Supplies, drugs & other prices at Brooks-TLC Hospital System, Inc
Dunkirk, NY · every code in this section with a posted price and a Medicare benchmark.
64 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,948 | $1,948 | 2.0× |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,491 | $1,491 | 3.4× |
| Admin hepatitis b vaccine (G0010) | $126 | $126 | 2.2× |
| Admin influenza virus vac (G0008) | $39 | $39 | 0.7× |
| Admin pneumococcal vaccine (G0009) | $62 | $62 | 1.1× |
| Autolog prp not diab ulcer (G0460) | $1,219 | $1,219 | 0.5× |
| Blind interatrial shunt ide (C9758) | $41,344 | $41,344 | 1.9× |
| Ca screen;pelvic/breast exam (G0101) | $66 | $66 | 0.5× |
| Chemo extend iv infus w/pump (G0498) | $1,928 | $1,928 | 4.7× |
| Cysto, litho, vacuum kidney (C9761) range across 3 matching MRF lines |
$18,031–$24,000 | $18,031–$24,000 | varies |
| Diab manage trn per indiv (G0108) | $226.93 | $226.93 | 4.1× |
| Diab manage trn ind/group (G0109) range across 3 matching MRF lines |
$27–$109 | $27–$109 | varies |
| Direct refer hospital observ (G0379) range across 12 matching MRF lines |
$54–$1,451 | $54–$1,451 | varies |
| Drug test def 1-7 classes (G0480) range across 39 matching MRF lines |
$41–$328 | $41–$328 | varies |
| Elec stim other than wound (G0283) | $50 | $50 | 3.9× |
| Group mnt 2 or more 30 mins (G0271) | $57 | $57 | 3.3× |
| Hbot, full body chamber, 30m (G0277) | $326 | $326 | 1.9× |
| Home sleep test/type 3 porta (G0399) | $514 | $514 | 1.9× |
| Hospital outpt clinic visit (G0463) range across 86 matching MRF lines |
$54–$510 | $54–$510 | varies |
| Inj for sacroiliac jt anesth (G0260) range across 8 matching MRF lines |
$1,995–$2,992 | $1,995–$2,992 | varies |
| Insj Wcs Lv Pg Compnt (0517T) | $25,276 | $25,276 | 1.9× |
| Mnt subs tx for change dx (G0270) | $106 | $106 | 3.3× |
| Mra w/cont, abd (C8900) | $1,669 | $1,669 | 3.8× |
| Mra w/cont, chest (C8909) | $1,525 | $1,525 | 3.5× |
| Mra w/cont, lwr ext (C8912) range across 2 matching MRF lines |
$1,669–$2,497 | $1,669–$2,497 | varies |
| Mra w/cont, pelvis (C8918) | $2,699 | $2,699 | 6.2× |
| Mra w/o cont, abd (C8901) | $1,517 | $1,517 | 5.1× |
| Mra w/o cont, chest (C8910) | $1,390 | $1,390 | 4.7× |
| Mra w/o cont, lwr ext (C8913) range across 2 matching MRF lines |
$1,517–$2,270 | $1,517–$2,270 | varies |
| Mra w/o cont, pelvis (C8919) | $2,699 | $2,699 | 9.1× |
| Mra w/o fol w/cont, abd (C8902) | $1,833 | $1,833 | 4.2× |
| Mra w/o fol w/cont, chest (C8911) | $1,669 | $1,669 | 3.8× |
| Mra w/o fol w/cont, lwr ext (C8914) range across 2 matching MRF lines |
$1,833–$2,747 | $1,833–$2,747 | varies |
| Mra, w/o&w/dye, upper extr (C8936) | $1,833 | $1,833 | 4.2× |
| Mri w/cont, breast, bi (C8906) | $2,702 | $2,702 | 6.2× |
| Mri w/cont, breast, uni (C8903) | $1,134 | $1,134 | 5.2× |
| Mri w/o fol w/cont, breast, (C8908) | $2,867 | $2,867 | 6.6× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,287 | $1,287 | 3.0× |
| Njx platelet plasma (0232T) | $3,501 | $3,501 | 6.3× |
| Obtaining screen pap smear (Q0091) | $33 | $33 | 0.9× |
| Perc d-e cor revasc chro sin (C9607) | $23,110 | $23,110 | 1.0× |
| Perc d-e cor revasc t cabg s (C9604) | $23,110 | $23,110 | 1.6× |
| Perc d-e cor stent ather s (C9602) | $23,110 | $23,110 | 1.0× |
| Perc drug-el cor stent sing (C9600) | $23,110 | $23,110 | 1.6× |
| Perq Sacral Augmt Bilat Inj (0201T) | $21,472 | $21,472 | 2.4× |
| Perq Sacral Augmt Unilat Inj (0200T) | $21,472 | $21,472 | 2.4× |
| Pet not otherwise specified (G0235) | $3,833 | $3,833 | 7.7× |
| Place device/marker, non pro (C9728) | $4,435 | $4,435 | 2.6× |
| Prostate biopsy, any mthd (G0416) | $646 | $646 | 1.4× |
| Psa screening (G0103) | $93 | $93 | 4.8× |
| Revasc intra lithotrip-stent (C9765) | $52,629 | $52,629 | 2.3× |
| Revasc intravasc lithotripsy (C9764) | $33,439 | $33,439 | 2.3× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $102 | $102 | 3.9× |
| Screen cerv/vag thin layer (G0123) | $63 | $63 | 3.1× |
| Screen pap by tech w md supv (P3000) range across 4 matching MRF lines |
$41–$82 | $41–$82 | varies |
| Spine device implant surgery (C9757) | $39,358 | $39,358 | 2.5× |
| Tee w or w/o fol w/cont, mon (C8927) | $1,491 | $1,491 | 1.5× |
| Tomosynthesis, mammo (G0279) | $145 | $145 | 11.4× |
| Trluml Perip Athrc Iliac Art (0238T) | $37,960 | $37,960 | 1.7× |
| Tte w or w/o contr, cont ecg (C8930) | $1,856 | $1,856 | 1.9× |
| Tte w or w/o fol w/con,stres (C8928) | $1,658 | $1,658 | 1.7× |
| Tte w or w/o fol w/cont, com (C8921) | $1,722 | $1,722 | 1.8× |
| Tte w or wo fol wcon,doppler (C8929) | $1,439 | $1,439 | 1.5× |
| Unsched dialysis esrd pt hos (G0257) | $1,030 | $1,030 | 1.2× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.