Supplies, drugs & other prices at Carle Bromenn Medical Center (Normal, IL)

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

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Procedure	Posted cash	Posted gross	× Medicare
2d tee w or w/o fol w/con,in (C8925)	$2,945	$2,945	3.5×
Adm tocilizu covid-19 1st (M0249)	$1,181	$1,181	2.5×
Adm tocilizu covid-19 2nd (M0250)	$1,181	$1,181	2.5×
Admin hepatitis b vaccine (G0010)	$113	$113	2.3×
Admin influenza virus vac (G0008)	$118	$118	2.4×
Admin pneumococcal vaccine (G0009)	$106	$106	2.1×
Alcohol/subs interv 15-30mn (G0396)	$144	$144	3.6×
Alcohol/subs interv >30 min (G0397)	$482	$482	2.5×
Anatomic guide 3d printed 1st anatomic guide (0561T)	$3,375	$3,375	23.7×
Anatomic Model 3D Printed 1St Compnt Antmc Strux (0559T)	$2,313	$2,313	16.2×
Annual alcohol screen 15 min (G0442)	$119	$119	3.0×
Behavior counsel obesity 15m (G0447)	$227	$227	2.1×
Brief alcohol misuse counsel (G0443)	$203	$203	1.9×
Ca screen;flexi sigmoidscope (G0104)	$1,014	$1,014	1.0×
Ca screen;pelvic/breast exam (G0101)	$214	$214	2.0×
Catheterize for urine spec (P9612)	$26	$26	2.8×
Chemo extend iv infus w/pump (G0498)	$596	$596	1.7×
Colon ca scrn not hi rsk ind (G0121)	$2,409	$2,409	2.4×
Colorectal scrn; hi risk ind (G0105)	$2,409	$2,409	2.4×
Compre Audiom Threshold Eval & Speech Recog (0212T)	$238	$238	1.7×
Computed tomography scan taken for the purpose of biomechanical computed tomography analysis Non-Facility Physician (0558T)	$2,360	$2,360	25.3×
Covid-19 lab test non-cdc (U0002)	$191	$191	3.7×
Cysto impl 4 or more (C9740)	$12,972	$12,972	1.3×
Cystoscopy prostatic imp 1-3 (C9739)	$6,821	$6,821	1.2×
Depression screen annual (G0444)	$125	$125	3.1×
Diab manage trn per indiv (G0108) range across 2 matching MRF lines	$49–$238	$49–$238	varies
Diab manage trn ind/group (G0109)	$67	$67	4.2×
Drug test def 1-7 classes (G0480)	$343	$343	3.0×
Ed svc ckd grp per session (G0421)	$54	$54	2.0×
Ed svc ckd ind per session (G0420)	$222	$222	2.0×
Eia hiv-1/hiv-2 screen (G0432)	$233	$233	11.9×
Elec stim other than wound (G0283)	$98	$98	7.7×
Elec stim unattend for press (G0281)	$76	$76	6.5×
Elisa hiv-1/hiv-2 screen (G0433)	$61	$61	3.3×
Fern test (Q0114)	$106	$106	10.9×
Glaucoma scrn hgh risk direc (G0117)	$125	$125	4.0×
Group mnt 2 or more 30 mins (G0271)	$50	$50	2.9×
Group train w/o patient (G0543)	$139	$139	4.5×
Hbot, full body chamber, 30m (G0277)	$882	$882	6.0×
Home sleep test/type 3 porta (G0399)	$596	$596	2.6×
Hospital outpt clinic visit (G0463) range across 47 matching MRF lines	$131–$943	$131–$943	varies
Initial preventive exam (G0402)	$286	$286	2.0×
Inj for sacroiliac jt anesth (G0260) range across 2 matching MRF lines	$1,980–$2,266	$1,980–$2,266	varies
Insertion perm ccm-d system pulse generator only (0916T)	$70,706	$70,706	3.0×
Insj perm ccm-d sys 1 transvns lead only (0917T)	$26,069	$26,069	2.9×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T)	$26,069	$26,069	2.9×
Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T)	$100,994	$100,994	3.0×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T)	$103,785	$103,785	3.1×
Intens behave ther cardio dx (G0446)	$119	$119	3.0×
Mra w/cont, abd (C8900)	$3,910	$3,910	10.5×
Mra w/cont, chest (C8909)	$5,068	$5,068	13.6×
Mra w/cont, lwr ext (C8912)	$3,577	$3,577	9.6×
Mra w/cont, pelvis (C8918)	$3,351	$3,351	9.0×
Mra w/o cont, abd (C8901)	$3,434	$3,434	13.4×
Mra w/o cont, chest (C8910)	$4,197	$4,197	16.4×
Mra w/o cont, lwr ext (C8913)	$4,830	$4,830	18.9×
Mra w/o cont, pelvis (C8919)	$2,934	$2,934	11.5×
Mra w/o fol w/cont, abd (C8902)	$6,785	$6,785	18.1×
Mra w/o fol w/cont, chest (C8911)	$6,869	$6,869	18.4×
Mra w/o fol w/cont, lwr ext (C8914)	$6,869	$6,869	18.4×
Mra w/o fol w/cont, pelvis (C8920)	$7,905	$7,905	21.1×
Mra, w/dye, spinal canal (C8931)	$2,409	$2,409	6.4×
Mra, w/dye, upper extremity (C8934)	$3,276	$3,276	8.8×
Mra, w/o dye, spinal canal (C8932)	$1,049	$1,049	4.1×
Mra, w/o dye, upper extr (C8935)	$6,475	$6,475	25.3×
Mra, w/o&w/dye, spinal canal (C8933)	$2,826	$2,826	7.6×
