Supplies, drugs & other prices at Bristol Regional Medical Center
Bristol, TN · every code in this section with a posted price and a Medicare benchmark.
109 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2019-ncov diagnostic p (U0001) | $10.35 | $69 | 0.3× |
| 2d tte w or w/o fol w/con,co (C8923) | $183.75 | $1,225 | 0.2× |
| 2d tte w or w/o fol w/con,fu (C8924) | $289.50 | $1,930 | 0.9× |
| Adm tocilizu covid-19 1st (M0249) | $130.20 | $868 | 0.3× |
| Adm tocilizu covid-19 2nd (M0250) | $130.20 | $868 | 0.3× |
| Admin hepatitis b vaccine (G0010) | $13.35 | $89 | 0.3× |
| Admin influenza virus vac (G0008) | $15.30 | $102 | 0.3× |
| Admin pneumococcal vaccine (G0009) | $13.35 | $89 | 0.3× |
| Bia whole body composition assessment w/i&r (0358T) | $15.60 | $104 | 0.6× |
| Brief alcohol misuse counsel (G0443) | $51.90 | $346 | 0.5× |
| Chemo extend iv infus w/pump (G0498) | $279.90 | $1,866 | 0.9× |
| Covid-19 lab test non-cdc (U0002) | $15 | $100 | 0.3× |
| Diab manage trn per indiv (G0108) | $21 | $140 | 0.4× |
| Diab manage trn ind/group (G0109) | $56.02 | $373.50 | 3.5× |
| Direct refer hospital observ (G0379) | $138 | $920 | 0.2× |
| Drug test def 1-7 classes (G0480) | $102.60 | $684 | 0.9× |
| Drug test def 15-21 classes (G0482) | $213 | $1,420 | 1.1× |
| Drug test def 22+ classes (G0483) | $276.30 | $1,842 | 1.1× |
| Drug test def 8-14 classes (G0481) | $157.80 | $1,052 | 1.0× |
| Elec stim other than wound (G0283) | $15.90 | $106 | 1.3× |
| Elec stim unattend for press (G0281) | $23.85 | $159 | 2.0× |
| Electrophysiologic eval icds w/ss electrode (0577T) | $538.20 | $3,588 | 0.5× |
| Fecal blood scrn immunoassay (G0328) | $25.20 | $168 | 1.4× |
| Glyca nuc mr spectroscopy quantitative (0024U) | $27.45 | $183 | 0.8× |
| Hbot, full body chamber, 30m (G0277) | $122.55 | $817 | 0.9× |
| Hiv combination assay (G0475) | $42.30 | $282 | 1.8× |
| Home sleep test/type 2 porta (G0398) | $161.70 | $1,078 | 0.8× |
| Home sleep test/type 4 porta (G0400) | $161.70 | $1,078 | 0.8× |
| Hopd mntl hlt, 15-29 min (C7900) | $10.35 | $69 | 0.3× |
| Hopd mntl hlt, 30-60 min (C7901) | $26.32 | $175.50 | 0.3× |
| Hopd mntl hlt, grp (C7903) | $8.10 | $54 | 0.2× |
| Hospital outpt clinic visit (G0463) | $39.15 | $261 | 0.3× |
| Inj for sacroiliac jt anesth (G0260) | $418.35 | $2,789 | 0.6× |
| Insertion of substernal implantable defibrillator electrode (0572T) unusually low: confirm this is the full procedure |
$3,842.10 | $25,614 | 0.5× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) unusually low: confirm this is the full procedure |
$14,877.60 | $99,184 | 0.5× |
| Intens cardiac rehab no exer (G0423) | $56.85 | $379 | 0.5× |
| Intens cardiac rehab w/exerc (G0422) | $56.85 | $379 | 0.5× |
| Interrogation dev eval icds w/ss eltrd in person (0576T) | $16.95 | $113 | 0.5× |
| Mra w/cont, abd (C8900) | $604.95 | $4,033 | 1.8× |
| Mra w/cont, chest (C8909) | $537.15 | $3,581 | 1.6× |
| Mra w/cont, lwr ext (C8912) | $636.75 | $4,245 | 1.9× |
