Supplies, drugs & other prices at Arkansas Children's Hospital
Little Rock, AR · every code in this section with a posted price and a Medicare benchmark.
41 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin pneumococcal vaccine (G0009) | $24.48 | $27.20 | 0.6× |
| Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic… (0559T) | $292.50 | $325 | 2.3× |
| Bitewings four images (D0274) | $65.50 | $72.78 | 0.3× |
| Comprehensve oral evaluation (D0150) | $72.66 | $80.73 | 0.6× |
| Cone beam ct both jaws (D0383) | $303.22 | $336.91 | 3.1× |
| Cone beam ct interp both jaw (D0367) | $428.66 | $476.29 | 4.4× |
| Covid-19 lab test non-cdc (U0002) | $124.76 | $138.62 | 2.4× |
| Dental bitewings two images (D0272) | $50.31 | $55.90 | 0.6× |
| Dental prophylaxis adult (D1110) | $93.18 | $103.53 | 0.7× |
| Diab manage trn per indiv (G0108) | $57.82 | $64.25 | 1.0× |
| Diab manage trn ind/group (G0109) | $22.68 | $25.20 | 1.4× |
| Direct refer hospital observ (G0379) | $270.21 | $300.23 | 0.5× |
| Drug test def 1-7 classes (G0480) | $82.34 | $91.49 | 0.7× |
| Drug test def 15-21 classes (G0482) | $202.50 | $225 | 1.0× |
| Drug test def 8-14 classes (G0481) | $176.72 | $196.36 | 1.1× |
| Extraction erupted tooth/exr (D7140) | $135.68 | $150.76 | 0.2× |
| Fractional abl lsr fenestration first 100 sqcm (0479T) | $265.89 | $295.43 | 0.4× |
| Full mouth debridement (D4355) | $136.96 | $152.18 | 0.2× |
| Hospital outpt clinic visit (G0463) | $79.22 | $88.02 | 0.6× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) | $49,372.68 | $54,858.53 | 1.7× |
| Instlj fecal microbiota ssp (0780T) | $971.06 | $1,078.96 | 7.8× |
| Intraor comprehensive series (D0210) | $132.83 | $147.59 | 0.6× |
| Intraoral occlusal film (D0240) | $93.82 | $104.24 | 1.1× |
| Intraoral periapical first (D0220) | $33.09 | $36.77 | 0.4× |
| Limit oral eval problm focus (D0140) | $72.02 | $80.02 | 0.6× |
| Mra w/cont, chest (C8909) | $1,229.70 | $1,366.33 | 3.8× |
| Mra w/o fol w/cont, abd (C8902) | $3,559.91 | $3,955.45 | 10.9× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $666.93 | $741.03 | 1.6× |
| Occ guard, hard, full arch (D9944) | $173.87 | $193.19 | 0.3× |
| Oral/facial photo images (D0350) | $66.83 | $74.26 | 0.8× |
| Panoramic image (D0330) | $118.75 | $131.94 | 0.5× |
| Periodic oral evaluation (D0120) | $59.99 | $66.66 | 0.5× |
| Post 1 srfc resinbased cmpst (D2391) | $336.55 | $373.94 | 0.6× |
| Post 2 srfc resinbased cmpst (D2392) | $200.82 | $223.13 | 0.3× |
| Prefab stnlss steel crown pe (D2931) | $278.29 | $309.21 | 0.5× |
| Prefab stnlss steel crwn pri (D2930) | $251.77 | $279.74 | 0.4× |
| Pulp cap indirect (D3120) | $198.47 | $220.52 | 0.3× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $291.27 | $323.63 | 0.4× |
| Re-eval,est pt,problem focus (D0170) | $61.88 | $68.75 | 0.5× |
| Resin one surface-anterior (D2330) | $283.66 | $315.18 | 0.5× |
| Resin two surfaces-anterior (D2331) | $175.11 | $194.57 | 0.3× |