Washakie Medical Center
400 S 15th Street, Worland, WY · Banner Health · · NPI 1255368593
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $25.04 | $39.00 | $18.72 – $37.83 | 15 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $7.70 | $12.00 | $5.76 – $11.64 | 15 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $37.24 | $58.00 | $26.88 – $54.32 | 15 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $37.24 | $58.00 | $27.36 – $55.29 | 15 |
| Graft axiofill 1000mg HCPCS J3590 | $38.13 | $47.20 | $3.24 – $6.56 | 15 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $51,395.76 | $67,894.00 | $1,293.60 – $2,614.15 | 15 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $7,013.61 | $9,265.00 | $285.12 – $576.18 | 15 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $502.04 | $663.20 | $223.34 – $451.34 | 15 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $24,870.48 | $32,854.00 | $150.24 – $303.61 | 15 |
| Great toe with reduction 28495 CPT 28495 | $276.14 | $461.00 | $147.36 – $297.79 | 15 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $7,489.41 | $13,895.00 | $79.68 – $161.02 | 15 |
| Gw stiffened micro access kit HCPCS C1894 | $168.71 | $313.00 | $46.08 – $93.12 | 15 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $119.32 | $152.00 | $72.96 – $147.44 | 15 |
| Hand X-ray CPT 73130 | $272.70 | $356.00 | $9.12 – $18.43 | 15 |
| Hand X-ray (2 views, both hands) CPT 73120 | $175.41 | $229.00 | $8.64 – $17.46 | 15 |
| Haptoglobin quantitative CPT 83010 | $37.88 | $59.00 | $25.44 – $51.41 | 15 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,294.20 | $1,800.00 | $864.00 – $1,746.00 | 15 |
| Hcg qualitative CPT 84703 | $14.77 | $23.00 | $11.04 – $22.31 | 15 |
| Hcg quantitative CPT 84702 | $43.01 | $67.00 | $22.08 – $44.62 | 15 |
| Hc nm kidney imaging with flow CPT 78701 | $590.65 | $808.00 | $387.84 – $783.76 | 15 |
| Head CT scan (with and without contrast) CPT 70470 | $1,448.36 | $2,249.00 | $62.40 – $126.10 | 15 |
| Head CT scan (with contrast) CPT 70460 | $1,206.86 | $1,874.00 | $55.68 – $112.52 | 15 |
| Head CT scan (without contrast) CPT 70450 | $965.36 | $1,499.00 | $42.24 – $85.36 | 15 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $179.24 | $234.00 | $8.16 – $16.49 | 15 |
| Helicobacter pylori antibody igm CPT 86677 | $92.27 | $78.00 | $37.44 – $75.66 | 15 |
| Hematocrit CPT 85014 | $43.95 | $69.00 | $3.84 – $7.76 | 15 |
| Hemoglobin CPT 85018 | $38.22 | $60.00 | $3.84 – $7.76 | 15 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $16.05 | $25.00 | $12.00 – $24.25 | 15 |
| Hemoglobin plasma CPT 83051 | $37.88 | $59.00 | $28.32 – $57.23 | 15 |
| Hemoglobin urine CPT 83069 | $41.73 | $65.00 | $31.20 – $63.05 | 15 |
| Hemophilus influenza antibdy CPT 86684 | $73.35 | $62.00 | $29.76 – $60.14 | 15 |
| Heparin assay CPT 85520 | $58.60 | $92.00 | $31.20 – $63.05 | 15 |
| Hepatitis a antibody igm CPT 86709 | $101.74 | $86.00 | $41.28 – $83.42 | 15 |
| Hepatitis b core antibody igm CPT 86705 | $113.57 | $96.00 | $46.08 – $93.12 | 15 |
| Hepatitis b core antibody total CPT 86704 | $65.06 | $55.00 | $26.40 – $53.35 | 15 |
| Hepatitis b surface antibody CPT 86706 | $65.06 | $55.00 | $26.40 – $53.35 | 15 |
| Hepatitis c antibody CPT 86803 | $112.39 | $95.00 | $45.60 – $92.15 | 15 |
| Herpes simplex 1 ag if CPT 87274 | $42.48 | $60.00 | $28.80 – $58.20 | 15 |
| Herpes simplex 2 ag if CPT 87273 | $42.48 | $60.00 | $28.80 – $58.20 | 15 |
| Herpes simplex type 1 antibody igg CPT 86695 | $62.70 | $53.00 | $19.20 – $38.80 | 15 |
| Herpes simplex type 2 antibody igg CPT 86696 | $69.80 | $59.00 | $28.32 – $57.23 | 15 |
| Herpes simplex virus isolation CPT 87255 | $72.22 | $102.00 | $48.96 – $98.94 | 15 |
| Heterophile antibodies screening CPT 86308 | $18.93 | $16.00 | $7.68 – $15.52 | 15 |
| Hhv-6 dna quant CPT 87533 | $89.21 | $126.00 | $60.48 – $122.22 | 15 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $209.12 | $273.00 | $11.52 – $23.28 | 15 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $340.87 | $445.00 | $14.88 – $30.07 | 15 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $169.29 | $221.00 | $9.60 – $19.40 | 15 |
| Hip X-ray CPT 73502 | $317.89 | $415.00 | $11.52 – $23.28 | 15 |
| Histamine CPT 83088 | $57.14 | $89.00 | $42.72 – $86.33 | 15 |
| Hla i & ii type verify lr CPT 81371 | $872.87 | $1,214.00 | $582.72 – $1,177.58 | 15 |
| Hla ii typing 1 loc hr CPT 81382 | $267.47 | $372.00 | $178.56 – $360.84 | 15 |
