCPCS 29581]

$429
$1,592

73% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 74176]

$1,540
$4,203

63% lower than market

Abdominal and pelvic CT scan without contrast, followed by contrast for injury, foreign bodies, or tumors [HCPCS 74178]

$2,440
$5,445

55% lower than market

Abdominal aorta and both leg arteries CTA scan with contrast [HCPCS 75635]

$1,832
$3,190

43% lower than market

Abdominal ultrasound (limited) [HCPCS 76705]

$472
$842

44% lower than market

Abdominal x-ray (2 views) [HCPCS 74019]

$178
$473

62% lower than market

Abdominal x-ray (single view) [HCPCS 74018]

$178
$342

48% lower than market

Abdominal x-ray, complete study including 2 or more views of abdomen and single view of chest [HCPCS 74022]

$285
$698

59% lower than market

Abdominal, pelvic, and/or scrotal arterial inflow and venous outflow ultrasound (complete study) [HCPCS 93975]

$663
$879

25% lower than market

Ankle x-ray (minimum of 3 views) [HCPCS 73610]

$285
$501

43% lower than market

Arm x-ray of upper arm (minimum of 2 views) [HCPCS 73060]

$178
$441

60% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (limited, one arm or leg) [HCPCS 93971]

$472
$1,234

62% lower than market

Arteries of both arms and legs ultrasound (complete) [HCPCS 93923]

$394
$911

57% lower than market

Blood flow (outside of the brain) ultrasound on both sides of head and neck [HCPCS 93880]

$663
$1,110

40% lower than market

Bone density measurement of the axial skeleton (hips, pelvis, spine) [HCPCS 77080]

$180
$328

45% lower than market

Breast ultrasound (one breast, limited) [HCPCS 76642]

$321
$710

55% lower than market

Chest CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 71260]

$1,565
$2,772

44% lower than market

Chest CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 71250]

$780
$2,375

67% lower than market

Chest x-ray (2 views) [HCPCS 71046]

$178
$405

56% lower than market

Chest x-ray (single view) [HCPCS 71045]

$178
$328

46% lower than market

Digital tomography of both breasts (screening exam) [HCPCS 77063]

$65
$97

33% lower than market

Facial CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70486]

$780
$2,136

63% lower than market

Fluoroscopy imaging guidance for procedure (up to 1 hour) [HCPCS 76000]

$236
$513

54% lower than market

Foot x-ray (2 views) [HCPCS 73620]

$178
$456

61% lower than market

Foot x-ray, complete study (minimum of 3 views) [HCPCS 73630]

$178
$488

64% lower than market

Hand x-ray (minimum of 2 views) [HCPCS 73130]

$178
$492

64% lower than market

Head and neck ultrasound [HCPCS 76536]

$472
$821

43% lower than market

Head or brain CT scan without contrast, followed by contrast to examine injury, foreign bodies, or tumors [HCPCS 70470]

$1,752
$3,207

45% lower than market

Heart ultrasound including color-depicted blood flow rate, direction, and valve function [HCPCS 93306]

$1,479
$2,323

36% lower than market

Hip x-ray of hip with pelvis (2 to 3 views) [HCPCS 73502]

$178
$392

55% lower than market

Imaging of arm joint by MRI without contrast [HCPCS 73221]

$1,861
$3,224

42% lower than market

Imaging of heart vessels with SPECT tomography and drugs or exercise (multiple studies) [HCPCS 78452]

$3,420
$5,297

35% lower than market

Imaging of upper spinal canal by MRI without contrast [HCPCS 72141]

$1,861
$2,944

37% lower than market

Knee x-ray (1 or 2 views) [HCPCS 73560]

$178
$381

53% lower than market

Knee x-ray (3 views) [HCPCS 73562]

$285
$474

40% lower than market

Leg ultrasound of arteries and arterial grafts of both legs (complete study) [HCPCS 93925]

$663
$1,449

54% lower than market

Lower leg x-ray (2 views) [HCPCS 73590]

$178
$405

56% lower than market

Rib cage x-ray of ribs on one side of body including chest (minimum of 3 views) [HCPCS 71101]

$285
$660

57% lower than market

Shoulder x-ray, complete study (minimum of 2 views) [HCPCS 73030]

$285
$421

32% lower than market

Spinal CT scan of lower spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72131]

$780
$2,583

70% lower than market

Spinal CT scan of upper spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72125]

$780
$2,465

68% lower than market

Spinal x-ray of lower and sacral spine (2 or 3 views) [HCPCS 72100]

$285
$464

39% lower than market

Spinal x-ray of middle spine (3 views) [HCPCS 72072]

$285
$650

56% lower than market

Spinal x-ray of upper spine (2 or 3 views) [HCPCS 72040]

$285
$511

44% lower than market

Ultrasound of area behind abdominal cavity (limited) [HCPCS 76775]

$472
$668

29% lower than market

Wrist x-ray, complete study (minimum of 3 views) [HCPCS 73110]

