Supplies, drugs & other prices at Children's Minnesota - Minneapolis Hospital

Minneapolis, MN · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Alveoloplasty w/extract 1-3 (D7311) $516 $516 0.3×
Alveoplasty w/o extraction (D7320) $5,630 $5,630 3.5×
Amalgam 4 or > surfaces perm (D2161) $918.50 $918.50 1.4×
Amalgam one surface permanen (D2140) $385 $385 0.6×
Amalgam three surfaces perma (D2160) $546.50 $546.50 0.8×
Amalgam two surfaces permane (D2150) $401 $401 0.6×
Ant resin-based cmpst crown (D2390) $630.50 $630.50 0.9×
Antibody treponema pallidum total & rpr ia qual (0064U) $198 $198 6.3×
Apexification/recalc initial (D3351) $365.50 $365.50 0.5×
Apexification/recalc interim (D3352) $135 $135 0.2×
Canal prep/fitting of dowel (D3950) $306 $306 0.5×
Closd rductn splint alveolus (D7670) $6,646 $6,646 1.9×
Comt gene analysis c.472g>a variant (0032U) $1,167 $1,167 6.7×
Core build-up incl any pins (D2950) $1,029 $1,029 1.5×
Coronectomy (D7251) $5,603 $5,603 3.4×
Covid-19 lab test non-cdc (U0002) $41 $41 0.8×
Crown porcelain/ceramic (D2740) $1,866.50 $1,866.50 2.8×
Crown resin-based indirect (D2710) $728 $728 1.1×
Cyp2d6 gen com&slct rar vrnt (0070U) $496.78 $496.78 0.7×
Dental prophylaxis adult (D1110) $369 $369 2.6×
Diab manage trn per indiv (G0108) $97 $97 1.7×
Diab manage trn ind/group (G0109) $58 $58 3.6×
Direct refer hospital observ (G0379) $1,338 $1,338 2.1×
Dist space maint, fixed unil (D1575) $1,277 $1,277 1.9×
Drug test def 1-7 classes (G0480) $1,722 $1,722 15.0×
End thxpy, anterior tooth (D3310) $772.50 $772.50 1.1×
End thxpy, molar tooth (D3330) $1,051 $1,051 1.6×
End thxpy, premolar tooth (D3320) $851.50 $851.50 1.3×
Endodontic endosseous implan (D3460) $1,213.50 $1,213.50 1.8×
Exposure of unerupted tooth (D7280) $630.50 $630.50 0.9×
Extraction coronal remnants (D7111) $1,025.50 $1,025.50 1.5×
Extraction erupted tooth/exr (D7140) $1,151 $1,151 1.7×
Fixed bilat space maint, man (D1517) $42 $42 0.1×
Fixed bilat space maint, max (D1516) $1,494 $1,494 2.2×
Gingivectomy/plasty 1 to 3 (D4211) $5,832.50 $5,832.50 1.7×
Gingivectomy/plasty 4 or mor (D4210) $6,605.50 $6,605.50 1.9×
Gingivectomy/plasty rest (D4212) $296.50 $296.50 0.1×
Gross pulpal debridement (D3221) $267 $267 0.4×
Guided tiss regen resorble (D4266) $2,908 $2,908 1.8×
Hbot, full body chamber, 30m (G0277) $177 $177 1.2×
Home sleep test/type 3 porta (G0399) $870 $870 3.8×
Hospital outpt clinic visit (G0463) $305 $305 2.2×
I&d absc intraoral soft tiss (D7510) $471 $471 0.6×
Ig paraprotein qual bld/ur (0077U) $266 $266 6.1×
Iliac Atherectomy (0238T) $33,187 $33,187 1.7×
Impact tooth rem bony w/comp (D7241) $6,001.50 $6,001.50 8.9×
Impact tooth remov comp bony (D7240) $1,417 $1,417 2.1×
Impact tooth remov part bony (D7230) $1,334.50 $1,334.50 2.0×
