Supplies, drugs & other prices at Cheyenne County Hospital

St. Francis, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Admin hepatitis b vaccine (G0010) $20 $20 0.5×
Admin influenza virus vac (G0008) $20 $20 0.5×
Admin pneumococcal vaccine (G0009) $20 $20 0.5×
Catheterize for urine spec (P9612) $50 $50 5.4×
Colon ca scrn not hi rsk ind (G0121) $678.06 $797.71 0.8×
Colorectal scrn; hi risk ind (G0105) $677.94 $797.57 0.8×
Diab manage trn per indiv (G0108) $46 $46 0.8×
Diab manage trn ind/group (G0109) $13.20 $13.20 0.8×
Elec stim other than wound (G0283) $78 $78 6.1×
Hbot, full body chamber, 30m (G0277) $1,967.83 $2,315.09 15.5×
Hopd mntl hlt, 15-29 min (C7900) $276.25 $325 8.0×
Hopd mntl hlt, 30-60 min (C7901) $616.25 $725 6.6×
Hopd mntl hlt, grp (C7903) $276.25 $325 8.0×
Hospital outpt clinic visit (G0463) $57.50 $57.50 0.5×
Initial preventive exam (G0402) $200.60 $236 1.6×
Liver dis 10 assays w/nash (0003M) $475.04 $558.87 0.9×
Ppps, initial visit (G0438) $200.60 $236 1.2×
Ppps, subseq visit (G0439) $200.60 $236 1.5×
Psa screening (G0103) $106.41 $106.41 5.5×
Therapeutic procd strg endur (G0237) $255 $300 9.6×
Tomosynthesis, mammo (G0279) $42.95 $42.95 3.4×
Trauma respons w/hosp criti (G0390) $850 $1,000 0.7×
Tte w or wo fol wcon,doppler (C8929) $2,041.28 $2,401.50 2.8×