Supplies, drugs & other prices at Charleston Area Medical Center

Charleston, WV · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2d cephalometric image (D0340) $106 $106 1.3×
2d tee w or w/o fol w/con,in (C8925) $3,922 $3,922 5.2×
2d tte w or w/o fol w/con,co (C8923) $3,019 $3,019 4.0×
2d tte w or w/o fol w/con,fu (C8924) $952 $952 2.8×
Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T) $3,301 $3,301 0.9×
Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T)
likely a partial charge, not the full procedure		 $1,735 $1,735 0.2×
Adm of soc dtr assess 5-15 m (G0136) $25.50 $25.50 0.7×
Adm tocilizu covid-19 1st (M0249) $947 $947 2.2×
Adm tocilizu covid-19 2nd (M0250) $947 $947 2.2×
Admin hepatitis b vaccine (G0010) $70 $70 1.6×
Admin influenza virus vac (G0008) $94 $94 2.1×
Admin pneumococcal vaccine (G0009) $94 $94 2.1×
Alcohol/subs interv 15-30mn (G0396) $104 $104 2.9×
Alcohol/subs interv >30 min (G0397) $170 $170 1.0×
Alveoloplasty not w/extracts (D7321) $174 $174 0.1×
Alveoloplasty w/extract 1-3 (D7311) $97 $97 0.1×
Alveoplasty w/ extraction (D7310) $353 $353 0.2×
Alveoplasty w/o extraction (D7320) $572 $572 0.4×
Amalgam 4 or > surfaces perm (D2161) $327 $327 0.5×
Amalgam one surface permanen (D2140) $179 $179 0.3×
Amalgam three surfaces perma (D2160) $270 $270 0.4×
Amalgam two surfaces permane (D2150) $221 $221 0.4×
Annual alcohol screen 15 min (G0442) $45 $45 1.3×
Ant resin-based cmpst crown (D2390) $549 $549 0.9×
Apicoectomy - anterior (D3410) $961 $961 1.5×
Auto tissue graft 1st tooth (D4273) $1,116 $1,116 0.7×
Behavior counsel obesity 15m (G0447) $90 $90 0.9×
Bio mtrls to aid soft/os reg (D4265) $214 $214 0.3×
Bitewings four images (D0274) $61 $61 0.3×
Brief alcohol misuse counsel (G0443) $83 $83 0.9×
Ca screen;pelvic/breast exam (G0101) $243 $243 2.5×
Chemo extend iv infus w/pump (G0498) $618 $618 2.0×
Closd rductn splint alveolus (D7670) $1,463 $1,463 0.5×
Colon ca scrn not hi rsk ind (G0121) $630 $630 0.7×
Colorectal scrn; hi risk ind (G0105) $630 $630 0.7×
Comprehensve oral evaluation (D0150) $125 $125 1.0×
Cone beam ct both jaws (D0383) $2,596 $2,596 25.9×
Cone beam ct capt & interp (D0364) $475 $475 4.7×
Cone beam ct capt mandible (D0381) $2,596 $2,596 25.9×
Cone beam ct capt maxilla (D0382) $2,596 $2,596 25.9×
Cone beam ct capture limited (D0380) $2,596 $2,596 25.9×
Cone beam ct capture tmj (D0384) $2,596 $2,596 25.9×
Cone beam ct interp both jaw (D0367) $475 $475 4.7×
Cone beam ct interprete man (D0365) $475 $475 4.7×
Cone beam ct interprete max (D0366) $475 $475 4.7×
Cone beam ct interprete tmj (D0368) $475 $475 4.7×
Coronectomy (D7251) $659 $659 0.4×
Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation… (0446T) $5,291 $5,291 1.3×
Cysto impl 4 or more (C9740)
likely a partial charge, not the full procedure		 $1,200 $1,200 0.1×
Cysto, litho, vacuum kidney (C9761)
likely a partial charge, not the full procedure		 $1,151 $1,151 0.1×
Cystoscopy prostatic imp 1-3 (C9739)
likely a partial charge, not the full procedure		 $800 $800 0.2×
Dental bitewing single image (D0270) $27 $27 0.3×
Dental bitewings two images (D0272) $43 $43 0.5×
Dental prophylaxis adult (D1110) $119 $119 0.9×
Depression screen annual (G0444) $45 $45 1.3×
Dermal filler injection(s) (G0429) $152 $152 0.1×
Devlopment test interpt&rep (G0451) $23 $23 0.2×
Diab manage trn per indiv (G0108) $196.50 $196.50 3.5×