$178
$452

61% lower than market

INPATIENT CARDIOLOGY

Description

Our Charge
Market Charge

Variance

Abnormal or Irregular Heartbeat with complications

$17,132
$19,894

14% lower than market

Acute myocardial infarction, discharged alive with major complications

$10,803
$35,739

70% lower than market

Cardiac arrhythmia & conduction disorders with major complications

$21,374
$34,675

38% lower than market

Heart failure & shock without complications

$10,615
$13,249

20% lower than market

Heart Failure with complications

$14,366
$23,203

38% lower than market

Heart Failure with major complications

$16,814
$28,530

41% lower than market

Hypertension without major complications

$5,755
$18,871

70% lower than market

Other circulatory system diagnoses with complications

$5,505
$17,938

69% lower than market

Peripheral vascular disorders with complications

$10,137
$25,972

61% lower than market

Syncope & collapse

$10,262
$24,819

59% lower than market

INPATIENT GYNECOLOGY

Description

Our Charge
Market Charge

Variance

Female reproductive system reconstructive procedures

$8,252
$43,731

81% lower than market

INPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Anemia or other red blood cell disorders without complications

$12,555
$18,475

32% lower than market

Blood Infection with major complications

$15,093
$45,108

67% lower than market

Blood infection without major complications

$18,458
$23,436

21% lower than market

Cirrhosis & alcoholic hepatitis with complications

$5,967
$21,068

72% lower than market

Diabetes with complications

$12,954
$23,389

45% lower than market

Diabetes without complications

$5,754
$26,231

78% lower than market

Disorders of pancreas except malignancy with complications

$8,238
$19,992

59% lower than market

Disorders of pancreas except malignancy without complications

$14,591
$19,185

24% lower than market

Esophagitis, gastroent & misc digest disorders with major complications

$8,464
$31,535

73% lower than market

G.I. obstruction with complications

$6,435
$21,896

71% lower than market

G.I. obstruction without complications

$6,606
$16,179

59% lower than market

Infection of the skin

$20,188
$21,664

7% lower than market

Nutritional or Metabolic Disorders without major complications

$7,882
$19,388

59% lower than market

Red blood cell disorders with major complications

$5,906
$30,070

80% lower than market

Stomach Disorder without complications

$5,746
$20,265

72% lower than market

INPATIENT NEUROLOGY

Description

Our Charge
Market Charge

Variance

Cranial & peripheral nerve disorders without major complications

$11,807
$25,192

53% lower than market

Seizures without major complications

$5,486
$19,889

72% lower than market

INPATIENT ORTHOPEDIC SURGERY

Description

Our Charge
Market Charge

Variance

Other musculoskelet system & connective tissue O.R. procedure with complications

$18,660
$37,125

50% lower than market

Revision of hip or knee replacement with complications

$83,302
$99,435

16% lower than market

INPATIENT ORTHOPEDICS

Description

Our Charge
Market Charge

Variance

Medical back problems without major complications

$8,593
$22,603

62% lower than market

INPATIENT PSYCHIATRY

Description

Our Charge
Market Charge

Variance

Alcohol or Drug Abuse without rehab or major complications

$5,778
$18,166

68% lower than market

Mental disturbances and retardation

$8,910
$20,381

56% lower than market

Mental Illness

$12,651
$21,067

40% lower than market

INPATIENT PULMONOLOGY

Description

Our Charge
Market Charge

Variance

Chronic Lung Disease with major complications

$6,131
$26,067

76% lower than market

Pneumonia with complications

$13,633
$24,520

44% lower than market

Pneumonia with major complications

$20,636
$29,786

31% lower than market

Pneumothorax with complications

$14,767
$28,143

48% lower than market

Respiratory Failure

$10,614
$29,271

64% lower than market

Respiratory infections and inflammations with major complications

$17,126
$36,024

52% lower than market

Respiratory signs & symptoms

$10,861
$18,992

43% lower than market

INPATIENT UROLOGY

Description

Our Charge
Market Charge

Variance

Kidney & urinary Infection with major complications

$13,850
$26,494

48% lower than market

Kidney & urinary Infection without complications

$6,339
$18,387

66% lower than market

Kidney failure with complications

$6,738
$18,555

64% lower than market

Kidney failure with major complications

$11,919
$32,152

63% lower than market

Renal failure without complications

$7,279
$16,127

55% lower than market

Transurethral prostatectomy with major complications

$10,074
$44,888

78% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Wagoner Community Hospital for your healthcare needs. We want to make understanding and paying your bill as easy as possible. Here are some ways you can help us as we work to make the billing process go smoothly.

• Please give us complete health insurance information.

In addition to your health insurance card, we may ask for a photo ID. If you have been seen at Wagoner Community Hospital, let us know if your personal information or insurance information has changed since your last visit.

• Please understand and follow the requirements of your health plan.

Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and Wagoner Community Hospital is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.

• Please respond promptly to any requests from your insurance provider.

You may receive multiple bills from your hospital visit, including your family doctor, specialists, physicians that read x-rays, providers that give anesthesia, or physicians that interpret blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from Wagoner Community Hospital indicating the bill is now your responsibility. All bills sent to you are due upon receipt.

Questions about Price and Billing Information

Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.

To ask questions or get more information about a bill for services you've received, please contact our Billing Department at 918-485-5514.

If you need more information about the price of a future service, please contact our Customer Service at 918-485-5514. A physician’s order or CPT code is strongly encouraged when you call to assist us in providing you with the most accurate estimate. You can obtain the CPT code from the ordering physician.