| Hla i low res one antigen equiv ea CPT 81374 | $160.34 | $223.00 | $107.04 – $216.31 | 15 |
| Hla i typing low res one locus ea CPT 81373 | $275.38 | $383.00 | $183.84 – $371.51 | 15 |
| Hla typing dr/dq CPT 86816 | $107.65 | $91.00 | $43.68 – $88.27 | 15 |
| Homocysteine CPT 83090 | $37.24 | $58.00 | $27.84 – $56.26 | 15 |
| Homogenization tissue CPT 87176 | $36.82 | $52.00 | $24.96 – $50.44 | 15 |
| Homovanillic acid (hva) CPT 83150 | $43.66 | $68.00 | $32.64 – $65.96 | 15 |
| H pylori (c-13) breath CPT 83013 | $130.33 | $203.00 | $97.44 – $196.91 | 15 |
| Hrdtry perph neurphy panel CPT 81448 | $1,261.85 | $1,755.00 | $842.40 – $1,702.35 | 15 |
| Human epididymis protein 4 (he4) CPT 86305 | $114.75 | $97.00 | $46.56 – $94.09 | 15 |
| Hysterosalpingography s&i CPT 74740 | $405.21 | $529.00 | $18.72 – $37.83 | 15 |
| Iaadi respiratory synctial virus CPT 87280 | $42.48 | $60.00 | $28.80 – $58.20 | 15 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $75.05 | $106.00 | $50.88 – $102.82 | 15 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | $160.89 | $136.00 | $65.28 – $131.92 | 15 |
| Ifnl3 gene CPT 81283 | $158.90 | $221.00 | $106.08 – $214.37 | 15 |
| Igh gene rearrange amp meth CPT 81261 | $427.09 | $594.00 | $285.12 – $576.18 | 15 |
| Igh@ var region somatic mutation analy CPT 81263 | $635.60 | $884.00 | $424.32 – $857.48 | 15 |
| Igk rearrangeabn clonal pop CPT 81264 | $373.16 | $519.00 | $249.12 – $503.43 | 15 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $77.68 | $137.00 | $65.76 – $132.89 | 15 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $195.05 | $344.00 | $165.12 – $333.68 | 15 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $74.53 | $63.00 | $30.24 – $61.11 | 15 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $74.53 | $63.00 | $30.24 – $61.11 | 15 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $66.25 | $56.00 | $26.88 – $54.32 | 15 |
| Immunodiffusion nes CPT 86329 | $65.06 | $55.00 | $26.40 – $53.35 | 15 |
| Immunofixation electrophoresis serum CPT 86334 | $167.99 | $142.00 | $32.64 – $65.96 | 15 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $107.16 | $189.00 | $90.72 – $183.33 | 15 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $195.05 | $344.00 | $165.12 – $333.68 | 15 |
| Immunoglobulin assay CPT 86023 | $279.19 | $236.00 | $113.28 – $228.92 | 15 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $16,581.33 | $21,904.00 | $76.32 – $154.23 | 15 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $604.80 | $1,080.00 | $260.16 – $525.74 | 15 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $547.28 | $773.00 | $371.04 – $749.81 | 15 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $547.28 | $773.00 | $371.04 – $749.81 | 15 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $274.00 | $387.00 | $185.76 – $375.39 | 15 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $547.28 | $773.00 | $371.04 – $749.81 | 15 |
| Infect ag ia optc obs influenza CPT 87804 | $35.40 | $50.00 | $24.00 – $48.50 | 15 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $42.48 | $60.00 | $28.80 – $58.20 | 15 |
| Infect ag if influenza a CPT 87276 | $42.48 | $60.00 | $28.80 – $58.20 | 15 |
| Infect ag if influenza b CPT 87275 | $42.48 | $60.00 | $28.80 – $58.20 | 15 |
| Infect ag if pneumocystis carinii CPT 87281 | $53.81 | $76.00 | $36.48 – $73.72 | 15 |
| Infect ag if varicella zoster CPT 87290 | $42.48 | $60.00 | $28.80 – $58.20 | 15 |
| Infect ag na hep b amp CPT 87516 | $95.58 | $135.00 | $64.80 – $130.95 | 15 |
| Infect ag na hpv high-risk types CPT 87624 | $75.05 | $106.00 | $50.88 – $102.82 | 15 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $203.90 | $288.00 | $138.24 – $279.36 | 15 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $109.03 | $154.00 | $73.92 – $149.38 | 15 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $885.71 | $1,251.00 | $600.48 – $1,213.47 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $42.48 | $60.00 | $28.80 – $58.20 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $29.74 | $42.00 | $20.16 – $40.74 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $46.73 | $66.00 | $17.28 – $34.92 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $53.10 | $75.00 | $21.12 – $42.68 | 15 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $163.55 | $231.00 | $21.60 – $43.65 | 15 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.