Supplies, drugs & other prices at Aurelia Osborn Fox Memorial Hospital
Oneonta, NY · every code in this section with a posted price and a Medicare benchmark.
90 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Alveoloplasty not w/extracts (D7321) | $115.67 | $428.40 | 0.1× |
| Alveoplasty w/ extraction (D7310) | $108.54 | $402 | 0.1× |
| Alveoplasty w/o extraction (D7320) | $147.42 | $546 | 0.1× |
| Amalgam 4 or > surfaces perm (D2161) | $62.65 | $232.05 | 0.1× |
| Amalgam one surface permanen (D2140) | $30.05 | $111.30 | 0.0× |
| Amalgam three surfaces perma (D2160) | $50.18 | $185.85 | 0.1× |
| Amalgam two surfaces permane (D2150) | $38.84 | $143.85 | 0.0× |
| Annual alcohol screen 15 min (G0442) | $14.18 | $52.50 | 0.3× |
| Ant resin-based cmpst crown (D2390) | $68.85 | $255 | 0.1× |
| Assessment of a patient (D0191) | $24.95 | $92.40 | 0.2× |
| Behavior counsel obesity 15m (G0447) | $25.80 | $95.55 | 0.2× |
| Bitewings - three images (D0273) | $17.01 | $63 | 0.1× |
| Bitewings four images (D0274) | $19.85 | $73.50 | 0.1× |
| Brief alcohol misuse counsel (G0443) | $38.27 | $141.75 | 0.3× |
| Ca screen;pelvic/breast exam (G0101) | $46.21 | $171.15 | 0.4× |
| Catheterize for urine spec (P9612) range across 3 matching MRF lines |
$7.02–$37.71 | $26–$139.65 | varies |
| Comp periodontal evaluation (D0180) | $31.75 | $117.60 | 0.2× |
| Comprehensve oral evaluation (D0150) | $19.39 | $71.82 | 0.1× |
| Core build-up incl any pins (D2950) | $89.30 | $330.75 | 0.1× |
| Covid-19 lab test non-cdc (U0002) range across 2 matching MRF lines |
$31.05–$55.08 | $115–$204 | varies |
| Crown porcelain w/ h noble m (D2750) | $314.40 | $1,164.45 | 0.4× |
| Crown porcelain/ceramic (D2740) | $347 | $1,285.20 | 0.4× |
| Dental bitewing single image (D0270) | $9.07 | $33.60 | 0.1× |
| Dental bitewings two images (D0272) | $13.04 | $48.30 | 0.1× |
| Dental prophylaxis adult (D1110) | $24.66 | $91.35 | 0.1× |
| Depression screen annual (G0444) | $14.18 | $52.50 | 0.3× |
| Devlopment test interpt&rep (G0451) | $5.76 | $21.34 | 0.0× |
| Diab manage trn per indiv (G0108) range across 2 matching MRF lines |
$11.34–$12.19 | $42–$45.15 | varies |
| Diab manage trn ind/group (G0109) range across 2 matching MRF lines |
$7.02–$13.04 | $26–$48.30 | varies |
| Direct refer hospital observ (G0379) | $25.05 | $92.78 | 0.0× |
| End thxpy, anterior tooth (D3310) | $222.83 | $825.30 | 0.3× |
| End thxpy, premolar tooth (D3320) | $292.86 | $1,084.65 | 0.4× |
| Extensv oral eval prob focus (D0160) | $22.11 | $81.90 | 0.1× |
| Extraction coronal remnants (D7111) | $27.50 | $101.85 | 0.0× |
| Extraction erupted tooth/exr (D7140) | $47.34 | $175.35 | 0.1× |
| Full mouth debridement (D4355) | $62.10 | $230 | 0.1× |
| Gingivectomy/plasty 1 to 3 (D4211) | $108 | $400 | 0.0× |
| Gingivectomy/plasty rest (D4212) | $85.62 | $317.10 | 0.0× |
| Guided tiss regen resorble (D4266) | $228.15 | $845 | 0.1× |
| High inten beh couns std 30m (G0445) | $27.78 | $102.90 | 0.2× |
| I&d absc intraoral soft tiss (D7510) | $42.81 | $158.55 | 0.0× |
| Impact tooth remov comp bony (D7240) | $146 | $540.75 | 0.2× |
