Supplies, drugs & other prices at Bon Secours St. Francis Hospital
Charleston, SC · every code in this section with a posted price and a Medicare benchmark.
57 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,975.35 | $3,039 | 2.7× |
| 2d tte w or w/o fol w/con,co (C8923) | $698.75 | $1,075 | 1.0× |
| 2d tte w or w/o fol w/con,fu (C8924) | $612.30 | $942 | 1.9× |
| Adm tocilizu covid-19 1st (M0249) | $768.30 | $1,182 | 1.9× |
| Admin hepatitis b vaccine (G0010) | $75.40 | $116 | 1.7× |
| Admin influenza virus vac (G0008) | $55.25 | $85 | 1.3× |
| Admin pneumococcal vaccine (G0009) | $55.25 | $85 | 1.3× |
| Catheterize for urine spec (P9612) | $49.40 | $76 | 5.3× |
| Chemo extend iv infus w/pump (G0498) | $722.80 | $1,112 | 2.4× |
| Colon ca scrn not hi rsk ind (G0121) | $5,768.36 | $9,613.94 | 6.7× |
| Colorectal scrn; hi risk ind (G0105) | $5,104.35 | $8,507.25 | 5.9× |
| Cysto impl 4 or more (C9740) | $23,947.04 | $39,911.73 | 2.7× |
| Cystoscopy prostatic imp 1-3 (C9739) | $14,192.59 | $23,654.32 | 2.8× |
| Diab manage trn per indiv (G0108) | $104 | $160 | 1.9× |
| Diab manage trn ind/group (G0109) | $28.60 | $44 | 1.8× |
| Direct refer hospital observ (G0379) | $299 | $460 | 0.5× |
| Drug test def 1-7 classes (G0480) | $144.30 | $222 | 1.3× |
| Elec stim other than wound (G0283) | $133.90 | $206 | 10.6× |
| Elec stim unattend for press (G0281) | $169 | $260 | 14.5× |
| Inj for sacroiliac jt anesth (G0260) | $2,651.15 | $4,418.58 | 4.0× |
| Mra w/cont, abd (C8900) | $2,837.25 | $4,365 | 8.7× |
| Mra w/cont, chest (C8909) | $2,694.90 | $4,146 | 8.3× |
| Mra w/cont, lwr ext (C8912) | $2,837.25 | $4,365 | 8.7× |
| Mra w/cont, pelvis (C8918) | $2,837.25 | $4,365 | 8.7× |
| Mra w/o cont, abd (C8901) | $2,837.25 | $4,365 | 12.8× |
| Mra w/o cont, chest (C8910) | $2,694.90 | $4,146 | 12.1× |
| Mra w/o cont, lwr ext (C8913) | $2,837.25 | $4,365 | 12.8× |
| Mra w/o cont, pelvis (C8919) | $2,837.25 | $4,365 | 12.8× |
| Mra w/o fol w/cont, abd (C8902) | $1,836.90 | $2,826 | 5.7× |
| Mra w/o fol w/cont, chest (C8911) | $2,694.90 | $4,146 | 8.3× |
| Mra w/o fol w/cont, pelvis (C8920) | $3,180.45 | $4,893 | 9.8× |
| Mra, w/dye, upper extremity (C8934) | $2,837.25 | $4,365 | 8.7× |
| Mri w/o fol w/cont, breast, (C8908) | $3,657.55 | $5,627 | 11.3× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $409.50 | $630 | 0.8× |
| Oth resp proc, group (G0239) | $81.25 | $125 | 2.3× |
| Oth resp proc, indiv (G0238) | $62.40 | $96 | 2.3× |
| Pathogen test for platelets (P9100) | $91 | $140 | 1.7× |
| Perq Sacral Augmt Bilat Inj (0201T) | $10,047.05 | $15,457 | 1.5× |
| Perq Sacral Augmt Unilat Inj (0200T) | $4,772.30 | $7,342 | 0.7× |
| Prostate biopsy, any mthd (G0416) | $1,833.65 | $2,821 | 5.5× |
| Psa screening (G0103) | $222.95 | $343 | 11.5× |
| Quan MRI alys brain with diagnostic MRI (0866T) | $873.60 | $1,344 | 3.9× |
| Quan MRI alys brn w/o dx MRI (0865T) | $873.60 | $1,344 | 3.9× |
| Rpr intst excl anrect fist (C9796) | $5,647.85 | $8,689 | 2.2× |
| Therapeutic procd strg endur (G0237) | $62.40 | $96 | 2.3× |
| Tomosynthesis, mammo (G0279) | $99.45 | $153 | 7.8× |
| Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) | $6,588.40 | $10,136 | 0.6× |
| Trluml Perip Athrc Renal Art (0234T) | $6,588.40 | $10,136 | 0.6× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $6,588.40 | $10,136 | 0.6× |
| Trluml peripheral atherectomy iliac artery ea (0238T) unusually low: confirm this is the full procedure |
$6,588.40 | $10,136 | 0.4× |
| Tte w or w/o fol w/con,stres (C8928) | $1,263.60 | $1,944 | 1.7× |
| Tte w or w/o fol w/cont, com (C8921) | $1,120.60 | $1,724 | 1.5× |
| Tte w or w/o fol w/cont, f/u (C8922) | $565.50 | $870 | 0.8× |
| Tte w or wo fol wcon,doppler (C8929) | $2,144.35 | $3,299 | 2.9× |
| Unsched dialysis esrd pt hos (G0257) | $526.50 | $810 | 0.8× |
| Vasc emb/occ w/prs cath (C9797) | $35,234.55 | $54,207 | 2.1× |
| Visit to determ ldct elig (G0296) | $165.10 | $254 | 1.7× |