Supplies, drugs & other prices at Bayside Community Hospital
Anahuac, TX · every code in this section with a posted price and a Medicare benchmark.
244 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d cephalometric image (D0340) | $109 | $109 | 1.2× |
| Add proc construct new crown (D2971) | $163 | $163 | 0.3× |
| Adm of soc dtr assess 5-15 m (G0136) range across 2 matching MRF lines |
$68–$227 | $68–$227 | varies |
| Alcohol/subs interv 15-30mn (G0396) | $38 | $38 | 1.0× |
| Alcohol/subs interv >30 min (G0397) | $74 | $74 | 0.4× |
| Alveoloplasty not w/extracts (D7321) | $430 | $430 | 0.3× |
| Alveoloplasty w/extract 1-3 (D7311) | $320 | $320 | 0.2× |
| Alveoplasty w/ extraction (D7310) | $320 | $320 | 0.2× |
| Alveoplasty w/o extraction (D7320) | $430 | $430 | 0.3× |
| Amalgam 4 or > surfaces perm (D2161) | $266 | $266 | 0.4× |
| Amalgam one surface permanen (D2140) | $146 | $146 | 0.2× |
| Amalgam three surfaces perma (D2160) | $224 | $224 | 0.3× |
| Amalgam two surfaces permane (D2150) | $185 | $185 | 0.3× |
| Ana crown exp 1-3 per quad (D4231) | $515 | $515 | 0.3× |
| Ana crown exp 4 or> per quad (D4230) | $607 | $607 | 0.2× |
| Annual alcohol screen 15 min (G0442) | $54 | $54 | 1.4× |
| Ant resin-based cmpst crown (D2390) | $394 | $394 | 0.6× |
| Apexification/recalc final (D3353) | $474 | $474 | 0.7× |
| Apexification/recalc initial (D3351) | $314 | $314 | 0.5× |
| Apexification/recalc interim (D3352) | $229 | $229 | 0.4× |
| Apically positioned flap (D4245) | $735 | $735 | 0.5× |
| Apicoectomy - anterior (D3410) | $648 | $648 | 1.0× |
| Assessment of a patient (D0191) | $21 | $21 | 0.2× |
| Auto tissue graft 1st tooth (D4273) | $959 | $959 | 0.6× |
| Behavior counsel obesity 15m (G0447) | $27 | $27 | 0.3× |
| Bitewings - three images (D0273) | $42 | $42 | 0.2× |
| Bitewings four images (D0274) | $79 | $79 | 0.3× |
| Bone replce graft first site (D4263) | $530 | $530 | 0.8× |
| Brief alcohol misuse counsel (G0443) | $27 | $27 | 0.3× |
| Ca screen;flexi sigmoidscope (G0104) range across 2 matching MRF lines |
$139–$300 | $139–$300 | varies |
| Ca screen;pelvic/breast exam (G0101) range across 3 matching MRF lines |
$39–$116 | $39–$116 | varies |
| Canal prep/fitting of dowel (D3950) | $226 | $226 | 0.3× |
| Cardiokymography (Q0035) | $21 | $21 | 0.6× |
| Catheterize for urine spec (P9612) range across 2 matching MRF lines |
$6–$121 | $6–$121 | varies |
| Colon ca scrn not hi rsk ind (G0121) range across 2 matching MRF lines |
$399–$2,565 | $399–$2,565 | varies |
| Colorectal scrn; hi risk ind (G0105) range across 2 matching MRF lines |
$399–$2,343 | $399–$2,343 | varies |
| Comp periodontal evaluation (D0180) | $84 | $84 | 0.6× |
| Complete occlusal adjustment (D9952) | $587 | $587 | 0.9× |
| Comprehensve oral evaluation (D0150) | $125 | $125 | 0.9× |
| Con tissue w pedicle graft (D4276) | $1,144 | $1,144 | 0.7× |
| Coping (D2975) | $528 | $528 | 0.8× |
| Core build-up incl any pins (D2950) | $263 | $263 | 0.4× |
| Crown 3/4 cast hi noble met (D2780) | $1,768 | $1,768 | 2.7× |
| Crown 3/4 porcelain/ceramic (D2783) | $1,068 | $1,068 | 1.6× |
| Crown 3/4 resin-based compos (D2712) | $825 | $825 | 1.3× |
