Supplies, drugs & other prices at Adventist Health White Memorial Montebello
Montebello, CA · every code in this section with a posted price and a Medicare benchmark.
46 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,co (C8923) | $40.86 | $227 | 0.0× |
| 2d tte w or w/o fol w/con,fu (C8924) | $21.06 | $117 | 0.0× |
| Catheterize for urine spec (P9612) | $18.90 | $105 | 2.0× |
| Direct refer hospital observ (G0379) | $199.98 | $1,111 | 0.3× |
| Fecal blood scrn immunoassay (G0328) range across 2 matching MRF lines |
$35.64–$58.50 | $198–$325 | varies |
| Group mnt 2 or more 30 mins (G0271) | $51.30 | $285 | 3.0× |
| Hbot, full body chamber, 30m (G0277) | $111.60 | $620 | 0.6× |
| Initial preventive exam (G0402) | $62.64 | $348 | 0.4× |
| Mnt subs tx for change dx (G0270) | $53.82 | $299 | 1.7× |
| Mra w/cont, lwr ext (C8912) | $1,575 | $8,750 | 3.5× |
| Mra w/cont, pelvis (C8918) | $2,043.90 | $11,355 | 4.6× |
| Mra w/o cont, lwr ext (C8913) | $1,359 | $7,550 | 4.4× |
| Mra w/o cont, pelvis (C8919) | $2,043.90 | $11,355 | 6.7× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,793.34 | $9,963 | 4.0× |
| Mra w/o fol w/cont, pelvis (C8920) | $2,043.90 | $11,355 | 4.6× |
| Neuro csf prion prtn qual (0035U) | $84.94 | $471.87 | 0.2× |
| Njx platelet plasma (0232T) range across 2 matching MRF lines |
$38.70–$138.60 | $215–$770 | varies |
| Non-ophthalmic fva (C9733) | $183.78 | $1,021 | 0.4× |
| Onc Merkel Cll Carc Srm Quan (0058U) | $61.45 | $341.38 | 0.2× |
| Oth resp proc, group (G0239) | $31.32 | $174 | 0.7× |
| Oth resp proc, indiv (G0238) | $31.32 | $174 | 0.8× |
| Perc d-e cor revasc chro sin (C9607) range across 2 matching MRF lines |
$8,412.30–$9,790.20 | $46,735–$54,390 | varies |
| Perc d-e cor revasc t cabg s (C9604) | $11,216.88 | $62,316 | 0.8× |
| Perc d-e cor stent ather s (C9602) unusually low: confirm this is the full procedure |
$7,935.12 | $44,084 | 0.3× |
| Perc drug-el cor stent sing (C9600) | $8,723.16 | $48,462 | 0.6× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) likely a partial charge, not the full procedure |
$3,078.90 | $17,105 | 0.2× |
| Ppps, initial visit (G0438) | $79.20 | $440 | 0.5× |
| Ppps, subseq visit (G0439) | $62.82 | $349 | 0.5× |
| Prostate biopsy, any mthd (G0416) | $101.34 | $563 | 0.2× |
| Psa screening (G0103) range across 4 matching MRF lines |
$2.29–$79.92 | $12.70–$444 | varies |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $43.20 | $240 | 0.1× |
| Revasc intra lithotrip-ather (C9766) unusually low: confirm this is the full procedure |
$10,864.98 | $60,361 | 0.5× |
| Revasc intra lithotrip-stent (C9765) unusually low: confirm this is the full procedure |
$11,675.52 | $64,864 | 0.5× |
| Revasc intravasc lithotripsy (C9764) unusually low: confirm this is the full procedure |
$6,911.82 | $38,399 | 0.5× |
| Revasc lithotr-ather tib/per (C9774) unusually low: confirm this is the full procedure |
$10,525.68 | $58,476 | 0.4× |
| Revasc lithotrip tibi/perone (C9772) | $8,025.12 | $44,584 | 0.5× |
| Revasc lithotrip-stent-ather (C9767) | $24,979.68 | $138,776 | 1.1× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $15,447.60 | $85,820 | 0.6× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) unusually low: confirm this is the full procedure |
$11,561.40 | $64,230 | 0.5× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) unusually low: confirm this is the full procedure |
$3,078.90 | $17,105 | 0.4× |
| Therapeutic procd strg endur (G0237) | $31.32 | $174 | 0.8× |
| Trim nail(s) (G0127) range across 2 matching MRF lines |
$6.30–$69.66 | $35–$387 | varies |
| Trluml Perip Athrc Iliac Art (0238T) range across 2 matching MRF lines unusually low: confirm this is the full procedure |
$10,293.12 | $2,740–$57,184 | 0.4× |
| Tte w or w/o contr, cont ecg (C8930) | $77.76 | $432 | 0.1× |
| Tte w or wo fol wcon,doppler (C8929) | $64.80 | $360 | 0.1× |
| Unsched dialysis esrd pt hos (G0257) | $849.24 | $4,718 | 1.0× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.