24 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Admin hepatitis b vaccine (G0010) |
$59 |
$59 |
1.1× |
| Admin influenza virus vac (G0008) |
$59 |
$59 |
1.1× |
| Admin pneumococcal vaccine (G0009) |
$59 |
$59 |
1.1× |
| Brief chkin by md/qhp, 11-20 (G2252) |
$95 |
$95 |
3.3× |
| Ca screen;flexi sigmoidscope (G0104) |
$2,293 |
$2,293 |
2.1× |
| Catheterize for urine spec (P9612) |
$66 |
$66 |
7.1× |
| Chemo extend iv infus w/pump (G0498) |
$524 |
$524 |
1.3× |
| Colon ca scrn not hi rsk ind (G0121) |
$3,225 |
$3,225 |
2.9× |
| Colorectal scrn; hi risk ind (G0105) |
$3,225 |
$3,225 |
2.9× |
| Diab manage trn per indiv (G0108) |
$169 |
$169 |
3.0× |
| Diab manage trn ind/group (G0109) |
$123 |
$123 |
7.7× |
| Direct refer hospital observ (G0379) |
$784 |
$784 |
1.1× |
| Hbot, full body chamber, 30m (G0277) |
$532 |
$532 |
3.2× |
| Home sleep test/type 3 porta (G0399) |
$355 |
$355 |
1.4× |
| Home sleep test/type 4 porta (G0400) |
$1,219 |
$1,219 |
4.7× |
| Hospital outpt clinic visit (G0463) |
$347.50 |
$347.50 |
2.2× |
| Instlj fecal microbiota ssp (0780T) |
$1,985 |
$1,985 |
12.4× |
| Mnt subs tx for change dx (G0270) |
$59 |
$59 |
1.9× |
| Oth resp proc, group (G0239) |
$128 |
$128 |
2.9× |
| Prgrmg dev eval ldls pm single car chamber ip (0826T) |
$69 |
$69 |
1.5× |
| Removal perm ccm-d system pulse generator only (0919T) |
$3,644 |
$3,644 |
0.8× |
| Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) |
$3,644 |
$3,644 |
0.8× |
| Trauma respons w/hosp criti (G0390) |
$4,789.50 |
$4,789.50 |
3.0× |
| Trluml peripheral atherectomy iliac artery ea (0238T) |
$22,607 |
$22,607 |
1.0× |