21 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) |
$48.49 |
$108 |
1.0× |
| Admin influenza virus vac (G0008) |
$48.49 |
$108 |
1.0× |
| Admin pneumococcal vaccine (G0009) |
$48.49 |
$108 |
1.0× |
| Catheterize for urine spec (P9612) |
$56.83 |
$74 |
6.1× |
| Diab manage trn per indiv (G0108) |
$124.03 |
$136 |
2.2× |
| Diab manage trn ind/group (G0109) |
$34.66 |
$38 |
2.2× |
| Direct refer hospital observ (G0379) |
$288.41 |
$654 |
0.5× |
| Fern test (Q0114) |
$40.59 |
$66 |
4.2× |
| Flt3 gene itd variants quan (0046U) |
$1,933.20 |
$1,800 |
4.7× |
| Instlj fecal microbiota ssp (0780T) |
$457.27 |
$584 |
3.4× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) |
$1,743.10 |
$1,623 |
3.2× |
| NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, quantitative Other Outpatient (0049U) |
$2,443.35 |
$2,275 |
6.0× |
| Oth resp proc, group (G0239) |
$122.84 |
$214 |
3.2× |
| Prostate biopsy, any mthd (G0416) |
$638.25 |
$925 |
1.7× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) |
$1,503.36 |
$2,160 |
2.1× |
| Therapeutic procd strg endur (G0237) |
$72.90 |
$127 |
2.5× |
| Tomosynthesis, mammo (G0279) |
$41.78 |
$56 |
3.3× |
| Trauma respons w/hosp criti (G0390) |
$1,803.16 |
$3,302.50 |
1.3× |
| Tte w or w/o contr, cont ecg (C8930) |
$1,283.49 |
$1,993 |
1.6× |
| Tte w or wo fol wcon,doppler (C8929) |
$2,382.80 |
$3,700 |
3.0× |
| Visit to determ ldct elig (G0296) |
$179.42 |
$250 |
1.7× |