Supplies, drugs & other prices at Archbold Memorial
Thomasville, GA · every code in this section with a posted price and a Medicare benchmark.
64 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,co (C8923) | $1,162.80 | $1,938 | 1.5× |
| 2d tte w or w/o fol w/con,fu (C8924) | $598.20 | $997 | 1.8× |
| Adm tocilizu covid-19 1st (M0249) | $372 | $620 | 0.9× |
| Adm tocilizu covid-19 2nd (M0250) | $372 | $620 | 0.9× |
| Admin hepatitis b vaccine (G0010) | $42.90 | $71.50 | 1.0× |
| Admin influenza virus vac (G0008) | $49.80 | $83 | 1.1× |
| Catheterize for urine spec (P9612) | $81 | $135 | 8.7× |
| Chemo extend iv infus w/pump (G0498) | $415.20 | $692 | 1.3× |
| Direct refer hospital observ (G0379) | $322.80 | $538 | 0.6× |
| Drug test def 1-7 classes (G0480) | $68.40 | $114 | 0.6× |
| Elec stim other than wound (G0283) | $28.20 | $47 | 2.2× |
| Elec stim unattend for press (G0281) | $30.60 | $51 | 2.6× |
| Hbot, full body chamber, 30m (G0277) | $207.60 | $346 | 1.6× |
| Home sleep test/type 3 porta (G0399) | $391.80 | $653 | 1.9× |
| Hospital outpt clinic visit (G0463) | $76.80 | $128 | 0.6× |
| Infectious disease (bacterial and fungal), organism identification, blood culture, using rRNA FISH, 6 or more organism… (0086U) | $106.80 | $178 | 0.5× |
| Initial preventive exam (G0402) | $254.40 | $424 | 2.0× |
| Instill pharm renal pelvis (C9789) | $2,539.20 | $4,232 | 2.2× |
| Mra w/cont, pelvis (C8918) | $531 | $885 | 1.6× |
| Mra w/o cont, abd (C8901) | $351 | $585 | 1.5× |
| Mra w/o cont, chest (C8910) | $427.20 | $712 | 1.9× |
| Mra w/o cont, pelvis (C8919) | $396 | $660 | 1.7× |
| Mra w/o fol w/cont, abd (C8902) | $2,062.20 | $3,437 | 6.1× |
| Mra w/o fol w/cont, chest (C8911) | $688.80 | $1,148 | 2.0× |
| Mra w/o fol w/cont, lwr ext (C8914) | $711.60 | $1,186 | 2.1× |
| Mra w/o fol w/cont, pelvis (C8920) | $640.80 | $1,068 | 1.9× |
| Mri w/cont, breast, bi (C8906) | $2,002.80 | $3,338 | 6.0× |
| Mri w/o fol w/cont, breast, (C8908) | $2,108.40 | $3,514 | 6.3× |
| Pathogen test for platelets (P9100) | $90 | $150 | 1.6× |
| Perc d-e cor revasc chro sin (C9607) | $21,510.60 | $35,851 | 1.2× |
| Perc d-e cor revasc t cabg s (C9604) | $14,533.80 | $24,223 | 1.3× |
| Perc d-e cor stent ather s (C9602) | $18,598.80 | $30,998 | 1.1× |
| Perc drug-el cor stent sing (C9600) | $14,533.80 | $24,223 | 1.3× |
| Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) | $6,451.20 | $10,752 | 0.6× |
| Ppps, initial visit (G0438) | $19.80 | $33 | 0.1× |
| Ppps, subseq visit (G0439) | $19.80 | $33 | 0.1× |
| Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) | $113.40 | $189 | 3.2× |
| Prostate biopsy, any mthd (G0416) | $439.80 | $733 | 1.3× |
| Psa screening (G0103) | $94.80 | $158 | 4.9× |
| Revasc intra lithotrip-ather (C9766) | $11,034.60 | $18,391 | 0.6× |
| Revasc intra lithotrip-stent (C9765) | $11,034.60 | $18,391 | 0.6× |
| Revasc intravasc lithotripsy (C9764) unusually low: confirm this is the full procedure |
$5,407.20 | $9,012 | 0.5× |
| Revasc lith-sten-ath tib/per (C9775) | $17,373 | $28,955 | 1.0× |
| Revasc lithotr-ather tib/per (C9774) | $17,373 | $28,955 | 1.0× |
| Revasc lithotr-stent tib/per (C9773) | $17,373 | $28,955 | 1.0× |
| Revasc lithotrip tibi/perone (C9772) | $10,861.80 | $18,103 | 1.0× |
| Revasc lithotrip-stent-ather (C9767) | $17,379 | $28,965 | 1.0× |
| Screen cerv/vag thin layer (G0123) | $75.60 | $126 | 3.7× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) | $15,835.20 | $26,392 | 0.9× |
| Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) | $15,835.20 | $26,392 | 0.9× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $16,087.20 | $26,812 | 0.9× |
| Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) | $4,165.20 | $6,942 | 1.4× |
| Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) | $4,165.20 | $6,942 | 1.4× |
| Tcat rmvl perm dual chamber ldls pm compl sys (0798T) | $4,165.20 | $6,942 | 1.4× |
| Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T) | $17,558.40 | $29,264 | 0.9× |
| Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) | $17,558.40 | $29,264 | 0.9× |
| Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) | $17,558.40 | $29,264 | 0.9× |
| Tomosynthesis, mammo (G0279) | $13.80 | $23 | 1.1× |
| Trluml peripheral atherectomy iliac artery ea (0238T) unusually low: confirm this is the full procedure |
$8,494.20 | $14,157 | 0.5× |
| Tte w or w/o contr, cont ecg (C8930) | $783 | $1,305 | 1.0× |
| Tte w or w/o fol w/cont, com (C8921) | $928.20 | $1,547 | 1.2× |
| Tte w or wo fol wcon,doppler (C8929) | $1,730.40 | $2,884 | 2.3× |
| Unsched dialysis esrd pt hos (G0257) | $370.80 | $618 | 0.6× |
| Wet mounts/ w preparations (Q0111) | $19.80 | $33 | 1.1× |