Supplies, drugs & other prices at Ascension Seton Edgar B Davis
Luling, TX · every code in this section with a posted price and a Medicare benchmark.
41 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) | $1,031.85 | $2,866.25 | 1.3× |
| 2d tte w or w/o fol w/con,fu (C8924) | $544.23 | $1,511.75 | 1.6× |
| Admin hepatitis b vaccine (G0010) | $32.31 | $89.75 | 0.7× |
| Admin influenza virus vac (G0008) | $94.36 | $262.12 | 2.0× |
| Admin pneumococcal vaccine (G0009) | $39.64 | $110.12 | 0.8× |
| Covid-19 lab test non-cdc (U0002) | $84.87 | $235.75 | 1.7× |
| Drug test def 1-7 classes (G0480) | $113.13 | $314.25 | 1.0× |
| Elec stim other than wound (G0283) | $49.68 | $138 | 3.9× |
| Elec stim unattend for press (G0281) | $39.20 | $108.88 | 3.4× |
| Hospital outpt clinic visit (G0463) | $77.26 | $214.62 | 0.6× |
| Inj for sacroiliac jt anesth (G0260) | $959.13 | $2,664.25 | 1.4× |
| Intens cardiac rehab no exer (G0423) | $103.95 | $288.75 | 0.8× |
| Intens cardiac rehab w/exerc (G0422) | $401.67 | $1,115.75 | 3.1× |
| Mra w/cont, abd (C8900) | $1,290.96 | $3,586 | 3.7× |
| Mra w/cont, chest (C8909) | $1,501.60 | $4,171.12 | 4.3× |
| Mra w/cont, lwr ext (C8912) | $1,654.47 | $4,595.75 | 4.7× |
| Mra w/o cont, abd (C8901) | $1,214.64 | $3,374 | 5.1× |
| Mra w/o cont, chest (C8910) | $1,355.85 | $3,766.25 | 5.7× |
| Mra w/o cont, lwr ext (C8913) | $1,044.09 | $2,900.25 | 4.4× |
| Mra w/o fol w/cont, abd (C8902) | $1,717.92 | $4,772 | 4.9× |
| Mra w/o fol w/cont, chest (C8911) | $1,894.59 | $5,262.75 | 5.4× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,507.86 | $4,188.50 | 4.3× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,531.22 | $4,253.38 | 4.4× |
| Mra, w/dye, upper extremity (C8934) | $888.75 | $2,468.75 | 2.5× |
| Mra, w/o dye, upper extr (C8935) | $1,039.32 | $2,887 | 4.3× |
| Mra, w/o&w/dye, upper extr (C8936) | $1,005.57 | $2,793.25 | 2.9× |
| Mri w/cont, breast, bi (C8906) | $1,225.98 | $3,405.50 | 3.5× |
| Mri w/cont, breast, uni (C8903) | $1,225.98 | $3,405.50 | 7.0× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,225.98 | $3,405.50 | 3.5× |
| Oth resp proc, group (G0239) | $53.42 | $148.38 | 1.4× |
| Oth resp proc, indiv (G0238) | $127.89 | $355.25 | 4.4× |
| Pathogen test for platelets (P9100) | $42.48 | $118 | 0.7× |
| Pne flu hepb cov home admin (M0201) | $39.51 | $109.75 | 1.1× |
| Prostate biopsy, any mthd (G0416) | $2,518.29 | $6,995.25 | 7.0× |
| Quan MRI alys brain with diagnostic MRI (0866T) | $284.49 | $790.25 | 1.2× |
| Quan MRI alys brn w/o dx MRI (0865T) | $284.49 | $790.25 | 1.2× |
| Therapeutic procd strg endur (G0237) | $47.97 | $133.25 | 1.7× |
| Tomosynthesis, mammo (G0279) | $49.95 | $138.75 | 3.9× |
| Trauma respons w/hosp criti (G0390) | $4,111.92 | $11,422 | 3.1× |
| Tte w or w/o fol w/con,stres (C8928) | $937.80 | $2,605 | 1.2× |
| Tte w or wo fol wcon,doppler (C8929) | $1,413.27 | $3,925.75 | 1.8× |