Supplies, drugs & other prices at Black Hills Surgical Hospital LLC
Rapid City, SD · every code in this section with a posted price and a Medicare benchmark.
20 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admin influenza virus vac (G0008) | $97.80 | $163 | 2.0× |
| Admin pneumococcal vaccine (G0009) | $97.80 | $163 | 2.0× |
| Arthro/shoul surg; w/spacer (C9781) unusually low: confirm this is the full procedure |
$5,434.49 | $9,057.48 | 0.4× |
| Autolog prp not diab ulcer (G0460) | $1,998.53 | $3,330.88 | 0.9× |
| Ca screen;flexi sigmoidscope (G0104) range across 4 matching MRF lines |
$597.15–$611.99 | $995.25–$1,019.99 | varies |
| Colon ca scrn not hi rsk ind (G0121) | $1,356.53 | $2,260.88 | 1.4× |
| Colorectal scrn; hi risk ind (G0105) | $1,356.53 | $2,260.88 | 1.4× |
| Extraction erupted tooth/exr (D7140) | $249.60 | $416 | 0.4× |
| Hospital outpt clinic visit (G0463) | $139.20 | $232 | 1.0× |
| Inj for sacroiliac jt anesth (G0260) range across 14 matching MRF lines |
$387.22–$968.06 | $645.37–$1,613.43 | varies |
| Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) | $968.06 | $1,613.43 | 1.1× |
| Mra, w/dye, upper extremity (C8934) | $1,121.40 | $1,869 | 3.1× |
| Njx bone sub matrl into subchondral bone defect (0707T) | $1,897.20 | $3,162 | 0.6× |
| Njx platelet plasma (0232T) | $1,095.15 | $1,825.25 | 2.4× |
| Non-ophthalmic fva (C9733) | $200.40 | $334 | 0.6× |
| Pelvic ring fracture uni/bil (G0413) | $4,821.67 | $8,036.12 | 0.7× |
| Perq njx algc cell &/prdct uni/bi fluor lmbr 1st (0627T) range across 2 matching MRF lines |
$11,333.96–$11,544.75 | $18,889.94–$19,241.25 | varies |
| Prolonged iv inf, req pump (C8957) | $287.66 | $479.44 | 1.3× |
| Psa screening (G0103) | $35.34 | $58.90 | 1.8× |
| Rem imp tooth w mucoper flp (D7210) | $249.60 | $416 | 0.2× |
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.