18 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Admin influenza virus vac (G0008) |
$31.20 |
$39 |
0.7× |
| Admin pneumococcal vaccine (G0009) |
$30 |
$37.50 |
0.6× |
| Antibody treponema pallidum total & rpr ia qual (0064U) |
$54.64 |
$68.30 |
1.7× |
| Behavior counsel obesity 15m (G0447) |
$40 |
$50 |
0.4× |
| Brief alcohol misuse counsel (G0443) |
$51.20 |
$64 |
0.5× |
| CYP1A2 (cytochrome P450 family 1, subfamily A, member 2) (eg, drug metabolism) gene analysis, common variants (ie, *1F,… (0031U) |
$567.90 |
$709.87 |
3.2× |
| Diab manage trn per indiv (G0108) |
$48 |
$60 |
0.9× |
| Diab manage trn ind/group (G0109) |
$28 |
$35 |
1.7× |
| Direct refer hospital observ (G0379) |
$177.60 |
$222 |
0.3× |
| Ekg tracing for initial prev (G0404) |
$34.80 |
$43.50 |
1.2× |
| Ig paraprotein qual bld/ur (0077U) |
$104.60 |
$130.75 |
2.4× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) |
$386.40 |
$483 |
3.2× |
| Liver Dis 10 Assays W/Nash (0003M) |
$600 |
$750 |
1.2× |
| Prolonged iv inf, req pump (C8957) |
$205.60 |
$257 |
1.0× |
| Syphilis tst non-treponemal antibody ia qual rpr (0065U) |
$39.20 |
$49 |
2.2× |
| Tomosynthesis, mammo (G0279) |
$62.40 |
$78 |
4.9× |
| Tpmt nudt15 gene analysis common variants (0034U) |
$436.80 |
$546 |
0.9× |
| Trauma respons w/hosp criti (G0390) |
$1,059.20 |
$1,324 |
0.8× |