| Crown full cast base metal (D2791) | $910 | $910 | 1.4× |
| Crown full cast high noble m (D2790) | $2,075 | $2,075 | 3.2× |
| Crown lengthen hard tissue (D4249) | $584 | $584 | 0.9× |
| Crown porcelain fused base m (D2751) | $1,675 | $1,675 | 2.6× |
| Crown porcelain w/ h noble m (D2750) | $1,675 | $1,675 | 2.6× |
| Crown porcelain/ceramic (D2740) | $1,675 | $1,675 | 2.6× |
| Crown repair (D2980) | $260 | $260 | 0.4× |
| Crown resin-based indirect (D2710) | $1,015 | $1,015 | 1.6× |
| Demonstrate use home inr mon (G0248) | $109 | $109 | 0.8× |
| Dental bitewing single image (D0270) | $24 | $24 | 0.3× |
| Dental bitewings two images (D0272) | $55 | $55 | 0.6× |
| Dental connector bar (D6920) | $902 | $902 | 1.4× |
| Dental gold foil one surface (D2410) | $554 | $554 | 0.9× |
| Dental gold foil three surfa (D2430) | $709 | $709 | 1.1× |
| Dental gold foil two surface (D2420) | $620 | $620 | 1.0× |
| Dental inlay metalic 1 surf (D2510) | $741 | $741 | 1.1× |
| Dental inlay metallic 2 surf (D2520) | $806 | $806 | 1.2× |
| Dental inlay metl 3/more sur (D2530) | $868 | $868 | 1.3× |
| Dental inlay resin 3/mre sur (D2652) | $816 | $816 | 1.3× |
| Dental onlay metallic 2 surf (D2542) | $873 | $873 | 1.3× |
| Dental onlay metallic 3 surf (D2543) | $919 | $919 | 1.4× |
| Dental onlay metl 4/more sur (D2544) | $954 | $954 | 1.5× |
| Dental onlay porc 3/more sur (D2630) | $869 | $869 | 1.3× |
| Dental onlay porc 4/more sur (D2644) | $1,261 | $1,261 | 1.9× |
| Dental onlay porcelin 2 surf (D2642) | $1,061 | $1,061 | 1.6× |
| Dental onlay porcelin 3 surf (D2643) | $1,161 | $1,161 | 1.8× |
| Dental onlay resin 2 surface (D2662) | $852 | $852 | 1.3× |
| Dental onlay resin 3 surface (D2663) | $860 | $860 | 1.3× |
| Dental onlay resin 4/mre sur (D2664) | $883 | $883 | 1.4× |
| Dental prophylaxis adult (D1110) | $172 | $172 | 1.3× |
| Depression screen annual (G0444) | $54 | $54 | 1.4× |
| Dermal filler injection(s) (G0429) | $103 | $103 | 0.0× |
| Devlopment test interpt&rep (G0451) | $8 | $8 | 0.1× |
| Diab manage trn per indiv (G0108) | $55 | $55 | 1.0× |
| Diab manage trn ind/group (G0109) | $15 | $15 | 0.9× |
| Direct refer hospital observ (G0379) range across 4 matching MRF lines |
$78–$253 | $78–$253 | varies |
| Drug test def 1-7 classes (G0480) range across 15 matching MRF lines |
$93–$798 | $93–$798 | varies |
| Drug test def 8-14 classes (G0481) | $174 | $174 | 1.1× |
| Each addtnl prefab post (D2957) | $176 | $176 | 0.3× |
| Ed svc ckd grp per session (G0421) | $27 | $27 | 1.0× |
| Ed svc ckd ind per session (G0420) | $115 | $115 | 1.0× |
| Eia hiv-1/hiv-2 screen (G0432) | $186 | $186 | 9.5× |
| Ekg tracing for initial prev (G0404) range across 3 matching MRF lines |
$8–$164 | $8–$164 | varies |
| Elec stim other than wound (G0283) range across 2 matching MRF lines |
$14–$111 | $14–$111 | varies |
| Elec stim unattend for press (G0281) | $14 | $14 | 1.2× |
| Electromagntic tx for ulcers (G0329) | $10 | $10 | 0.9× |
| End thxpy, anterior tooth (D3310) | $1,163 | $1,163 | 1.8× |
| End thxpy, molar tooth (D3330) | $1,563 | $1,563 | 2.4× |
| End thxpy, premolar tooth (D3320) | $1,363 | $1,363 | 2.1× |