Diab manage trn ind/group (G0109) $43 $43 2.7×
Direct refer hospital observ (G0379) $776 $776 1.4×
Drug test def 1-7 classes (G0480) $666 $666 5.8×
Drug test def 15-21 classes (G0482) $643.50 $643.50 3.2×
Drug test def 22+ classes (G0483) $1,520 $1,520 6.2×
Drug test def 8-14 classes (G0481) $199 $199 1.3×
Ed svc ckd grp per session (G0421) $71 $71 2.6×
Ed svc ckd ind per session (G0420) $297 $297 2.6×
Ekg tracing for initial prev (G0404) $50 $50 1.8×
Elec stim other than wound (G0283) $271 $271 21.4×
End thxpy, anterior tooth (D3310) $992 $992 1.6×
End thxpy, molar tooth (D3330) $1,369 $1,369 2.2×
End thxpy, premolar tooth (D3320) $1,156 $1,156 1.9×
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) $31,234.50 $31,234.50 0.7×
Esd endoscopy or colonoscopy (C9779) $558 $558 0.2×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $22,610 $22,610 2.0×
Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie,… (0184T) $12,066 $12,066 2.1×
Exposure of unerupted tooth (D7280) $306 $306 0.5×
Extensv oral eval prob focus (D0160) $138 $138 1.1×
Extraction coronal remnants (D7111) $189 $189 0.3×
Extraction erupted tooth/exr (D7140) $210 $210 0.3×
Extrnl counterpulse, per tx (G0166) $1,047 $1,047 8.2×
Fecal blood scrn immunoassay (G0328) $33 $33 1.8×
Fecal microbiota prep instil (G0455) $205 $205 0.2×
Full mouth debridement (D4355) $229 $229 0.4×
Gingivectomy/plasty 1 to 3 (D4211) $377 $377 0.1×
Gingivectomy/plasty 4 or mor (D4210) $840 $840 0.3×
Group mnt 2 or more 30 mins (G0271) $142 $142 8.3×
Guided tiss regen resorble (D4266) $1,053 $1,053 0.7×
Hbot, full body chamber, 30m (G0277) $911 $911 6.9×
High inten beh couns std 30m (G0445) $82 $82 0.8×
Hiv combination assay (G0475) $37 $37 1.5×
Home sleep test/type 2 porta (G0398) $324 $324 1.6×
Home sleep test/type 3 porta (G0399) $605 $605 2.9×
Home sleep test/type 4 porta (G0400) $145.50 $145.50 0.7×
Hospital outpt clinic visit (G0463) $253 $253 2.0×
I&d absc intraoral soft tiss (D7510) $286 $286 0.4×
I&d abscess extraoral (D7520) $517 $517 0.8×
Ig paraprotein qual bld/ur (0077U) $103.26 $103.26 2.4×
Iliac Atherectomy (0238T) $31,914 $31,914 1.8×
Impact tooth rem bony w/comp (D7241) $684 $684 1.1×
Impact tooth remov comp bony (D7240) $632 $632 1.0×
Impact tooth remov part bony (D7230) $543 $543 0.9×
Impact tooth remov soft tiss (D7220) $424 $424 0.7×
Incision/drain abscess intra (D7511) $105 $105 0.2×
Initial care training 30 m (G0539) $126 $126 2.4×
Initial foot exam pt lops (G0245) $214 $214 1.7×
Initial preventive exam (G0402) $342 $342 2.7×
Insertion of sinus tarsi implant (0335T) $7,753 $7,753 1.1×
Intens behave ther cardio dx (G0446) $83 $83 2.3×
Intens cardiac rehab no exer (G0423) $228 $228 1.8×
Intens cardiac rehab w/exerc (G0422) $235 $235 1.9×
Intraor comprehensive series (D0210) $139 $139 0.6×
Intraoral periapical first (D0220) $29 $29 0.3×
Lev 1 hosp type b ed visit (G0380) $311 $311 4.4×
Lev 2 hosp type b ed visit (G0381) $731 $731 8.2×
Lev 3 hosp type b ed visit (G0382) $1,750 $1,750 10.6×
Lev 4 hosp type b ed visit (G0383) $3,083 $3,083 12.2×
Lev 5 hosp type b ed visit (G0384) $5,261 $5,261 13.4×
Limit oral eval problm focus (D0140) $112 $112 0.9×
Liver Dis 10 Assays W/Nash (0003M) $1,065 $1,065 2.1×
Mandible graft (D7950) $3,330 $3,330 0.6×
Mesial/distal wedge proc (D4274) $165 $165 0.3×
Mnt subs tx for change dx (G0270) $79 $79 2.5×
