Supplies, drugs & other prices at Box Butte General Hospital

Alliance, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Admin hepatitis b vaccine (G0010) $19.80 $22 0.4×
Admin influenza virus vac (G0008) $47.70 $53 1.0×
Admin pneumococcal vaccine (G0009) $42.30 $47 0.9×
Catheterize for urine spec (P9612) $209.70 $233 22.5×
Colon ca scrn not hi rsk ind (G0121) $1,879.20 $2,088 1.9×
Colorectal scrn; hi risk ind (G0105) $2,144.25 $2,382.50 2.2×
Diab manage trn per indiv (G0108) $155.70 $173 2.8×
Diab manage trn ind/group (G0109) $45.45 $50.50 2.8×
Direct refer hospital observ (G0379) $171.90 $191 0.3×
Drug test def 1-7 classes (G0480) $262.80 $292 2.3×
Elec stim other than wound (G0283) $86.40 $96 6.8×
Fern test (Q0114) $27.90 $31 2.9×
Hbot, full body chamber, 30m (G0277) $257.40 $286 1.8×
Hepb screen high risk indiv (G0499) $139.95 $155.50 5.0×
Liver dis 10 assays w/nash (0003M) $1,090.80 $1,212 2.2×
Mnt subs tx for change dx (G0270) $360 $400 11.3×
Oral hiv-1/hiv-2 screen (G0435) $132.30 $147 11.0×
Prostate biopsy, any mthd (G0416) $853.20 $948 2.3×
Psa screening (G0103) $135.45 $150.50 7.0×
Tomosynthesis, mammo (G0279) $56.25 $62.50 4.4×
Tpmt Nudt15 Gene Analysis Common Variants (0034U) $844.20 $938 1.8×
Trauma respons w/hosp criti (G0390) $989.10 $1,099 0.7×
Warfarin response genotype (0030U) $1,344.60 $1,494 10.0×