Supplies, drugs & other prices at Ascension Seton Smithville

Smithville, TX · every code in this section with a posted price and a Medicare benchmark.

76 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $807.84 $2,244 1.0×
2d tte w or w/o fol w/con,co (C8923) $966.10 $2,683.62 1.2×
2d tte w or w/o fol w/con,fu (C8924) $553.54 $1,537.62 1.6×
Admin influenza virus vac (G0008) $22.86 $63.50 0.5×
Admin pneumococcal vaccine (G0009) $61.96 $172.12 1.3×
Bdy surf activation mapg pm/cvdfb leads tm f/up (0696T) $63.18 $175.50 1.7×
Covid-19 lab test non-cdc (U0002) $80.46 $223.50 1.6×
Diab manage trn per indiv (G0108) $61.92 $172 1.1×
Direct refer hospital observ (G0379) $156.33 $434.25 0.3×
Drug test def 1-7 classes (G0480) $92.61 $257.25 0.8×
Elec stim other than wound (G0283) $38.61 $107.25 3.0×
Elec stim unattend for press (G0281) $42.70 $118.62 3.7×
Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein, open or… (0524T) $5,416.20 $15,045 1.7×
Followup eval of foot pt lop (G0246) $125.64 $349 0.9×
Hospital outpt clinic visit (G0463) $48.24 $134 0.4×
Initial foot exam pt lops (G0245) $125.64 $349 0.9×
Inj for sacroiliac jt anesth (G0260) $1,112.85 $3,091.25 1.6×
Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming,… (0516T) $15,181.47 $42,170.75 1.4×
Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming,… (0517T) $15,181.47 $42,170.75 1.4×
Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial… (0526T) $15,181.47 $42,170.75 1.8×
Insertion wrls car stimulator lv pacg compl sys (0515T) $12,886.11 $35,794.75 0.6×
Insertion/replacement complete iims (0525T) $20,256.57 $56,268.25 1.0×
Insertion/replacement iims implantable mntr only (0527T) $15,181.47 $42,170.75 1.8×
Intens cardiac rehab no exer (G0423) $147.51 $409.75 1.1×
Intens cardiac rehab w/exerc (G0422) $226.98 $630.50 1.8×
Interrog dev eval iims ip (0529T) $76.23 $211.75 2.0×
Interrog dev eval wcs ip (0521T) $35.28 $98 1.2×
Mra w/cont, abd (C8900) $1,316.88 $3,658 3.8×
Mra w/cont, chest (C8909) $1,652.94 $4,591.50 4.7×
Mra w/cont, lwr ext (C8912) $1,652.94 $4,591.50 4.7×
Mra w/o cont, abd (C8901) $1,316.88 $3,658 5.5×
Mra w/o cont, chest (C8910) $1,337.22 $3,714.50 5.6×
Mra w/o cont, lwr ext (C8913) $1,108.80 $3,080 4.6×
Mra w/o fol w/cont, abd (C8902) $2,009.43 $5,581.75 5.7×
Mra w/o fol w/cont, chest (C8911) $2,143.62 $5,954.50 6.1×
Mra w/o fol w/cont, lwr ext (C8914) $1,264.77 $3,513.25 3.6×
Mra w/o fol w/cont, pelvis (C8920) $1,389.42 $3,859.50 4.0×
Mra, w/dye, spinal canal (C8931) $1,040.49 $2,890.25 3.0×
Mra, w/dye, upper extremity (C8934) $943.83 $2,621.75 2.7×
Mra, w/o dye, spinal canal (C8932) $697.86 $1,938.50 2.9×
Mra, w/o dye, upper extr (C8935) $665.42 $1,848.38 2.8×
Mra, w/o&w/dye, spinal canal (C8933) $1,176.75 $3,268.75 3.4×
Mra, w/o&w/dye, upper extr (C8936) $1,067.94 $2,966.50 3.0×
Mri w/cont, breast, bi (C8906) $1,737.45 $4,826.25 5.0×
Mri w/cont, breast, uni (C8903) $1,484.46 $4,123.50 8.4×
Mri w/o fol w/cont, breast, (C8908) $835.20 $2,320 2.4×
Mri w/o fol w/cont, brst, un (C8905) $835.20 $2,320 2.4×
Pathogen test for platelets (P9100) $40.23 $111.75 0.7×
Perc d-e cor revasc chro sin (C9607) $26,911.80 $74,755 1.5×
Perc d-e cor revasc t cabg s (C9604) $26,911.80 $74,755 2.3×
Perc d-e cor stent ather s (C9602) $26,911.80 $74,755 1.5×
Perc drug-el cor stent sing (C9600) $26,911.80 $74,755 2.3×
Pne flu hepb cov home admin (M0201) $45.45 $126.25 1.3×
Potassium hydroxide preps (Q0112) $21.78 $60.50 3.7×
Prgrmg dev eval iims ip (0528T) $76.23 $211.75 2.0×
Prgrmg dev eval wcs ip (0522T) $76.23 $211.75 2.0×
Prolonged iv inf, req pump (C8957) $102.60 $285 0.5×
Prostate biopsy, any mthd (G0416) $1,902.51 $5,284.75 5.3×
Quan MRI alys brain with diagnostic MRI (0866T) $308.52 $857 1.3×
Quan MRI alys brn w/o dx MRI (0865T) $308.52 $857 1.3×
Removal and replacement of wireless cardiac stimulator for left ventricular pacing pulse generator component(s)… (0520T) $45,101.43 $125,281.75 4.3×
Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s)… (0519T) $6,418.89 $17,830.25 0.6×
Removal complete iims (0530T) $6,418.89 $17,830.25 1.7×
Removal iims electrode only (0531T) $6,418.89 $17,830.25 1.7×
Removal iims implt mntr only (0532T) $6,418.89 $17,830.25 1.7×
Removal of only pulse generator component(s) (battery and/or transmitter) of wireless cardiac stimulator for left… (0518T) $6,418.89 $17,830.25 1.7×
Routine footcare pt w lops (G0247) $125.64 $349 0.6×
Tee w or w/o fol w/cont, mon (C8927) $807.84 $2,244 1.0×
Tee w or w/o fol w/cont,cong (C8926) $1,079.73 $2,999.25 1.4×
Therapeutic procd strg endur (G0237) $27.81 $77.25 1.0×
Tomosynthesis, mammo (G0279) $53.82 $149.50 4.2×
Trauma respons w/hosp criti (G0390) $3,048.75 $8,468.75 2.3×
Tte w or w/o contr, cont ecg (C8930) $1,974.24 $5,484 2.5×
Tte w or w/o fol w/con,stres (C8928) $1,341.54 $3,726.50 1.7×
Tte w or wo fol wcon,doppler (C8929) $2,181.87 $6,060.75 2.8×
Unsched dialysis esrd pt hos (G0257) $625.95 $1,738.75 0.9×