Supplies, drugs & other prices at Benefis Hospitals Inc
Great Falls, MT · every code in this section with a posted price and a Medicare benchmark.
107 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Adm of soc dtr assess 5-15 m (G0136) range across 2 matching MRF lines |
$10.20–$22.80 | $17–$38 | varies |
| Admin hepatitis b vaccine (G0010) | $36 | $60 | 0.8× |
| Admin influenza virus vac (G0008) | $36 | $60 | 0.8× |
| Admin pneumococcal vaccine (G0009) | $36 | $60 | 0.8× |
| Adrnl cortcl tum bchm asy 25 (0015M) | $2,005.20 | $3,342 | 1.5× |
| Alcohol/sub misuse assess (G2011) | $31.20 | $52 | 1.1× |
| Alveoloplasty w/extract 1-3 (D7311) | $1,908.60 | $3,181 | 1.2× |
| Alveoplasty w/ extraction (D7310) | $1,908.60 | $3,181 | 1.2× |
| Annual alcohol screen 15 min (G0442) | $14.40 | $24 | 0.4× |
| Behavior counsel obesity 15m (G0447) | $124.20 | $207 | 1.2× |
| Bitewings - three images (D0273) | $114.60 | $191 | 0.5× |
| Bitewings four images (D0274) | $114.60 | $191 | 0.5× |
| Brief alcohol misuse counsel (G0443) range across 2 matching MRF lines |
$28.20–$30 | $47–$50 | varies |
| Ca screen;flexi sigmoidscope (G0104) | $84 | $140 | 0.1× |
| Ca screen;pelvic/breast exam (G0101) | $59.40 | $99 | 0.6× |
| Colon ca scrn not hi rsk ind (G0121) range across 4 matching MRF lines |
$294.60–$676.80 | $491–$1,128 | varies |
| Colorectal scrn; hi risk ind (G0105) range across 2 matching MRF lines |
$294.60–$676.80 | $491–$1,128 | varies |
| Crown porcelain/ceramic (D2740) | $1,101.60 | $1,836 | 1.7× |
| Cyp2d6 gen com&slct rar vrnt (0070U) | $498 | $830 | 0.7× |
| Dental bitewing single image (D0270) | $114.60 | $191 | 1.3× |
| Dental bitewings two images (D0272) | $114.60 | $191 | 1.3× |
| Dental prophylaxis adult (D1110) | $166.20 | $277 | 1.2× |
| Depression screen annual (G0444) range across 2 matching MRF lines |
$14.40–$21.60 | $24–$36 | varies |
| Diab manage trn per indiv (G0108) range across 3 matching MRF lines |
$72–$130.80 | $120–$218 | varies |
| Diab manage trn ind/group (G0109) | $67.20 | $112 | 4.2× |
| Direct refer hospital observ (G0379) | $334.80 | $558 | 0.6× |
| Dist space maint, fixed unil (D1575) | $1,101.60 | $1,836 | 1.7× |
| Drug test def 1-7 classes (G0480) range across 3 matching MRF lines |
$26.40–$111.60 | $44–$186 | varies |
| Drug test def 15-21 classes (G0482) | $357.60 | $596 | 1.8× |
| Drug test def 22+ classes (G0483) | $444.60 | $741 | 1.8× |
| Drug test def 8-14 classes (G0481) | $282 | $470 | 1.8× |
| Egd flexible transnasal dx w/collj spec br/wa (0652T) | $2,380.20 | $3,967 | 1.2× |
| Egd flexible transnasal w/biopsy single/multiple (0653T) | $2,380.20 | $3,967 | 1.2× |
| Egd flexible transnasal w/insj intral tube/cath (0654T) | $4,919.40 | $8,199 | 1.2× |
| Ekg tracing for initial prev (G0404) | $22.20 | $37 | 0.8× |
| Elec stim other than wound (G0283) | $54 | $90 | 4.3× |
| Elec stim unattend for press (G0281) | $37.80 | $63 | 3.2× |
| Endo defect closure gi tract (C9901) | $13,119 | $21,865 | 1.2× |
| Extraction erupted tooth/exr (D7140) range across 2 matching MRF lines |
$1,101.60–$2,036.40 | $1,836–$3,394 | varies |
| Full mouth debridement (D4355) | $1,101.60 | $1,836 | 1.7× |
| Group behave couns 2-10 (G0473) | $124.80 | $208 | 3.3× |
| Group mnt 2 or more 30 mins (G0271) | $47.40 | $79 | 2.8× |
| Hbot, full body chamber, 30m (G0277) | $376.20 | $627 | 2.7× |
| Home sleep test/type 2 porta (G0398) | $142.80 | $238 | 0.6× |
| Home sleep test/type 3 porta (G0399) | $285.60 | $476 | 1.3× |
| Hospital outpt clinic visit (G0463) range across 36 matching MRF lines |
$106.80–$160.20 | $178–$267 | varies |
| Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) range across 3 matching MRF lines |
$80.40–$261.60 | $134–$436 | varies |
| Impact tooth rem bony w/comp (D7241) | $1,101.60 | $1,836 | 1.7× |
| Impact tooth remov comp bony (D7240) | $1,101.60 | $1,836 | 1.7× |
| Impact tooth remov part bony (D7230) | $1,101.60 | $1,836 | 1.7× |
| Initial preventive exam (G0402) | $207.60 | $346 | 1.5× |
