Supplies, drugs & other prices at Bsa Hospital
Amarillo, TX · every code in this section with a posted price and a Medicare benchmark.
69 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $223.10 | $2,231 | 0.3× |
| 2d tte w or w/o fol w/con,fu (C8924) | $104.60 | $1,046 | 0.3× |
| Adm tocilizu covid-19 1st (M0249) | $150.30 | $1,503 | 0.3× |
| Adm tocilizu covid-19 2nd (M0250) | $150.30 | $1,503 | 0.3× |
| Admin influenza virus vac (G0008) | $21.30 | $213 | 0.5× |
| Admin pneumococcal vaccine (G0009) | $21.30 | $213 | 0.5× |
| Ca screen;flexi sigmoidscope (G0104) | $371 | $3,710 | 0.4× |
| Catheterize for urine spec (P9612) | $41.10 | $411 | 4.4× |
| Colon ca scrn not hi rsk ind (G0121) | $528 | $5,280 | 0.6× |
| Colorectal scrn; hi risk ind (G0105) | $528 | $5,280 | 0.6× |
| Covid-19 lab test non-cdc (U0002) | $17.10 | $171 | 0.3× |
| Devlopment test interpt&rep (G0451) | $78.30 | $783 | 0.8× |
| Direct refer hospital observ (G0379) | $191.90 | $1,919 | 0.3× |
| Drug test def 1-7 classes (G0480) | $61.10 | $611 | 0.5× |
| Drug test def 15-21 classes (G0482) | $73.30 | $733 | 0.4× |
| Drug test def 22+ classes (G0483) | $91 | $910 | 0.4× |
| Drug test def 8-14 classes (G0481) | $42.80 | $428 | 0.3× |
| Eia hiv-1/hiv-2 screen (G0432) | $7.30 | $73 | 0.4× |
| Elec stim other than wound (G0283) | $9.10 | $91 | 0.7× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) likely a partial charge, not the full procedure |
$2,500.70 | $25,007 | 0.2× |
| Hbot, full body chamber, 30m (G0277) | $47.70 | $477 | 0.3× |
| Home sleep test/type 2 porta (G0398) | $91.50 | $915 | 0.4× |
| Home sleep test/type 3 porta (G0399) | $46.40 | $464 | 0.2× |
| Hospital outpt clinic visit (G0463) | $54.30 | $543 | 0.4× |
| Inj for sacroiliac jt anesth (G0260) | $439.12 | $4,391.25 | 0.6× |
| Mra w/cont, abd (C8900) | $542 | $5,420 | 1.5× |
| Mra w/cont, chest (C8909) | $350.30 | $3,503 | 1.0× |
| Mra w/o cont, abd (C8901) | $509.30 | $5,093 | 2.1× |
| Mra w/o cont, chest (C8910) | $322.90 | $3,229 | 1.3× |
| Mra w/o cont, lwr ext (C8913) | $311.30 | $3,113 | 1.3× |
| Mra w/o cont, pelvis (C8919) | $141.80 | $1,418 | 0.6× |
| Mra w/o fol w/cont, abd (C8902) | $623 | $6,230 | 1.8× |
| Mra w/o fol w/cont, chest (C8911) | $573.60 | $5,736 | 1.6× |
| Mra w/o fol w/cont, lwr ext (C8914) | $358 | $3,580 | 1.0× |
| Mra w/o fol w/cont, pelvis (C8920) | $186.10 | $1,861 | 0.5× |
| Mri w/cont, breast, bi (C8906) | $591.40 | $5,914 | 1.7× |
| Mri w/cont, breast, uni (C8903) | $434.50 | $4,345 | 2.5× |
| Mri w/o fol w/cont, breast, (C8908) | $714.10 | $7,141 | 2.0× |
| Mri w/o fol w/cont, brst, un (C8905) | $542.10 | $5,421 | 1.5× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $179.10 | $1,791 | 0.3× |
| Non-ophthalmic fva (C9733) | $499.70 | $4,997 | 1.4× |
| Onc merkel cell carc detcj antb serum reprtd +/- (0059U) | $109.70 | $1,097 | 0.3× |
| Oth resp proc, group (G0239) | $11.60 | $116 | 0.3× |
| Oth resp proc, indiv (G0238) | $8 | $80 | 0.3× |
| Perc d-e cor revasc chro sin (C9607) likely a partial charge, not the full procedure |
$2,029.40 | $20,294 | 0.1× |
| Perc d-e cor revasc t cabg s (C9604) likely a partial charge, not the full procedure |
$2,029.40 | $20,294 | 0.2× |
| Perc d-e cor stent ather s (C9602) likely a partial charge, not the full procedure |
$2,899.10 | $28,991 | 0.2× |
| Perc drug-el cor stent sing (C9600) likely a partial charge, not the full procedure |
$2,899.10 | $28,991 | 0.2× |
| Psa screening (G0103) | $13.60 | $136 | 0.7× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $80.40 | $804 | 0.1× |
| Revasc intra lithotrip-ather (C9766) likely a partial charge, not the full procedure |
$3,320.60 | $33,206 | 0.2× |
| Revasc intra lithotrip-stent (C9765) likely a partial charge, not the full procedure |
$2,905.50 | $29,055 | 0.2× |
| Revasc intravasc lithotripsy (C9764) likely a partial charge, not the full procedure |
$1,147.30 | $11,473 | 0.1× |
| Revasc lith-sten-ath tib/per (C9775) likely a partial charge, not the full procedure |
$5,311.30 | $53,113 | 0.3× |
| Revasc lithotr-ather tib/per (C9774) likely a partial charge, not the full procedure |
$5,311.30 | $53,113 | 0.3× |
| Revasc lithotr-stent tib/per (C9773) likely a partial charge, not the full procedure |
$5,311.30 | $53,113 | 0.3× |
| Revasc lithotrip tibi/perone (C9772) likely a partial charge, not the full procedure |
$3,320.60 | $33,206 | 0.3× |
| Revasc lithotrip-stent-ather (C9767) likely a partial charge, not the full procedure |
$5,311.30 | $53,113 | 0.3× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) likely a partial charge, not the full procedure |
$1,687.60 | $16,876 | 0.3× |
| Therapeutic procd strg endur (G0237) | $8 | $80 | 0.3× |
| Trauma respons w/hosp criti (G0390) | $1,660.80 | $16,608 | 1.2× |
| Trluml Perip Athrc Renal Art (0234T) likely a partial charge, not the full procedure |
$3,420 | $34,200 | 0.3× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) unusually low: confirm this is the full procedure |
$3,511.10 | $35,111 | 0.3× |
| Trluml peripheral atherectomy iliac artery ea (0238T) likely a partial charge, not the full procedure |
$5,423.10 | $54,231 | 0.3× |
| Tte w or wo fol wcon,doppler (C8929) | $223.10 | $2,231 | 0.3× |
| Unsched dialysis esrd pt hos (G0257) | $255.10 | $2,551 | 0.4× |
| Vasc emb/occ w/prs cath (C9797) unusually low: confirm this is the full procedure |
$5,526.10 | $55,261 | 0.3× |
| Ven blood coll snf/hha (G0471) | $3.60 | $36 | 0.3× |
| Visit to determ ldct elig (G0296) | $28.20 | $282 | 0.3× |