Supplies, drugs & other prices at Bellville Medical Center (Bellville, TX)

28 codes. Prices are the hospital's own posted facility charges.

Procedure	Cash price	Gross charge	× Medicare
Admin influenza virus vac (G0008)	$127	$127	2.7×
Admin pneumococcal vaccine (G0009)	$127	$127	2.7×
Amalgam 4 or > surfaces perm (D2161)	$295	$295	0.5×
Ca screen;flexi sigmoidscope (G0104)	$2,400	$2,400	2.6×
Colon ca scrn not hi rsk ind (G0121)	$1,911	$1,911	2.0×
Colorectal scrn; hi risk ind (G0105)	$1,911	$1,911	2.0×
Crown resin-based indirect (D2710)	$295	$295	0.5×
Direct refer hospital observ (G0379)	$156.50	$156.50	0.3×
Elec stim other than wound (G0283)	$111	$111	8.7×
End thxpy, anterior tooth (D3310)	$712	$712	1.1×
Extraction erupted tooth/exr (D7140)	$413.50	$413.50	0.6×
Hbot, full body chamber, 30m (G0277)	$377	$377	2.7×
Hepb screen high risk indiv (G0499)	$103	$103	3.6×
Hospital outpt clinic visit (G0463)	$375	$375	2.8×
Inj for sacroiliac jt anesth (G0260)	$3,500	$3,500	4.9×
Njx pltlt plasma w/img harvest/preparation (0232T)	$1,009	$1,009	2.2×
Non-ophthalmic fva (C9733)	$767	$767	2.2×
Oth resp proc, group (G0239)	$87	$87	2.3×
Oth resp proc, indiv (G0238)	$153	$153	5.3×
Post 3 srfc resinbased cmpst (D2393)	$429	$429	0.7×
Prostate biopsy, any mthd (G0416)	$1,131	$1,131	3.1×
Psa screening (G0103)	$92	$92	4.8×
Pulpal therapy posterior pri (D3240)	$574	$574	0.9×
Resin 4/> surf or w incis an (D2335)	$712	$712	1.1×
Therapeutic procd strg endur (G0237)	$153	$153	5.3×
Tomosynthesis, mammo (G0279)	$179	$179	14.1×
Trauma respons w/hosp criti (G0390)	$3,150	$3,150	2.4×
Unsched dialysis esrd pt hos (G0257)	$1,529	$1,529	2.2×