Supplies, drugs & other prices at Bon Secours Southside Medical Center
Petersburg, VA · every code in this section with a posted price and a Medicare benchmark.
29 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,co (C8923) | $891.60 | $2,972 | 1.2× |
| Admin influenza virus vac (G0008) | $13.20 | $44 | 0.3× |
| Admin pneumococcal vaccine (G0009) | $19.20 | $64 | 0.4× |
| Alveolus clsd reduc stblz te (D7771) | $3,043.80 | $10,146 | 0.9× |
| Colon ca scrn not hi rsk ind (G0121) | $12,287.92 | $20,479.88 | 13.5× |
| Colorectal scrn; hi risk ind (G0105) | $12,765.24 | $21,275.40 | 14.1× |
| Cysto impl 4 or more (C9740) | $35,758.27 | $59,597.12 | 3.9× |
| Direct refer hospital observ (G0379) | $570.90 | $1,903 | 1.0× |
| Drug test def 1-7 classes (G0480) | $51.45 | $160 | 0.4× |
| Elec stim other than wound (G0283) | $216.90 | $723 | 17.1× |
| Hbot, full body chamber, 30m (G0277) | $960.90 | $3,203 | 7.2× |
| Hepb screen high risk indiv (G0499) | $46.50 | $155 | 1.6× |
| Iliac Atherectomy (0238T) | $9,771.90 | $32,573 | 0.5× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $39,734.37 | $66,223.95 | 91.2× |
| Oth resp proc, indiv (G0238) | $26.10 | $87 | 0.9× |
| Pathogen test for platelets (P9100) | $33 | $110 | 0.6× |
| Perc d-e cor revasc chro sin (C9607) | $17,897.10 | $59,657 | 1.0× |
| Perc d-e cor stent ather s (C9602) | $17,897.10 | $59,657 | 1.0× |
| Perq Sacral Augmt Bilat Inj (0201T) | $4,214.70 | $14,049 | 0.6× |
| Psa screening (G0103) | $33.60 | $112 | 1.7× |
| Revasc intravasc lithotripsy (C9764) | $5,975.10 | $19,917 | 0.5× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $18,022.50 | $60,075 | 1.0× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $18,022.20 | $60,074 | 1.0× |
| Tomosynthesis, mammo (G0279) | $83.10 | $277 | 6.5× |
| Tooth reimplantation (D7270) | $832.50 | $2,775 | 1.3× |
| Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) | $5,788.20 | $19,294 | 1.7× |
| Tte w or w/o fol w/cont, com (C8921) | $264.90 | $883 | 0.3× |
| Tte w or wo fol wcon,doppler (C8929) | $3,641.70 | $12,139 | 4.8× |
| Unsched dialysis esrd pt hos (G0257) | $9,357.30 | $31,191 | 14.0× |