| Endodontic procedure (D3999) | $112 | $112 | 0.2× |
| Excision benign lesion>1.25c (D7411) | $594 | $594 | 0.4× |
| Exposure of unerupted tooth (D7280) | $432 | $432 | 0.7× |
| Extensv oral eval prob focus (D0160) | $140 | $140 | 1.0× |
| Extraction coronal remnants (D7111) | $118 | $118 | 0.2× |
| Extraction erupted tooth/exr (D7140) | $198 | $198 | 0.3× |
| Extraoral 2d project image (D0250) | $56 | $56 | 0.6× |
| Extrnl counterpulse, per tx (G0166) | $135 | $135 | 1.0× |
| Fecal microbiota prep instil (G0455) | $128 | $128 | 0.1× |
| Followup eval of foot pt lop (G0246) | $39 | $39 | 0.3× |
| Full mouth debridement (D4355) | $175 | $175 | 0.3× |
| Gingival flap proc w/ planin (D4240) | $662 | $662 | 0.2× |
| Gingivectomy/plasty 1 to 3 (D4211) | $277 | $277 | 0.1× |
| Gingivectomy/plasty 4 or mor (D4210) | $554 | $554 | 0.2× |
| Gingivectomy/plasty rest (D4212) | $277 | $277 | 0.1× |
| Glaucoma scrn hgh risk direc (G0118) | $45 | $45 | 1.2× |
| Glaucoma scrn hgh risk direc (G0117) | $56 | $56 | 1.9× |
| Gngvl flap w rootplan 1-3 th (D4241) | $555 | $555 | 0.4× |
| Gross pulpal debridement (D3221) | $198 | $198 | 0.3× |
| Group mnt 2 or more 30 mins (G0271) range across 2 matching MRF lines |
$17–$54 | $17–$54 | varies |
| Guided tiss regen nonresorb (D4267) | $836 | $836 | 0.5× |
| Guided tiss regen resorble (D4266) | $670 | $670 | 0.4× |
| High inten beh couns std 30m (G0445) | $28 | $28 | 0.3× |
| I&d absc intraoral soft tiss (D7510) | $209 | $209 | 0.3× |
| I&d abscess extraoral (D7520) | $563 | $563 | 0.8× |
| Impact tooth rem bony w/comp (D7241) | $509 | $509 | 0.8× |
| Impact tooth remov comp bony (D7240) | $455 | $455 | 0.7× |
| Impact tooth remov part bony (D7230) | $358 | $358 | 0.6× |
| Impact tooth remov soft tiss (D7220) | $283 | $283 | 0.4× |
| Incision/drain abscess intra (D7511) | $299 | $299 | 0.4× |
| Incomplete endodontic tx (D3332) | $387 | $387 | 0.6× |
| Initial foot exam pt lops (G0245) | $68 | $68 | 0.5× |
| Initial preventive exam (G0402) range across 2 matching MRF lines |
$170–$431 | $170–$431 | varies |
| Inlay composite/resin one su (D2650) | $762 | $762 | 1.2× |
| Inlay composite/resin two su (D2651) | $783 | $783 | 1.2× |
| Inlay porcelain/ceramic 1 su (D2610) | $796 | $796 | 1.2× |
| Inlay porcelain/ceramic 2 su (D2620) | $831 | $831 | 1.3× |
| Intens behave ther cardio dx (G0446) | $27 | $27 | 0.7× |
| Intens cardiac rehab no exer (G0423) | $106 | $106 | 0.8× |
| Intens cardiac rehab w/exerc (G0422) | $106 | $106 | 0.8× |
| Intentional replantation (D3470) | $712 | $712 | 1.1× |
| Interim crown (D2799) | $215 | $215 | 0.3× |
| Internal root repair (D3333) | $281 | $281 | 0.4× |
| Intraor comprehensive series (D0210) | $158 | $158 | 0.7× |
| Intraoral occlusal film (D0240) | $37 | $37 | 0.4× |
| Intraoral periapical first (D0220) | $35 | $35 | 0.4× |
| Isolation- tooth w rubb dam (D3910) | $205 | $205 | 0.3× |
| Labial veneer porc indirect (D2962) | $1,890 | $1,890 | 2.9× |
| Labial veneer resin direct (D2960) | $1,018 | $1,018 | 1.6× |
| Labial veneer resin indirect (D2961) | $875 | $875 | 1.3× |
| Limit oral eval problm focus (D0140) | $110 | $110 | 0.8× |
