19 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| 2019-ncov diagnostic p (U0001) |
$279 |
$279 |
7.8× |
| Admin influenza virus vac (G0008) |
$118 |
$118 |
2.4× |
| Admin pneumococcal vaccine (G0009) |
$107.50 |
$107.50 |
2.2× |
| Catheterize for urine spec (P9612) |
$25 |
$25 |
2.7× |
| Covid-19 lab test non-cdc (U0002) |
$104 |
$104 |
2.0× |
| Cysto impl 4 or more (C9740) |
$21,903.50 |
$21,903.50 |
2.2× |
| Cystoscopy prostatic imp 1-3 (C9739) |
$15,796 |
$15,796 |
2.8× |
| Direct refer hospital observ (G0379) |
$2,001.50 |
$2,001.50 |
3.2× |
| Ekg tracing for initial prev (G0404) |
$82 |
$82 |
2.7× |
| Extraction erupted tooth/exr (D7140) |
$821.80 |
$821.80 |
1.2× |
| Hospital outpt clinic visit (G0463) |
$161 |
$161 |
1.1× |
| Impltj ant sgm io nbiodegradable rx eluting sys (0660T) |
$15,678.01 |
$15,678.01 |
3.6× |
| Inj for sacroiliac jt anesth (G0260) |
$2,671 |
$2,671 |
3.6× |
| Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and… (0671T) |
$15,678.01 |
$15,678.01 |
2.8× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$1,510 |
$1,510 |
3.2× |
| Obtaining screen pap smear (Q0091) |
$30.50 |
$30.50 |
1.0× |
| Prefab stnlss steel crwn pri (D2930) |
$4,917.42 |
$4,917.42 |
7.2× |
| Prostate biopsy, any mthd (G0416) |
$319 |
$319 |
0.8× |
| Trauma respons w/hosp criti (G0390) |
$5,289 |
$5,289 |
3.8× |