Supplies, drugs & other prices at Alliancehealth Seminole
Seminole, OK · every code in this section with a posted price and a Medicare benchmark.
43 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,171.50 | $2,130 | 1.6× |
| 2d tte w or w/o fol w/con,fu (C8924) | $515.35 | $937 | 1.5× |
| Adm tocilizu covid-19 1st (M0249) | $662.75 | $1,205 | 1.6× |
| Adm tocilizu covid-19 2nd (M0250) | $662.75 | $1,205 | 1.6× |
| Admin hepatitis b vaccine (G0010) | $55 | $100 | 1.2× |
| Admin influenza virus vac (G0008) | $30.25 | $55 | 0.7× |
| Admin pneumococcal vaccine (G0009) | $30.25 | $55 | 0.7× |
| Behavior counsel obesity 15m (G0447) | $21.78 | $39.60 | 0.2× |
| Ca screen;pelvic/breast exam (G0101) | $31.28 | $56.88 | 0.3× |
| Catheterize for urine spec (P9612) | $62.70 | $114 | 6.7× |
| Chemo extend iv infus w/pump (G0498) | $521.40 | $948 | 1.6× |
| Covid-19 lab test non-cdc (U0002) | $78.10 | $142 | 1.5× |
| Direct refer hospital observ (G0379) | $539 | $980 | 0.9× |
| Elec stim other than wound (G0283) | $55.22 | $100.40 | 4.4× |
| Fecal blood scrn immunoassay (G0328) | $18.70 | $34 | 1.0× |
| Hbot, full body chamber, 30m (G0277) | $393.80 | $716 | 3.0× |
| Home sleep test/type 3 porta (G0399) | $549.45 | $999 | 2.6× |
| Hospital outpt clinic visit (G0463) | $68.75 | $125 | 0.5× |
| Initial preventive exam (G0402) | $136.22 | $247.68 | 1.1× |
| Mra w/o cont, abd (C8901) | $1,353 | $2,460 | 5.9× |
| Mri w/o fol w/cont, breast, (C8908) | $1,656.60 | $3,012 | 4.9× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $652.85 | $1,187 | 1.2× |
| Perc d-e cor revasc chro sin (C9607) | $12,264.45 | $22,299 | 0.7× |
| Perc d-e cor revasc t cabg s (C9604) | $11,464.75 | $20,845 | 1.0× |
| Perc d-e cor stent ather s (C9602) | $12,264.45 | $22,299 | 0.7× |
| Perc drug-el cor stent sing (C9600) | $11,464.75 | $20,845 | 1.0× |
| Psa screening (G0103) | $89.10 | $162 | 4.6× |
| Revasc intra lithotrip-ather (C9766) | $15,207.50 | $27,650 | 0.9× |
| Revasc intra lithotrip-stent (C9765) | $15,207.50 | $27,650 | 0.9× |
| Revasc intravasc lithotripsy (C9764) | $7,506.95 | $13,649 | 0.7× |
| Revasc lith-sten-ath tib/per (C9775) | $24,324.85 | $44,227 | 1.4× |
| Revasc lithotr-ather tib/per (C9774) | $24,324.85 | $44,227 | 1.4× |
| Revasc lithotr-stent tib/per (C9773) | $24,324.85 | $44,227 | 1.4× |
| Revasc lithotrip tibi/perone (C9772) | $15,207.50 | $27,650 | 1.4× |
| Revasc lithotrip-stent-ather (C9767) | $24,324.85 | $44,227 | 1.4× |
| Scr c/v cyto,thinlayer,rescr (G0143) | $210.65 | $383 | 7.8× |
| Screen cerv/vag thin layer (G0123) | $332.75 | $605 | 16.4× |
| Screen pap by tech w md supv (P3000) | $185.35 | $337 | 10.0× |
| Trluml peripheral atherectomy iliac artery ea (0238T) | $29,723.10 | $54,042 | 1.7× |
| Tte w or w/o fol w/con,stres (C8928) | $924 | $1,680 | 1.2× |
| Tte w or wo fol wcon,doppler (C8929) | $2,135.10 | $3,882 | 2.8× |
| Unsched dialysis esrd pt hos (G0257) | $1,382.15 | $2,513 | 2.1× |
| Visit to determ ldct elig (G0296) | $58.21 | $105.84 | 0.6× |