Mra, w/o&w/dye, upper extr (C8936)	$3,276	$3,276	8.8×
Mri w/cont, breast, bi (C8906)	$2,791	$2,791	7.5×
Mri w/cont, breast, uni (C8903)	$1,491	$1,491	7.9×
Mri w/o fol w/cont, breast, (C8908) range across 2 matching MRF lines	$4,745–$6,738	$4,745–$6,738	varies
Mri w/o fol w/cont, brst, un (C8905)	$2,432	$2,432	6.5×
Njx platelet plasma (0232T)	$502	$502	1.0×
No pt prsnt train initial 30 (G0541)	$75	$75	2.4×
Obtaining screen pap smear (Q0091)	$29	$29	0.9×
Oct middle ear with i&r bilateral (0486T)	$118	$118	2.9×
Oct middle ear with i&r unilateral (0485T)	$118	$118	2.9×
Off base opioid tx 70min (G2086)	$227	$227	1.2×
Off base opioid tx, 60 m (G2087)	$167	$167	0.9×
Ortho impl mvmt alys pair CT (0946T)	$335	$335	3.0×
Oth resp proc, group (G0239)	$167	$167	4.2×
Oth resp proc, indiv (G0238)	$125	$125	4.0×
Pathogen test for platelets (P9100)	$133	$133	2.1×
Perc d-e cor revasc chro sin (C9607)	$28,855	$28,855	1.5×
Perc d-e cor revasc t cabg s (C9604)	$37,226	$37,226	3.0×
Perc d-e cor stent ather s (C9602)	$25,516	$25,516	1.3×
Perc drug-el cor stent sing (C9600)	$13,474	$13,474	1.1×
Perq Sacral Augmt Bilat Inj (0201T)	$21,431	$21,431	2.8×
Perq Sacral Augmt Unilat Inj (0200T)	$21,431	$21,431	2.8×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T)	$17,960	$17,960	1.5×
Place device/marker, non pro (C9728)	$4,371	$4,371	2.9×
Post-coital mucous exam (Q0115)	$49	$49	2.0×
Potassium hydroxide preps (Q0112)	$75	$75	12.9×
Ppps, initial visit (G0438)	$382	$382	2.2×
Ppps, subseq visit (G0439)	$280	$280	2.0×
Prostate biopsy, any mthd (G0416)	$1,026	$1,026	2.7×
Psa screening (G0103)	$233	$233	12.1×
Quan CT tiss charac i&r w/cncrnt CT exam (0722T)	$2,132	$2,132	3.1×
Relocation skin pocket implanted ccm-d pg (0925T)	$5,762	$5,762	2.6×
Removal perm ccm-d system pulse generator only (0919T)	$11,464	$11,464	2.9×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T)	$1,948	$1,948	2.9×
Revasc intra lithotrip-ather (C9766)	$39,114	$39,114	2.0×
Revasc intra lithotrip-stent (C9765)	$39,114	$39,114	2.0×
Revasc intravasc lithotripsy (C9764)	$24,439	$24,439	2.0×
Revasc lith-sten-ath tib/per (C9775)	$39,114	$39,114	2.0×
Revasc lithotr-ather tib/per (C9774)	$39,114	$39,114	2.0×
Revasc lithotr-stent tib/per (C9773)	$39,114	$39,114	2.0×
Revasc lithotrip tibi/perone (C9772)	$24,439	$24,439	2.0×
Revasc lithotrip-stent-ather (C9767)	$39,114	$39,114	2.0×
Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T)	$11,464	$11,464	2.9×
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T)	$11,464	$11,464	2.9×
Rmvl perm ccm-d sys dual transvns leads only (0922T)	$11,464	$11,464	2.9×
Rmvl&rplcmt permanent ccm-d pulse generator only (0923T)	$70,706	$70,706	3.0×
Scr c/v cyto,thinlayer,rescr (G0145)	$310	$310	11.7×
Screen cerv/vag thin layer (G0123)	$238	$238	11.7×
Tcat implt wrls l atr prs snr l-t l atr prs mntr (0933T)	$10,131	$10,131	2.9×
Therapeutic procd strg endur (G0237)	$149	$149	4.8×
Tomosynthesis, mammo (G0279)	$191	$191	15.1×
Transcatheter Renal Sympath Denervation Bilat (0339T)	$17,105	$17,105	2.8×
Transcatheter renal sympath denervation unilat (0338T)	$11,885	$11,885	1.9×
Trauma respons w/hosp criti (G0390)	$2,552	$2,552	1.8×
Trim nail(s) (G0127)	$110	$110	1.7×
Trluml perip athrc abd aorta (0236T)	$34,022	$34,022	2.8×
Trluml Perip Athrc Brchiocph (0237T)	$34,022	$34,022	2.8×
Trluml Perip Athrc Iliac Art (0238T)	$53,870	$53,870	2.7×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T)	$13,688	$13,688	1.1×
Tte w or w/o contr, cont ecg (C8930)	$2,945	$2,945	3.5×
Tte w or w/o fol w/cont, com (C8921)	$1,264	$1,264	1.5×
Tte w or w/o fol w/cont, f/u (C8922)	$2,370	$2,370	2.8×
Tte w or wo fol wcon,doppler (C8929)	$2,717	$2,717	3.2×
Unsched dialysis esrd pt hos (G0257)	$1,825	$1,825	2.5×
Visit esketamine 56m or less (G2082)	$3,452	$3,452	3.1×
Visit esketamine, > 56m (G2083)	$1,587	$1,587	0.9×
Visit to determ ldct elig (G0296)	$250	$250	2.3×
Wet mounts/ w preparations (Q0111)	$82	$82	4.4×

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.