| Limited occlusal adjustment (D9951) | $158 | $158 | 0.2× |
| Localized delivery antimicro (D4381) | $66 | $66 | 0.1× |
| Mesial/distal wedge proc (D4274) | $594 | $594 | 0.9× |
| Mnt subs tx for change dx (G0270) range across 2 matching MRF lines |
$32–$74 | $32–$74 | varies |
| Non-auto graft 1st tooth (D4275) | $884 | $884 | 0.6× |
| Non-surg tx root canal obs (D3331) | $502 | $502 | 0.8× |
| Obtaining screen pap smear (Q0091) | $45 | $45 | 1.5× |
| Occ guard, hard, full arch (D9944) | $575 | $575 | 0.9× |
| Occ guard, hard, part arch (D9946) | $575 | $575 | 0.9× |
| Occ guard, soft, full arch (D9945) | $575 | $575 | 0.9× |
| Occlusion analysis (D9950) | $307 | $307 | 0.5× |
| Open tx iliac spine uni/bil (G0412) likely a partial charge, not the full procedure |
$758 | $758 | 0.1× |
| Open tx post pelvic fxcture (G0415) | $1,439 | $1,439 | 0.4× |
| Oral antral fistula closure (D7260) | $836 | $836 | 1.3× |
| Oral/facial photo images (D0350) | $92 | $92 | 1.1× |
| Osseous surg 1 to 3 teeth (D4261) | $789 | $789 | 0.2× |
| Osseous surgery 4 or more (D4260) likely a partial charge, not the full procedure |
$958 | $958 | 0.2× |
| Oth resp proc, group (G0239) | $13 | $13 | 0.3× |
| Oth resp proc, indiv (G0238) | $11 | $11 | 0.4× |
| Other tmj images by report (D0321) | $177 | $177 | 2.0× |
| Panoramic image (D0330) | $150 | $150 | 0.6× |
| Part pulp for apexogenesis (D3222) | $140 | $140 | 0.2× |
| Pedicle soft tissue graft pr (D4270) | $748 | $748 | 0.5× |
| Pelvic ring fracture uni/bil (G0413) likely a partial charge, not the full procedure |
$1,116 | $1,116 | 0.2× |
| Pelvic ring fx treat int fix (G0414) likely a partial charge, not the full procedure |
$1,039 | $1,039 | 0.1× |
| Periodic oral evaluation (D0120) | $80 | $80 | 0.6× |
| Periodontal maint procedures (D4910) | $154 | $154 | 0.2× |
| Periodontal scaling & root (D4341) | $150 | $150 | 0.2× |
| Periodontal scaling 1-3teeth (D4342) | $97 | $97 | 0.1× |
| Place direct restoration (D2940) | $118 | $118 | 0.2× |
| Post 1 srfc resinbased cmpst (D2391) | $190 | $190 | 0.3× |
| Post 2 srfc resinbased cmpst (D2392) | $240 | $240 | 0.4× |
| Post 3 srfc resinbased cmpst (D2393) | $299 | $299 | 0.5× |
| Post >=4srfc resinbase cmpst (D2394) | $342 | $342 | 0.5× |
| Post and core cast + crown (D2952) | $374 | $374 | 0.6× |
| Ppps, initial visit (G0438) range across 2 matching MRF lines |
$175–$638 | $175–$638 | varies |
| Ppps, subseq visit (G0439) range across 2 matching MRF lines |
$117–$434 | $117–$434 | varies |
| Prefab porc/ceram crown pri (D2929) | $263 | $263 | 0.4× |
| Prefab post/core + crown (D2954) | $298 | $298 | 0.5× |
| Prefab stainless steel crown (D2933) | $326 | $326 | 0.5× |
| Prefab steel crown primary (D2934) | $320 | $320 | 0.5× |
| Prefab stnlss steel crown pe (D2931) | $289 | $289 | 0.4× |
| Prefab stnlss steel crwn pri (D2930) | $242 | $242 | 0.4× |
| Prefabricated resin crown (D2932) | $314 | $314 | 0.5× |
| Primary closure sinus perf (D7261) | $673 | $673 | 1.0× |
| Prostate biopsy, any mthd (G0416) | $652 | $652 | 1.8× |
| Provide inr test mater/equip (G0249) | $109 | $109 | 0.8× |
| Psa screening (G0103) range across 3 matching MRF lines |