| Interim crown (D2799) | $1,101.60 | $1,836 | 1.7× |
| Intraor comprehensive series (D0210) | $307.20 | $512 | 1.3× |
| Intraoral bite radio image (D0708) | $114.60 | $191 | 1.3× |
| Intraoral occlusal film (D0240) | $114.60 | $191 | 1.3× |
| Intraoral periapical first (D0220) | $114.60 | $191 | 1.3× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) | $379.80 | $633 | 3.1× |
| Mnt subs tx for change dx (G0270) | $47.40 | $79 | 1.5× |
| Ncntc nr ifr spectrsc oth/thn pad 1st antmc site (0640T) range across 2 matching MRF lines |
$40.80–$50.40 | $68–$84 | varies |
| Neuro csf prion prtn qual (0035U) | $595.20 | $992 | 1.1× |
| Njx platelet plasma (0232T) range across 2 matching MRF lines |
$283.80–$425.70 | $473–$709.50 | varies |
| Obtaining screen pap smear (Q0091) range across 2 matching MRF lines |
$27–$41.40 | $45–$69 | varies |
| Oth resp proc, group (G0239) | $100.20 | $167 | 2.6× |
| Oth resp proc, indiv (G0238) | $100.80 | $168 | 3.4× |
| Perc d-e cor stent ather s (C9602) | $14,225.40 | $23,709 | 0.8× |
| Perc drug-el cor stent sing (C9600) | $14,225.40 | $23,709 | 1.2× |
| Periodontal scaling & root (D4341) | $1,101.60 | $1,836 | 1.7× |
| Periodontal scaling 1-3teeth (D4342) | $1,101.60 | $1,836 | 1.7× |
| Place device/marker, non pro (C9728) | $1,421.40 | $2,369 | 1.0× |
| Post 1 srfc resinbased cmpst (D2391) | $1,101.60 | $1,836 | 1.7× |
| Post 2 srfc resinbased cmpst (D2392) | $1,101.60 | $1,836 | 1.7× |
| Post 3 srfc resinbased cmpst (D2393) | $1,101.60 | $1,836 | 1.7× |
| Post >=4srfc resinbase cmpst (D2394) | $1,101.60 | $1,836 | 1.7× |
| Potassium hydroxide preps (Q0112) | $10.80 | $18 | 1.9× |
| Prefab porc/cer crown perm (D2928) | $1,101.60 | $1,836 | 1.7× |
| Prefab porc/ceram crown pri (D2929) | $1,101.60 | $1,836 | 1.7× |
| Prefab stnlss steel crown pe (D2931) | $1,101.60 | $1,836 | 1.7× |
| Prefab stnlss steel crwn pri (D2930) | $1,101.60 | $1,836 | 1.7× |
| Prgrmg dev eval scrms phys/qhp remote (0650T) | $48 | $80 | 1.3× |
| Psa screening (G0103) | $113.40 | $189 | 5.9× |
| Pulp cap direct (D3110) | $1,101.60 | $1,836 | 1.7× |
| Pulp cap indirect (D3120) | $1,101.60 | $1,836 | 1.7× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $1,360.80 | $2,268 | 1.9× |
| Rem imp tooth w mucoper flp (D7210) | $1,908.60 | $3,181 | 1.2× |
| Resin 4/> surf or w incis an (D2335) | $1,101.60 | $1,836 | 1.7× |
| Resin one surface-anterior (D2330) | $1,101.60 | $1,836 | 1.7× |
| Resin three surfaces-anterio (D2332) | $1,101.60 | $1,836 | 1.7× |
| Resin two surfaces-anterior (D2331) | $1,101.60 | $1,836 | 1.7× |
| Revasc intra lithotrip-ather (C9766) | $23,455.80 | $39,093 | 1.3× |
| Revasc intra lithotrip-stent (C9765) | $23,455.80 | $39,093 | 1.3× |
| Revasc intravasc lithotripsy (C9764) | $14,494.80 | $24,158 | 1.2× |
| Revasc lith-sten-ath tib/per (C9775) | $23,455.80 | $39,093 | 1.3× |
| Revasc lithotr-ather tib/per (C9774) | $23,455.80 | $39,093 | 1.3× |
| Revasc lithotr-stent tib/per (C9773) | $23,455.80 | $39,093 | 1.3× |
| Revasc lithotrip tibi/perone (C9772) | $14,494.80 | $24,158 | 1.2× |
| Revasc lithotrip-stent-ather (C9767) | $23,455.80 | $39,093 | 1.3× |
| Rx Metab Advrs Trgt Seq Alys (0029U) | $888 | $1,480 | 1.2× |
| Safety plan interven (G0560) | $33 | $55 | 0.8× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $6,862.20 | $11,437 | 1.2× |
| Therapeutic procd strg endur (G0237) | $100.80 | $168 | 3.4× |
| Therapeutic pulpotomy (D3220) | $1,101.60 | $1,836 | 1.7× |
| Tooth root removal (D7250) | $1,101.60 | $1,836 | 1.7× |
| Tpmt and Nudt15 Genotype (0034U) | $429 | $715 | 0.9× |
| Trauma respons w/hosp criti (G0390) range across 2 matching MRF lines |
$5,941.20–$6,917.40 | $9,902–$11,529 | varies |
| Trim nail(s) (G0127) range across 2 matching MRF lines |
$12–$49.80 | $20–$83 | varies |
| Trluml Perip Athrc Iliac Art (0238T) | $15,239.40 | $25,399 | 0.8× |
| Unsched dialysis esrd pt hos (G0257) range across 3 matching MRF lines |
$621.60–$814.20 | $1,036–$1,357 | 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.