Supplies, drugs & other prices at Bon Secours Maryview Medical Center

Portsmouth, VA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $1,650 $2,750 2.2×
2d tte w or w/o fol w/con,co (C8923) $1,535.40 $2,559 2.0×
2d tte w or w/o fol w/con,fu (C8924) $1,415.40 $2,359 4.2×
Admin hepatitis b vaccine (G0010) $29.40 $49 0.6×
Admin influenza virus vac (G0008) $26.40 $44 0.6×
Admin pneumococcal vaccine (G0009) $40.20 $67 0.9×
Alveolus clsd reduc stblz te (D7771) $6,087.60 $10,146 1.9×
Ca screen;flexi sigmoidscope (G0104) $2,828.10 $4,713.50 3.1×
Catheterize for urine spec (P9612) $44.40 $74 4.8×
Chemo extend iv infus w/pump (G0498) $1,296.60 $2,161 4.0×
Colon ca scrn not hi rsk ind (G0121) $3,612.18 $6,020.30 4.0×
Colorectal scrn; hi risk ind (G0105) $3,196.82 $5,328.04 3.5×
Cysto impl 4 or more (C9740) $41,300.20 $68,833.67 4.5×
Cysto, litho, vacuum kidney (C9761) $26,572.66 $44,287.76 2.9×
Diab manage trn per indiv (G0108) $42 $70 0.8×
Diab manage trn ind/group (G0109) $68.40 $114 4.3×
Direct refer hospital observ (G0379) $424.80 $708 0.7×
Drug test def 1-7 classes (G0480) $124.80 $208 1.1×
Elec stim other than wound (G0283) $129.60 $216 10.2×
Facility svs dental rehab (G0330) $13,826.98 $23,044.97 4.3×
Hepb screen high risk indiv (G0499) $93 $155 3.3×
Iliac Atherectomy (0238T) $33,938.40 $56,564 1.9×
Inj for sacroiliac jt anesth (G0260) $1,344 $2,240 2.0×
Intens behave ther cardio dx (G0446) $32.40 $54 0.9×
Mra w/cont, lwr ext (C8912) $1,762.20 $2,937 5.2×
Mra w/o fol w/cont, abd (C8902) $1,650 $2,750 4.8×
Mra w/o fol w/cont, chest (C8911) $2,018.40 $3,364 5.9×
Mra w/o fol w/cont, lwr ext (C8914) $1,762.20 $2,937 5.2×
Mra w/o fol w/cont, pelvis (C8920) $2,230.20 $3,717 6.6×
Mri w/o fol w/cont, breast, (C8908) $4,941.60 $8,236 14.5×
Njx pltlt plasma w/img harvest/preparation (0232T) $28,618.36 $47,697.27 65.7×
Obtaining screen pap smear (Q0091) $18.60 $31 0.7×
Oth resp proc, group (G0239) $104.40 $174 2.9×
Oth resp proc, indiv (G0238) $97.20 $162 3.4×
Pathogen test for platelets (P9100) $66 $110 1.1×
Perc d-e cor revasc chro sin (C9607) $35,794.20 $59,657 2.0×
Perc d-e cor revasc t cabg s (C9604) $22,216.80 $37,028 2.0×
Perc d-e cor stent ather s (C9602) $35,794.20 $59,657 2.0×
Perq Sacral Augmt Bilat Inj (0201T) $9,643.20 $16,072 1.4×
Psa screening (G0103) $115.20 $192 6.0×
Revasc intra lithotrip-stent (C9765) $33,155.40 $55,259 1.9×
Revasc intravasc lithotripsy (C9764) $20,800.80 $34,668 1.8×
Screen pap by tech w md supv (P3000) $60.60 $101 3.3×
Therapeutic procd strg endur (G0237) $102 $170 3.6×
Tomosynthesis, mammo (G0279) $279 $465 22.0×
Tooth reimplantation (D7270) $1,665 $2,775 2.6×
Transcatheter Renal Sympath Denervation Bilat (0339T) $10,807.80 $18,013 1.9×
Transcatheter renal sympath denervation unilat (0338T) $10,807.80 $18,013 1.9×
Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) $11,576.40 $19,294 3.3×
Tte w or w/o fol w/con,stres (C8928) $1,886.40 $3,144 2.5×
Tte w or wo fol wcon,doppler (C8929) $2,758.80 $4,598 3.6×
Unsched dialysis esrd pt hos (G0257) $505.20 $842 0.8×
Visit to determ ldct elig (G0296) $190.20 $317 1.9×