| Mra w/cont, pelvis (C8918) | $636.75 | $4,245 | 1.9× |
| Mra w/o cont, abd (C8901) | $636.75 | $4,245 | 2.8× |
| Mra w/o cont, chest (C8910) | $636.75 | $4,245 | 2.8× |
| Mra w/o cont, lwr ext (C8913) | $537.15 | $3,581 | 2.4× |
| Mra w/o cont, pelvis (C8919) | $537.15 | $3,581 | 2.4× |
| Mra w/o fol w/cont, abd (C8902) | $668.55 | $4,457 | 2.0× |
| Mra w/o fol w/cont, chest (C8911) | $668.55 | $4,457 | 2.0× |
| Mra w/o fol w/cont, lwr ext (C8914) | $668.55 | $4,457 | 2.0× |
| Mra w/o fol w/cont, pelvis (C8920) | $659.55 | $4,397 | 2.0× |
| Mra, w/dye, spinal canal (C8931) | $537.15 | $3,581 | 1.6× |
| Mra, w/dye, upper extremity (C8934) | $537.15 | $3,581 | 1.6× |
| Mra, w/o dye, spinal canal (C8932) | $537.15 | $3,581 | 2.4× |
| Mra, w/o dye, upper extr (C8935) | $537.15 | $3,581 | 2.4× |
| Mra, w/o&w/dye, spinal canal (C8933) | $537.15 | $3,581 | 1.6× |
| Mra, w/o&w/dye, upper extr (C8936) | $537.15 | $3,581 | 1.6× |
| Mri w/o fol w/cont, breast, (C8908) | $668.55 | $4,457 | 2.0× |
| Mri w/o fol w/cont, brst, un (C8905) | $636.75 | $4,245 | 1.9× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $468.75 | $3,125 | 0.9× |
| Obtaining screen pap smear (Q0091) | $5.55 | $37 | 0.2× |
| Oth resp proc, group (G0239) | $79.05 | $527 | 2.2× |
| Oth resp proc, indiv (G0238) | $79.05 | $527 | 2.9× |
| Perc d-e cor revasc chro sin (C9607) likely a partial charge, not the full procedure |
$4,926.60 | $32,844 | 0.3× |
| Perc d-e cor revasc t cabg s (C9604) unusually low: confirm this is the full procedure |
$4,926.60 | $32,844 | 0.4× |
| Perc d-e cor stent ather s (C9602) likely a partial charge, not the full procedure |
$4,926.60 | $32,844 | 0.3× |
| Perc drug-el cor stent sing (C9600) unusually low: confirm this is the full procedure |
$4,926.60 | $32,844 | 0.4× |
| Perq Sacral Augmt Bilat Inj (0201T) likely a partial charge, not the full procedure |
$1,421.70 | $9,478 | 0.2× |
| Perq Sacral Augmt Unilat Inj (0200T) likely a partial charge, not the full procedure |
$1,421.70 | $9,478 | 0.2× |
| Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) likely a partial charge, not the full procedure |
$2,454.45 | $16,363 | 0.2× |
| Place device/marker, non pro (C9728) | $582.75 | $3,885 | 0.4× |
| Prgrmg dev eval icds ss ip (0575T) | $16.95 | $113 | 0.5× |
| Prgrmg dev eval ldls pm single car chamber ip (0826T) | $513.90 | $3,426 | 14.5× |
| Prostate biopsy, any mthd (G0416) | $326.70 | $2,178 | 1.0× |
| Psa screening (G0103) | $32.25 | $215 | 1.7× |
| Quan MRI alys brn w/o dx MRI (0865T) | $636.75 | $4,245 | 2.8× |
| Rbc DNA gnotyp 10 bld groups (0084U) | $923.85 | $6,159 | 1.3× |
| Remote interrogation device evaluation of implantable cardioverter-defibrillator system with lead under breastbone,… (0579T) | $16.95 | $113 | 0.5× |
| Repos prev impl ss impltbl dfb pacing eltrd (0574T) | $1,775.85 | $11,839 | 0.5× |
| Revasc intra lithotrip-ather (C9766) unusually low: confirm this is the full procedure |
