Supplies, drugs & other prices at Bon Secours St. Francis Medical Center
Midlothian, VA · every code in this section with a posted price and a Medicare benchmark.
36 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) | $1,284 | $2,140 | 1.7× |
| Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T) | $18,535.90 | $30,893.17 | 2.2× |
| Admin influenza virus vac (G0008) | $25.20 | $42 | 0.6× |
| Admin pneumococcal vaccine (G0009) | $38.40 | $64 | 0.8× |
| Alveolus clsd reduc stblz te (D7771) | $6,087.60 | $10,146 | 1.9× |
| Autolog prp not diab ulcer (G0460) | $3,448.80 | $5,748 | 1.7× |
| Ca screen;flexi sigmoidscope (G0104) | $2,963.34 | $4,938.91 | 3.3× |
| Ca screen;pelvic/breast exam (G0101) | $35.40 | $59 | 0.4× |
| Catheterize for urine spec (P9612) | $17.40 | $29 | 1.9× |
| Colon ca scrn not hi rsk ind (G0121) | $3,825.56 | $6,375.92 | 4.2× |
| Colorectal scrn; hi risk ind (G0105) | $4,090.75 | $6,817.92 | 4.5× |
| Cysto impl 4 or more (C9740) | $35,400.73 | $59,001.22 | 3.8× |
| Cysto, litho, vacuum kidney (C9761) | $39,912.74 | $66,521.23 | 4.3× |
| Drug test def 1-7 classes (G0480) | $439.20 | $732 | 3.8× |
| Elec stim other than wound (G0283) | $100.20 | $167 | 7.9× |
| Hbot, full body chamber, 30m (G0277) | $496.20 | $827 | 3.7× |
| Hepb screen high risk indiv (G0499) | $93 | $155 | 3.3× |
| Mra w/cont, chest (C8909) | $2,116.20 | $3,527 | 6.2× |
| Mra w/o cont, lwr ext (C8913) | $1,919.40 | $3,199 | 8.2× |
| Mra w/o fol w/cont, abd (C8902) | $1,587.60 | $2,646 | 4.7× |
| Mri w/o fol w/cont, breast, (C8908) | $3,868.80 | $6,448 | 11.4× |
| Obtaining screen pap smear (Q0091) | $84.60 | $141 | 3.0× |
| Oth resp proc, group (G0239) | $331.20 | $552 | 9.1× |
| Perc d-e cor stent ather s (C9602) | $91,422.90 | $152,371.50 | 5.1× |
| Perq Sacral Augmt Unilat Inj (0200T) | $4,009.20 | $6,682 | 0.6× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $36,044.40 | $60,074 | 1.9× |
| Therapeutic procd strg endur (G0237) | $116.40 | $194 | 4.1× |
| Tomosynthesis, mammo (G0279) | $237.60 | $396 | 18.7× |
| Tooth reimplantation (D7270) | $1,665 | $2,775 | 2.6× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $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 contr, cont ecg (C8930) | $3,625.80 | $6,043 | 4.7× |
| Tte w or wo fol wcon,doppler (C8929) | $2,967.60 | $4,946 | 3.9× |
| Unsched dialysis esrd pt hos (G0257) | $1,370.40 | $2,284 | 2.0× |
| Visit to determ ldct elig (G0296) | $58.20 | $97 | 0.6× |
| Wet mounts/ w preparations (Q0111) | $58.80 | $98 | 3.2× |