| Impact tooth remov part bony (D7230) | $119.07 | $441 | 0.1× |
| Intens behave ther cardio dx (G0446) | $12.69 | $47 | 0.3× |
| Intraor comprehensive series (D0210) | $34.30 | $127.05 | 0.1× |
| Intraoral occlusal film (D0240) | $13.04 | $48.30 | 0.1× |
| Intraoral periapical first (D0220) | $9.07 | $33.60 | 0.1× |
| Limit oral eval problm focus (D0140) | $22.11 | $81.90 | 0.1× |
| Neuro csf prion prtn qual (0035U) | $175.61 | $650.41 | 0.3× |
| Njx platelet plasma (0232T) range across 2 matching MRF lines |
$125.55–$139.05 | $465–$515 | varies |
| Obtaining screen pap smear (Q0091) range across 2 matching MRF lines |
$3.24–$17.55 | $12–$65 | varies |
| Occ guard, hard, full arch (D9944) | $147.15 | $545 | 0.2× |
| Oral antral fistula closure (D7260) | $418.50 | $1,550 | 0.5× |
| Oral/facial photo images (D0350) | $21.60 | $80 | 0.2× |
| Panoramic image (D0330) | $33.45 | $123.90 | 0.1× |
| Pathogen test for platelets (P9100) | $22.14 | $82 | 0.3× |
| Periodic oral evaluation (D0120) | $13.50 | $50 | 0.1× |
| Periodontal maint procedures (D4910) | $35.10 | $130 | 0.0× |
| Periodontal scaling & root (D4341) | $64.80 | $240 | 0.1× |
| Periodontal scaling 1-3teeth (D4342) | $33.94 | $125.69 | 0.0× |
| Place direct restoration (D2940) | $32.60 | $120.75 | 0.0× |
| Post 1 srfc resinbased cmpst (D2391) | $45.90 | $170 | 0.1× |
| Post 2 srfc resinbased cmpst (D2392) | $60.67 | $224.70 | 0.1× |
| Post 3 srfc resinbased cmpst (D2393) | $81.08 | $300.30 | 0.1× |
| Post >=4srfc resinbase cmpst (D2394) | $86.40 | $320 | 0.1× |
| Ppps, subseq visit (G0439) | $55.85 | $206.85 | 0.4× |
| Prefab post/core + crown (D2954) | $97.52 | $361.20 | 0.1× |
| Prefab stnlss steel crwn pri (D2930) | $68.85 | $255 | 0.1× |
| Prostate biopsy, any mthd (G0416) | $92.47 | $342.48 | 0.2× |
| Pulp cap direct (D3110) | $22.40 | $82.95 | 0.0× |
| Pulp cap indirect (D3120) | $22.41 | $83 | 0.0× |
| Rad exc lesion up to 1.25 cm (D7410) | $140.62 | $520.80 | 0.1× |
| Re-cement or re-bond crown (D2920) | $33.29 | $123.29 | 0.0× |
| Rem imp tooth w mucoper flp (D7210) | $70.59 | $261.45 | 0.0× |
| Removal of sloughed off bone (D7550) | $184.41 | $683 | 0.2× |
| Remove torus mandibularis (D7473) | $228.22 | $845.25 | 0.3× |
| Resin 4/> surf or w incis an (D2335) | $78.30 | $290 | 0.1× |
| Resin one surface-anterior (D2330) | $40.54 | $150.15 | 0.1× |
| Resin three surfaces-anterio (D2332) | $63.45 | $235 | 0.1× |
| Resin two surfaces-anterior (D2331) | $51.30 | $190 | 0.1× |
| Space maintainer fxd unilat (D1510) | $93.84 | $347.55 | 0.1× |
| Splint extra-coronal (D4323) | $168.75 | $625 | 0.2× |
| Splint intra-coronal (D4322) | $168.75 | $625 | 0.2× |
| Therapeutic pulpotomy (D3220) | $56.42 | $208.95 | 0.1× |
| Tomosynthesis, mammo (G0279) | $38.74 | $143.47 | 3.1× |
| Tooth root removal (D7250) | $113.68 | $421.05 | 0.1× |
| Tpmt and Nudt15 Genotype (0034U) | $409.41 | $1,516.34 | 0.9× |
| Trim nail(s) (G0127) | $24.57 | $91 | 0.3× |
| Vert bitewings 7 to 8 images (D0277) | $31.32 | $116 | 0.1× |
| Visit to determ ldct elig (G0296) | $37.85 | $140.20 | 0.3× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.