Supplies, drugs & other prices at Bellin Memorial Hospital
Green Bay, WI · every code in this section with a posted price and a Medicare benchmark.
83 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Ablation, irreversible electroporation; 1 or more tumors, including fluoroscopic and ultrasound guidance, when… (0601T) | $7,538.10 | $16,281 | 0.7× |
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) | $4,412.39 | $9,530 | 2.3× |
| Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv (0442T) | $4,694.82 | $10,140 | 0.6× |
| Adm tocilizu covid-19 1st (M0249) | $383.83 | $829 | 0.9× |
| Adm tocilizu covid-19 2nd (M0250) | $383.83 | $829 | 0.9× |
| Adrnl cortcl tum bchm asy 25 (0015M) | $3,777.62 | $8,159 | 2.9× |
| Alcohol/subs interv 15-30mn (G0396) | $53.71 | $116 | 1.5× |
| Behavior counsel obesity 15m (G0447) | $122.70 | $265 | 1.2× |
| Ca screen;flexi sigmoidscope (G0104) | $666.72 | $1,440 | 0.7× |
| Ca screen;pelvic/breast exam (G0101) | $83.80 | $181 | 0.8× |
| Catheterize for urine spec (P9612) range across 2 matching MRF lines |
$25.93–$26.39 | $56–$57 | varies |
| Chemo extend iv infus w/pump (G0498) range across 2 matching MRF lines |
$568.56–$645.42 | $1,228–$1,394 | varies |
| Collagen Cross-Linking Cornea&Pachymetry (0402T) | $1,688.56 | $3,647 | 0.7× |
| Colon ca scrn not hi rsk ind (G0121) range across 2 matching MRF lines |
$891.28–$1,607.54 | $1,925–$3,472 | varies |
| Colorectal scrn; hi risk ind (G0105) range across 2 matching MRF lines |
$891.28–$1,750.60 | $1,925–$3,781 | varies |
| Cyp2d6 gen com&slct rar vrnt (0070U) | $1,957.10 | $4,227 | 2.9× |
| Diab manage trn per indiv (G0108) | $36.58 | $79 | 0.7× |
| Diab manage trn ind/group (G0109) | $11.58 | $25 | 0.7× |
| Direct refer hospital observ (G0379) range across 3 matching MRF lines |
$356.05–$1,035.27 | $769–$2,236 | varies |
| Eia hiv-1/hiv-2 screen (G0432) | $56.49 | $122 | 2.9× |
| Ekg tracing for initial prev (G0404) | $20.84 | $45 | 0.7× |
| Elec stim other than wound (G0283) | $23.15 | $50 | 1.8× |
| Endo outlet restrict w/tube (C9785) unusually low: confirm this is the full procedure |
$4,775.85 | $10,315 | 0.5× |
| Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) likely a partial charge, not the full procedure |
$10,805.49 | $23,338 | 0.3× |
| Evac Meibomian Glnds Auto Ht& Intmt Press Uni (0207T) | $90.29 | $195 | 0.7× |
| Extrnl counterpulse, per tx (G0166) | $291.23 | $629 | 2.3× |
| Fecal blood scrn immunoassay (G0328) | $52.32 | $113 | 2.9× |
| Fern test (Q0114) range across 2 matching MRF lines |
$20.37–$28.24 | $44–$61 | varies |
| Glaucoma scrn hgh risk direc (G0117) | $29.17 | $63 | 1.0× |
| Glyca nuc mr spectroscopy quantitative (0024U) | $99.08 | $214 | 2.9× |
| Group behave couns 2-10 (G0473) | $23.61 | $51 | 0.6× |
| Group mnt 2 or more 30 mins (G0271) | $9.72 | $21 | 0.6× |
| Hbot, full body chamber, 30m (G0277) range across 2 matching MRF lines |
$180.11–$279.65 | $389–$604 | varies |
| Hep c screen high risk/other (G0472) range across 2 matching MRF lines |
$89.36–$134.27 | $193–$290 | varies |
| Hepb screen high risk indiv (G0499) | $81.95 | $177 | 2.9× |
| Home sleep test/type 3 porta (G0399) range across 2 matching MRF lines |
$304.65–$485.22 | $658–$1,048 | varies |
| Hopd mntl hlt, 15-29 min (C7900) | $24.54 | $53 | 0.7× |
| Hopd mntl hlt, 30-60 min (C7901) | $62.51 | $135 | 0.6× |
| Hpv combo assay ca screen (G0476) range across 2 matching MRF lines |
$67.60–$101.40 | $146–$219 | varies |
| Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) | $125.47 | $271 | 2.9× |
| Initial preventive exam (G0402) | $68.06 | $147 | 0.5× |
| Ire Abltj 1+Tum Organ Perq (0600T) | $7,538.10 | $16,281 | 0.7× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) | $352.81 | $762 | 2.9× |