Mra w/cont, abd (C8900) $3,656 $3,656 10.9×
Mra w/cont, chest (C8909) $3,743 $3,743 11.2×
Mra w/cont, lwr ext (C8912) $3,544 $3,544 10.6×
Mra w/cont, pelvis (C8918) $3,669 $3,669 11.0×
Mra w/o cont, abd (C8901) $4,801 $4,801 21.0×
Mra w/o cont, chest (C8910) $3,743 $3,743 16.4×
Mra w/o cont, lwr ext (C8913) $3,544 $3,544 15.5×
Mra w/o cont, pelvis (C8919) $3,557 $3,557 15.5×
Mra w/o fol w/cont, abd (C8902) $3,656 $3,656 10.9×
Mra w/o fol w/cont, chest (C8911) $3,854 $3,854 11.5×
Mra w/o fol w/cont, lwr ext (C8914) $3,544 $3,544 10.6×
Mra w/o fol w/cont, pelvis (C8920) $3,669 $3,669 11.0×
Mra, w/dye, upper extremity (C8934) $2,498 $2,498 7.5×
Mra, w/o dye, upper extr (C8935) $2,498 $2,498 10.9×
Mra, w/o&w/dye, upper extr (C8936) $2,498 $2,498 7.5×
Mri w/o fol w/cont, breast, (C8908) $7,205 $7,205 21.5×
Mri w/o fol w/cont, brst, un (C8905) $6,079 $6,079 18.2×
Njx pltlt plasma w/img harvest/preparation (0232T) $490 $490 1.1×
Non-ophthalmic fva (C9733) $3,921 $3,921 11.7×
Obtaining screen pap smear (Q0091) $115 $115 4.1×
Occ guard, hard, full arch (D9944) $652 $652 1.1×
Occlusion analysis (D9950) $291 $291 0.5×
Off base opioid tx 70min (G2086) $1,129 $1,129 6.6×
Off base opioid tx, 60 m (G2087) $1,064 $1,064 6.2×
Open reduc compd alveolus fx (D7770)
likely a partial charge, not the full procedure		 $1,344 $1,344 0.2×
Open tx iliac spine uni/bil (G0412)
unusually low: confirm this is the full procedure		 $2,608 $2,608 0.4×
Oral antral fistula closure (D7260) $2,035 $2,035 3.3×
Osseous surg 1 to 3 teeth (D4261) $1,172 $1,172 0.4×
Oth resp proc, indiv (G0238) $234 $234 8.4×
Panoramic image (D0330) $141 $141 0.6×
Perc d-e cor revasc chro sin (C9607) $48,512 $48,512 2.8×
Perc d-e cor revasc t cabg s (C9604) $65,867 $65,867 5.9×
Perc d-e cor stent ather s (C9602) $24,092 $24,092 1.4×
Perc drug-el cor stent sing (C9600) $48,512 $48,512 4.4×
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T)
likely a partial charge, not the full procedure		 $281 $281 0.0×
Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without… (0274T) $3,551 $3,551 0.5×
Periodic oral evaluation (D0120) $60 $60 0.5×
Periodontal scaling & root (D4341) $335 $335 0.5×
Periodontal scaling 1-3teeth (D4342) $245 $245 0.4×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $9,239.50 $9,239.50 0.8×
Place direct restoration (D2940) $139 $139 0.2×
Place intra-socket bio dress (D7922) $53 $53 0.1×
Post 1 srfc resinbased cmpst (D2391) $223 $223 0.4×
Post 2 srfc resinbased cmpst (D2392) $290 $290 0.5×
Post 3 srfc resinbased cmpst (D2393) $367 $367 0.6×
Post >=4srfc resinbase cmpst (D2394) $434 $434 0.7×
Post and core cast + crown (D2952) $218 $218 0.4×
Ppps, initial visit (G0438) $444 $444 2.5×
Ppps, subseq visit (G0439) $324 $324 2.4×
Prefab stnlss steel crown pe (D2931) $412 $412 0.7×
Prefab stnlss steel crwn pri (D2930) $359 $359 0.6×
Primary closure sinus perf (D7261) $890 $890 1.4×
Psa screening (G0103) $238 $238 12.3×
Rad exc lesion up to 1.25 cm (D7410) $533 $533 0.4×
Re-cement or re-bond crown (D2920) $134 $134 0.2×
Re-eval,est pt,problem focus (D0170) $103 $103 0.8×
Recement inlay onlay or part (D2910) $118 $118 0.2×
Rem exostosis any site (D7471) $671 $671 0.2×
Rem imp tooth w mucoper flp (D7210) $346 $346 0.2×
Rem nonodonto cyst > 1.25 cm (D7461) $2,294 $2,294 3.7×
Rem nonodonto cyst to 1.25cm (D7460) $1,158 $1,158 1.9×