$8,623.20 | $57,488 | 0.5× |
| Revasc intra lithotrip-stent (C9765) unusually low: confirm this is the full procedure |
$8,623.20 | $57,488 | 0.5× |
| Revasc intravasc lithotripsy (C9764) unusually low: confirm this is the full procedure |
$4,311.45 | $28,743 | 0.4× |
| Revasc lith-sten-ath tib/per (C9775) unusually low: confirm this is the full procedure |
$7,624.35 | $50,829 | 0.4× |
| Revasc lithotr-ather tib/per (C9774) unusually low: confirm this is the full procedure |
$7,624.35 | $50,829 | 0.4× |
| Revasc lithotr-stent tib/per (C9773) unusually low: confirm this is the full procedure |
$7,624.35 | $50,829 | 0.4× |
| Revasc lithotrip tibi/perone (C9772) unusually low: confirm this is the full procedure |
$4,766.55 | $31,777 | 0.4× |
| Revasc lithotrip-stent-ather (C9767) | $13,872.30 | $92,482 | 0.8× |
| Rmvl substernal implantable defibrillator eltrd (0573T) | $1,775.85 | $11,839 | 0.5× |
| Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) | $1,775.85 | $11,839 | 0.5× |
| Rmvl&rplcmt substernal impltbl defibrillator pg (0614T) | $10,659.45 | $71,063 | 0.5× |
| Slctv nzmtc dbrdmt brn eschar anes s/n/hf&/md 1 (0975T) | $172.20 | $1,148 | 0.4× |
| Slctv nzmtc dbrdmt brn eschar req anes t/a/l 1st (0973T) | $172.20 | $1,148 | 0.4× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) likely a partial charge, not the full procedure |
$4,025.10 | $26,834 | 0.2× |
| Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) | $1,414.05 | $9,427 | 0.5× |
| Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) likely a partial charge, not the full procedure |
$4,025.10 | $26,834 | 0.2× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) unusually low: confirm this is the full procedure |
$2,402.55 | $16,017 | 0.4× |
| Therapeutic procd strg endur (G0237) | $79.05 | $527 | 2.9× |
| Tomosynthesis, mammo (G0279) | $74.10 | $494 | 5.8× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) unusually low: confirm this is the full procedure |
$2,510.10 | $16,734 | 0.5× |
| Transcatheter renal sympath denervation unilat (0338T) unusually low: confirm this is the full procedure |
$2,510.10 | $16,734 | 0.5× |
| Trauma respons w/hosp criti (G0390) | $988.65 | $6,591 | 0.8× |
| Trim nail(s) (G0127) | $12.15 | $81 | 0.2× |
| Trluml Perip Athrc Renal Art (0234T) unusually low: confirm this is the full procedure |
$3,443.70 | $22,958 | 0.3× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) unusually low: confirm this is the full procedure |
$4,196.55 | $27,977 | 0.4× |
| Trluml peripheral atherectomy iliac artery ea (0238T) likely a partial charge, not the full procedure |
$4,196.55 | $27,977 | 0.2× |
| Tte w or w/o fol w/con,stres (C8928) | $585 | $3,900 | 0.8× |
| Tte w or wo fol wcon,doppler (C8929) | $473.85 | $3,159 | 0.6× |
| Unsched dialysis esrd pt hos (G0257) | $166.80 | $1,112 | 0.3× |
| Visit to determ ldct elig (G0296) | $38.55 | $257 | 0.4× |
| Wet mounts/ w preparations (Q0111) | $7.20 | $48 | 0.4× |