Supplies, drugs & other prices at Aultman Alliance Community Hospital
Alliance, OH · every code in this section with a posted price and a Medicare benchmark.
23 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admin influenza virus vac (G0008) | $18.45 | $41 | 0.4× |
| Admin pneumococcal vaccine (G0009) | $18.45 | $41 | 0.4× |
| Catheterize for urine spec (P9612) | $6.30 | $14 | 0.7× |
| Diab manage trn per indiv (G0108) | $58.05 | $129 | 1.0× |
| Diab manage trn ind/group (G0109) | $17.55 | $39 | 1.1× |
| Direct refer hospital observ (G0379) | $89.10 | $198 | 0.2× |
| Drug test def 1-7 classes (G0480) range across 3 matching MRF lines |
$36–$45 | $80–$100 | varies |
| Elec stim other than wound (G0283) | $58.95 | $131 | 4.6× |
| Hbot, full body chamber, 30m (G0277) | $217.80 | $484 | 1.7× |
| Home sleep test/type 3 porta (G0399) | $355.05 | $789 | 1.7× |
| Home sleep test/type 4 porta (G0400) | $390.60 | $868 | 1.9× |
| Hospital outpt clinic visit (G0463) range across 13 matching MRF lines |
$71.55–$245.25 | $159–$545 | varies |
| Inj for sacroiliac jt anesth (G0260) range across 2 matching MRF lines |
$452.25–$904.50 | $1,005–$2,010 | varies |
| Mra w/cont, pelvis (C8918) | $1,017 | $2,260 | 3.1× |
| Mra w/o fol w/cont, abd (C8902) | $1,017 | $2,260 | 3.1× |
| Mra w/o fol w/cont, chest (C8911) | $986.85 | $2,193 | 3.0× |
| Mra w/o fol w/cont, lwr ext (C8914) | $986.85 | $2,193 | 3.0× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,017 | $2,260 | 3.1× |
| Oth resp proc, group (G0239) | $97.20 | $216 | 2.8× |
| Psa screening (G0103) | $49.50 | $110 | 2.6× |
| Tomosynthesis, mammo (G0279) | $80.10 | $178 | 6.3× |
| Tte w or wo fol wcon,doppler (C8929) | $1,718.10 | $3,818 | 2.3× |
| Unsched dialysis esrd pt hos (G0257) | $1,188.90 | $2,642 | 1.8× |
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.