| Lev 1 hosp type b ed visit (G0380) | $31.95 | $69 | 0.4× |
| Lev 2 hosp type b ed visit (G0381) | $57.88 | $125 | 0.6× |
| Lev 3 hosp type b ed visit (G0382) | $101.40 | $219 | 0.6× |
| Lev 4 hosp type b ed visit (G0383) | $145.85 | $315 | 0.6× |
| Lev 5 hosp type b ed visit (G0384) | $179.18 | $387 | 0.4× |
| Mnt subs tx for change dx (G0270) | $19.45 | $42 | 0.6× |
| Neuro csf prion prtn qual (0035U) range across 2 matching MRF lines |
$1,036.66–$1,565.40 | $2,239–$3,381 | varies |
| Njx platelet plasma (0232T) range across 3 matching MRF lines |
$278.26–$1,324.18 | $601–$2,860 | varies |
| Onc merkel cell carc detcj antb serum reprtd +/- (0059U) range across 2 matching MRF lines |
$448.65–$934.80 | $969–$2,019 | varies |
| Onc Merkel Cll Carc Srm Quan (0058U) range across 2 matching MRF lines |
$448.65–$934.80 | $969–$2,019 | varies |
| Oth resp proc, group (G0239) range across 2 matching MRF lines |
$58.80–$62.97 | $127–$136 | varies |
| Oth resp proc, indiv (G0238) | $43.99 | $95 | 1.6× |
| Pathogen test for platelets (P9100) range across 2 matching MRF lines |
$110.19–$645.89 | $238–$1,395 | varies |
| Perq Sacral Augmt Bilat Inj (0201T) range across 2 matching MRF lines |
$5,643.51–$12,624.16 | $12,189–$27,266 | varies |
| Perq Sacral Augmt Unilat Inj (0200T) range across 2 matching MRF lines |
$5,643.51–$13,230.23 | $12,189–$28,575 | varies |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) range across 2 matching MRF lines |
$4,128.11–$21,003.07 | $8,916–$45,363 | varies |
| Pne flu hepb cov home admin (M0201) | $27.32 | $59 | 0.8× |
| Prostate biopsy, any mthd (G0416) | $634.77 | $1,371 | 1.8× |
| Psa screening (G0103) range across 2 matching MRF lines |
$46.76–$56.02 | $101–$121 | varies |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $1,000.08 | $2,160 | 1.4× |
| Revasc intra lithotrip-ather (C9766) | $33,255.90 | $71,827 | 1.9× |
| Revasc intra lithotrip-stent (C9765) range across 2 matching MRF lines |
$9,071.10–$33,255.90 | $19,592–$71,827 | varies |
| Revasc intravasc lithotripsy (C9764) range across 2 matching MRF lines |
$7,801.55–$21,003.07 | $16,850–$45,363 | varies |
| Revasc lith-sten-ath tib/per (C9775) | $33,255.90 | $71,827 | 1.9× |
| Revasc lithotr-ather tib/per (C9774) | $33,255.90 | $71,827 | 1.9× |
| Revasc lithotr-stent tib/per (C9773) | $33,255.90 | $71,827 | 1.9× |
| Revasc lithotrip tibi/perone (C9772) | $21,003.07 | $45,363 | 1.9× |
| Revasc lithotrip-stent-ather (C9767) | $33,255.90 | $71,827 | 1.9× |
| Rx Metab Advrs Trgt Seq Alys (0029U) | $2,147.86 | $4,639 | 2.9× |
| Rx metab warfarin rx response trgt seq alys (0030U) | $387.99 | $838 | 2.9× |
| Screen cerv/vag thin layer (G0123) | $58.80 | $127 | 2.9× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $4,335.53 | $9,364 | 0.8× |
| Therapeutic apheresis with selective HDL delipidation and plasma reinfusion (0342T) | $3,679.46 | $7,947 | 0.9× |
| Tpmt and Nudt15 Genotype (0034U) | $1,349.18 | $2,914 | 2.9× |
| Trauma respons w/hosp criti (G0390) range across 2 matching MRF lines |
$1,281.12–$2,563.17 | $2,767–$5,536 | varies |
| Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) | $4,861.50 | $10,500 | 1.4× |
| Trluml Perip Athrc Iliac Art (0238T) range across 2 matching MRF lines |
$8,301.59–$33,255.90 | $17,930–$71,827 | varies |
| Unsched dialysis esrd pt hos (G0257) range across 5 matching MRF lines |
$772.75–$1,295.94 | $1,669–$2,799 | varies |
| Vasc emb/occ w/prs cath (C9797) range across 2 matching MRF lines |
$7,773.77–$33,255.90 | $16,790–$71,827 | varies |
| Visit to determ ldct elig (G0296) range across 2 matching MRF lines |
$79.17–$180.11 | $171–$389 | varies |
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.