$75–$164 | $75–$164 | varies |
| Pulp cap direct (D3110) | $73 | $73 | 0.1× |
| Pulp cap indirect (D3120) | $73 | $73 | 0.1× |
| Pulp vitality test (D0460) | $52 | $52 | 0.1× |
| Pulpal therapy anterior prim (D3230) | $265 | $265 | 0.4× |
| Pulpal therapy posterior pri (D3240) | $275 | $275 | 0.4× |
| Rad exc lesion up to 1.25 cm (D7410) | $363 | $363 | 0.2× |
| Re-cement or re-bond crown (D2920) | $96 | $96 | 0.1× |
| Re-eval,est pt,problem focus (D0170) | $62 | $62 | 0.5× |
| Reattach tooth fragment (D2921) | $305 | $305 | 0.5× |
| Recement cast or prefab post (D2915) | $96 | $96 | 0.1× |
| Recement inlay onlay or part (D2910) | $96 | $96 | 0.1× |
| Rem imp tooth w mucoper flp (D7210) | $302 | $302 | 0.2× |
| Removal fb skin/areolar tiss (D7530) | $361 | $361 | 0.6× |
| Removal of fb reaction (D7540) | $610 | $610 | 0.9× |
| Remove unilat space maintain (D1520) | $349 | $349 | 0.5× |
| Resin 4/> surf or w incis an (D2335) | $308 | $308 | 0.5× |
| Resin one surface-anterior (D2330) | $174 | $174 | 0.3× |
| Resin three surfaces-anterio (D2332) | $257 | $257 | 0.4× |
| Resin two surfaces-anterior (D2331) | $208 | $208 | 0.3× |
| Restorative foundation (D2949) | $56 | $56 | 0.1× |
| Retreat root canal anterior (D3346) | $768 | $768 | 1.2× |
| Retreat root canal molar (D3348) | $1,030 | $1,030 | 1.6× |
| Retreat root canal premolar (D3347) | $869 | $869 | 1.3× |
| Retrograde filling (D3430) | $248 | $248 | 0.4× |
| Risk ascvd tst once pr 12 mo (G0537) | $23 | $23 | 0.6× |
| Root amputation (D3450) | $433 | $433 | 0.7× |
| Root surgery molar (D3425) | $794 | $794 | 1.2× |
| Root surgery premolar (D3421) | $735 | $735 | 1.1× |
| Routine footcare pt w lops (G0247) | $74 | $74 | 0.4× |
| Scaling gingiv inflammation (D4346) | $228 | $228 | 0.4× |
| Single energy x-ray study (G0130) | $35 | $35 | 0.3× |
| Soft tissue graft firsttooth (D4277) | $723 | $723 | 0.5× |
| Space maintainer fxd unilat (D1510) | $295 | $295 | 0.5× |
| Surgical revision procedure (D4268) | $724 | $724 | 1.1× |
| Therapeutic procd strg endur (G0237) | $10 | $10 | 0.3× |
| Therapeutic pulpotomy (D3220) | $178 | $178 | 0.3× |
| Tooth pin retention (D2951) | $63 | $63 | 0.1× |
| Tooth reimplantation (D7270) | $492 | $492 | 0.8× |
| Tooth root removal (D7250) | $270 | $270 | 0.4× |
| Tooth splitting (D3920) | $416 | $416 | 0.6× |
| Tooth transplantation (D7272) | $665 | $665 | 1.0× |
| Transseptal fiberotomy (D7291) | $277 | $277 | 0.4× |
| Trauma respons w/hosp criti (G0390) | $5,390 | $5,390 | 4.0× |
| Treatment of complications (D9930) | $117 | $117 | 0.2× |
| Trim nail(s) (G0127) | $23 | $23 | 0.4× |
| Unscheduled dressing change (D4920) | $91 | $91 | 0.1× |
| Urine specimen collect mult (P9615) | $7 | $7 | 0.7× |
| Vert bitewings 7 to 8 images (D0277) | $91 | $91 | 0.4× |
| Vestibuloplasty exten graft (D7350) unusually low: confirm this is the full procedure |
$2,126 | $2,126 | 0.4× |
| Vestibuloplasty ridge extens (D7340) likely a partial charge, not the full procedure |
$1,019 | $1,019 | 0.2× |
| Visit to determ ldct elig (G0296) | $118 | $118 | 1.2× |
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.