Supplies, drugs & other prices at CHI St. Vincent Infirmary
Little Rock, AR · every code in this section with a posted price and a Medicare benchmark.
64 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) | $648.95 | $2,529 | 0.9× |
| 2d tte w or w/o fol w/con,fu (C8924) | $311.77 | $1,215 | 0.9× |
| Adm tocilizu covid-19 1st (M0249) | $374.13 | $1,458 | 0.9× |
| Adm tocilizu covid-19 2nd (M0250) | $374.13 | $1,458 | 0.9× |
| Admin hepatitis b vaccine (G0010) | $33.88 | $132 | 0.8× |
| Admin influenza virus vac (G0008) | $33.88 | $132 | 0.8× |
| Admin pneumococcal vaccine (G0009) | $44.66 | $174 | 1.0× |
| Chemo extend iv infus w/pump (G0498) | $290.48 | $1,132 | 0.9× |
| Covid-19 lab test non-cdc (U0002) | $51.07 | $199 | 1.0× |
| Diab manage trn per indiv (G0108) | $58.77 | $229 | 1.1× |
| Direct refer hospital observ (G0379) | $164.74 | $642 | 0.3× |
| Drug test def 1-7 classes (G0480) | $37.34 | $136 | 0.3× |
| Drug test def 15-21 classes (G0482) | $145.50 | $567 | 0.7× |
| Hbot, full body chamber, 30m (G0277) | $146.52 | $571 | 1.1× |
| Hospital outpt clinic visit (G0463) | $67.10 | $261.50 | 0.5× |
| Inj for sacroiliac jt anesth (G0260) | $479.33 | $1,868 | 0.7× |
| Mra w/cont, abd (C8900) | $696.55 | $2,714.50 | 2.1× |
| Mra w/cont, chest (C8909) | $827.54 | $3,225 | 2.5× |
| Mra w/o cont, abd (C8901) | $693.85 | $2,704 | 3.0× |
| Mra w/o cont, chest (C8910) | $744.14 | $2,900 | 3.3× |
| Mra w/o cont, lwr ext (C8913) | $744.14 | $2,900 | 3.3× |
| Mra w/o fol w/cont, abd (C8902) | $762.36 | $2,971 | 2.3× |
| Mra w/o fol w/cont, chest (C8911) | $766.22 | $2,986 | 2.3× |
| Mra w/o fol w/cont, lwr ext (C8914) | $915.56 | $3,568 | 2.7× |
| Mra w/o fol w/cont, pelvis (C8920) | $973.80 | $3,795 | 2.9× |
| Mra, w/dye, spinal canal (C8931) | $662.55 | $2,582 | 2.0× |
| Mra, w/dye, upper extremity (C8934) | $971.24 | $3,785 | 2.9× |
| Mra, w/o dye, spinal canal (C8932) | $421.60 | $1,643 | 1.8× |
| Mra, w/o dye, upper extr (C8935) | $599.30 | $2,335.50 | 2.6× |
| Mra, w/o&w/dye, spinal canal (C8933) | $825.49 | $3,217 | 2.5× |
| Mra, w/o&w/dye, upper extr (C8936) | $816.90 | $3,183.50 | 2.4× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $183.22 | $714 | 0.3× |
| Oth resp proc, group (G0239) | $34.13 | $133 | 1.0× |
| Oth resp proc, indiv (G0238) | $34.13 | $133 | 1.2× |
| Pathogen test for platelets (P9100) | $126.25 | $492 | 2.2× |
| Pemivibart infusion (M0224) | $284.06 | $1,107 | 0.7× |
| Perc d-e cor revasc chro sin (C9607) unusually low: confirm this is the full procedure |
$7,399.07 | $28,835 | 0.4× |
| Perc d-e cor revasc t cabg s (C9604) | $7,956.14 | $31,006 | 0.7× |
| Perc d-e cor stent ather s (C9602) unusually low: confirm this is the full procedure |
$7,956.14 | $31,006 | 0.5× |
| Perc drug-el cor stent sing (C9600) | $7,956.14 | $31,006 | 0.7× |
| Perq Sacral Augmt Bilat Inj (0201T) likely a partial charge, not the full procedure |
$2,075.39 | $8,088 | 0.3× |
| Perq Sacral Augmt Unilat Inj (0200T) likely a partial charge, not the full procedure |
$2,075.39 | $8,088 | 0.3× |
| Pet not otherwise specified (G0235) | $1,582.20 | $6,166 | 4.1× |
| Place device/marker, non pro (C9728) | $976.62 | $3,806 | 0.7× |
| Prostate biopsy, any mthd (G0416) | $1,028.72 | $4,009 | 3.0× |
| Psa screening (G0103) | $68.77 | $268 | 3.6× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $209.65 | $817 | 0.3× |
| Revasc intra lithotrip-ather (C9766) likely a partial charge, not the full procedure |
$3,130.52 | $12,200 | 0.2× |
| Revasc intra lithotrip-stent (C9765) likely a partial charge, not the full procedure |
$3,130.52 | $12,200 | 0.2× |
| Revasc intravasc lithotripsy (C9764) unusually low: confirm this is the full procedure |
$3,565.72 | $13,896 | 0.3× |
| Revasc lith-sten-ath tib/per (C9775) likely a partial charge, not the full procedure |
$5,007.55 | $19,515 | 0.3× |
| Revasc lithotr-ather tib/per (C9774) likely a partial charge, not the full procedure |
$5,007.55 | $19,515 | 0.3× |
| Revasc lithotr-stent tib/per (C9773) likely a partial charge, not the full procedure |
$5,007.55 | $19,515 | 0.3× |
| Revasc lithotrip tibi/perone (C9772) likely a partial charge, not the full procedure |
$3,130.52 | $12,200 | 0.3× |
| Revasc lithotrip-stent-ather (C9767) likely a partial charge, not the full procedure |
$5,007.55 | $19,515 | 0.3× |
| Therapeutic procd strg endur (G0237) | $34.13 | $133 | 1.2× |
| Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) unusually low: confirm this is the full procedure |
$3,348.12 | $13,048 | 0.3× |
| Trauma respons w/hosp criti (G0390) | $1,272.48 | $4,959 | 1.0× |
| Trluml Perip Athrc Renal Art (0234T) likely a partial charge, not the full procedure |
$3,124.11 | $12,175 | 0.3× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) likely a partial charge, not the full procedure |
$3,174.14 | $12,370 | 0.3× |
| Trluml peripheral atherectomy iliac artery ea (0238T) likely a partial charge, not the full procedure |
$3,124.11 | $12,175 | 0.2× |
| Tte w or w/o fol w/con,stres (C8928) | $536.04 | $2,089 | 0.7× |
| Tte w or wo fol wcon,doppler (C8929) | $515 | $2,007 | 0.7× |
| Unsched dialysis esrd pt hos (G0257) | $468.17 | $1,824.50 | 0.7× |