17 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
| 2019-ncov diagnostic p (U0001) |
$46 |
$46 |
1.3× |
| Admin hepatitis b vaccine (G0010) |
$160 |
$160 |
3.4× |
| Admin influenza virus vac (G0008) |
$160 |
$160 |
3.4× |
| Admin pneumococcal vaccine (G0009) |
$160 |
$160 |
3.4× |
| Colon ca scrn not hi rsk ind (G0121) |
$3,174 |
$3,174 |
3.4× |
| Colorectal scrn; hi risk ind (G0105) |
$3,174 |
$3,174 |
3.4× |
| Covid-19 lab test non-cdc (U0002) |
$129 |
$129 |
2.5× |
| Direct refer hospital observ (G0379) |
$197 |
$197 |
0.3× |
| Elec stim other than wound (G0283) |
$150 |
$150 |
11.8× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) |
$65,000 |
$65,000 |
5.6× |
| Hospital outpt clinic visit (G0463) |
$2,061 |
$2,061 |
15.4× |
| Inj for sacroiliac jt anesth (G0260) |
$6,235 |
$6,235 |
8.8× |
| Mri w/o fol w/cont, breast, (C8908) |
$5,224 |
$5,224 |
14.9× |
| Mri w/o fol w/cont, brst, un (C8905) |
$9,328 |
$9,328 |
26.6× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$8,912.50 |
$8,912.50 |
19.9× |
| Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) |
$17,605 |
$17,605 |
1.4× |
| Place device/marker, non pro (C9728) |
$7,257 |
$7,257 |
5.2× |