Rem odontogen cyst > 1.25 cm (D7451) $2,294 $2,294 0.7×
Rem odontogen cyst to 1.25cm (D7450) $1,150 $1,150 0.4×
Removal and reinsertion of sinus tarsi implant (0511T) $7,753 $7,753 1.1×
Removal fb skin/areolar tiss (D7530) $559 $559 0.9×
Removal of fb reaction (D7540) $963 $963 1.6×
Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision (0447T) $189 $189 1.0×
Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and… (0448T) $5,291 $5,291 1.3×
Removal of sloughed off bone (D7550) $2,063 $2,063 3.3×
Removal of torus palatinus (D7472) $398 $398 0.6×
Remove torus mandibularis (D7473) $398 $398 0.6×
Resin 4/> surf or w incis an (D2335) $383 $383 0.6×
Resin one surface-anterior (D2330) $209 $209 0.3×
Resin three surfaces-anterio (D2332) $303 $303 0.5×
Resin two surfaces-anterior (D2331) $256 $256 0.4×
Retreat root canal molar (D3348) $1,571 $1,571 2.5×
Revasc intra lithotrip-ather (C9766) $26,763 $26,763 1.5×
Revasc intra lithotrip-stent (C9765) $15,212 $15,212 0.9×
Revasc intravasc lithotripsy (C9764) $9,666.50 $9,666.50 0.9×
Revasc lithotr-stent tib/per (C9773)
likely a partial charge, not the full procedure		 $3,661 $3,661 0.2×
Revasc lithotrip tibi/perone (C9772) $9,276 $9,276 0.8×
Revasc lithotrip-stent-ather (C9767) $26,763 $26,763 1.5×
Root surgery molar (D3425) $375 $375 0.6×
Root surgery premolar (D3421) $375 $375 0.6×
Safety plan interven (G0560) $118 $118 2.8×
Scr c/v cyto,thinlayer,rescr (G0145) $211 $211 8.0×
Screen cerv/vag thin layer (G0123) $34 $34 1.7×
Screen pap by tech w md supv (P3000) $60 $60 3.2×
Semen analysis (G0027) $129.50 $129.50 19.9×
Soft tissue graft firsttooth (D4277) $924 $924 0.6×
Space maintainer fxd unilat (D1510) $462 $462 0.7×
Splint intra-coronal (D4322) $260 $260 0.4×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $20,315 $20,315 1.1×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $7,810.50 $7,810.50 1.4×
Therapeutic procd strg endur (G0237) $208 $208 7.5×
Therapeutic pulpotomy (D3220) $267 $267 0.4×
Therapeutic ultrafiltration (0692T) $760 $760 0.5×
Tomosynthesis, mammo (G0279) $228 $228 18.0×
Tooth pin retention (D2951) $50 $50 0.1×
Tooth reimplantation (D7270) $369 $369 0.6×
Tooth root removal (D7250) $410 $410 0.7×
Tpmt nudt15 gene analysis common variants (0034U) $675 $675 1.4×
Train for caregiver add 15 (G0540) $68 $68 2.6×
Transcatheter Renal Sympath Denervation Bilat (0339T) $11,036.50 $11,036.50 2.0×
Transcatheter renal sympath denervation unilat (0338T) $10,124 $10,124 1.9×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $18,124 $18,124 1.6×
Trauma respons w/hosp criti (G0390) $5,582 $5,582 4.4×
Treatment of complications (D9930) $97 $97 0.2×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T)
likely a partial charge, not the full procedure		 $1,841 $1,841 0.2×
Tte w or w/o fol w/con,stres (C8928) $2,485 $2,485 3.3×
Tte w or wo fol wcon,doppler (C8929) $4,028 $4,028 5.4×
Unsched dialysis esrd pt hos (G0257) $2,427 $2,427 3.7×
Vasc emb/occ w/prs cath (C9797) $11,117.50 $11,117.50 0.6×
Vestibuloplasty exten graft (D7350)
likely a partial charge, not the full procedure		 $1,565 $1,565 0.3×
Vestibuloplasty ridge extens (D7340)
likely a partial charge, not the full procedure		 $523 $523 0.1×
Visit esketamine 56m or less (G2082) $96 $96 0.1×
Visit esketamine, > 56m (G2083) $96 $96 0.1×
Visit to determ ldct elig (G0296) $69 $69 0.7×