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25 codes. Prices are the hospital's own posted facility charges.
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Procedure Posted cash Posted gross × Medicare
Admin influenza virus vac (G0008) range across 3 matching MRF lines
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$28–$67
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Admin pneumococcal vaccine (G0009) range across 2 matching MRF lines
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$28–$95
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Ca screen;flexi sigmoidscope (G0104)
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$415
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Ca screen;pelvic/breast exam (G0101)
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$130
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Catheterize for urine spec (P9612) range across 2 matching MRF lines
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$47–$59
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Colon ca scrn not hi rsk ind (G0121)
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$1,207
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Colorectal scrn; hi risk ind (G0105)
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$1,318
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Direct refer hospital observ (G0379)
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$177
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Drug test def 1-7 classes (G0480)
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$386
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Drug test def 15-21 classes (G0482)
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$670
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Drug test def 22+ classes (G0483)
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$832
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Drug test def 8-14 classes (G0481)
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$527
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Elec stim other than wound (G0283)
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$98
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Elec stim unattend for press (G0281)
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$98
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Fecal blood scrn immunoassay (G0328)
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$87
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Hospital outpt clinic visit (G0463)
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$328
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Initial preventive exam (G0402)
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$436
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Mri w/cont, breast, bi (C8906)
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$3,908
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Mri w/o fol w/cont, brst, un (C8905)
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$4,397
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Obtaining screen pap smear (Q0091)
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$149
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Oth resp proc, group (G0239)
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$70
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Oth resp proc, indiv (G0238)
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$70
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Ppps, initial visit (G0438)
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$511
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Psa screening (G0103)
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$220
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Therapeutic procd strg endur (G0237)
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$70
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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.