Impact tooth remov soft tiss (D7220) $1,225 $1,225 1.8×
Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) $2,516 $2,516 2.7×
Interim crown (D2799) $244 $244 0.4×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) $583 $583 4.8×
Labial veneer resin direct (D2960) $4,013.50 $4,013.50 5.9×
Limited occlusal adjustment (D9951) $446 $446 0.7×
Mandible graft (D7950) $6,056 $6,056 1.0×
Mra w/cont, abd (C8900) $3,192 $3,192 8.7×
Mra w/cont, chest (C8909) $3,276.50 $3,276.50 9.0×
Mra w/cont, lwr ext (C8912) $4,276 $4,276 11.7×
Mra w/cont, pelvis (C8918) $3,724 $3,724 10.2×
Mra w/o cont, abd (C8901) $3,045 $3,045 12.2×
Mra w/o cont, chest (C8910) $2,802 $2,802 11.2×
Mra w/o cont, lwr ext (C8913) $2,924 $2,924 11.7×
Mra w/o cont, pelvis (C8919) $2,369 $2,369 9.5×
Mra w/o fol w/cont, abd (C8902) $4,912 $4,912 13.4×
Mra w/o fol w/cont, chest (C8911) $5,435 $5,435 14.9×
Mra w/o fol w/cont, lwr ext (C8914) $5,106 $5,106 14.0×
Mra w/o fol w/cont, pelvis (C8920) $3,666 $3,666 10.0×
Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) $2,516 $2,516 2.7×
Obtaining screen pap smear (Q0091) $87 $87 2.9×
Periodic oral evaluation (D0120) $64 $64 0.5×
Periodontal scaling & root (D4341) $335.50 $335.50 0.5×
Periodontal scaling 1-3teeth (D4342) $283 $283 0.4×
Place direct restoration (D2940) $1,372 $1,372 2.0×
Place intra-socket bio dress (D7922) $274.50 $274.50 0.4×
Post 1 srfc resinbased cmpst (D2391) $275.50 $275.50 0.4×
Post 2 srfc resinbased cmpst (D2392) $321 $321 0.5×
Post 3 srfc resinbased cmpst (D2393) $401 $401 0.6×
Post >=4srfc resinbase cmpst (D2394) $424 $424 0.6×
Prefab porc/ceram crown pri (D2929) $321 $321 0.5×
Prefab stainless steel crown (D2933) $401 $401 0.6×
Prefab steel crown primary (D2934) $401 $401 0.6×
Prefab stnlss steel crown pe (D2931) $365.50 $365.50 0.5×
Prefab stnlss steel crwn pri (D2930) $321 $321 0.5×
Prefabricated resin crown (D2932) $321 $321 0.5×
Primary closure sinus perf (D7261) $3,083 $3,083 4.6×
Pulp cap direct (D3110) $321 $321 0.5×
Pulp cap indirect (D3120) $548.50 $548.50 0.8×
Re-cement or re-bond crown (D2920) $244 $244 0.4×
Rem imp tooth w mucoper flp (D7210) $1,063 $1,063 0.7×
Rem nonodonto cyst to 1.25cm (D7460) $1,321 $1,321 2.0×
Rem odontogen cyst > 1.25 cm (D7451) $4,224 $4,224 1.2×
Rem odontogen cyst to 1.25cm (D7450) $1,230.50 $1,230.50 0.4×
Resin 4/> surf or w incis an (D2335) $433 $433 0.6×
Resin one surface-anterior (D2330) $275.50 $275.50 0.4×
Resin three surfaces-anterio (D2332) $401 $401 0.6×
Resin two surfaces-anterior (D2331) $321 $321 0.5×
Scaling gingiv inflammation (D4346) $6,109.50 $6,109.50 9.0×
Scr c/v cyto,thinlayer,rescr (G0145) $119 $119 4.5×
Space maintainer fxd unilat (D1510) $1,008 $1,008 1.5×
Splint extra-coronal (D4323) $3,005 $3,005 4.4×
Surgical revision procedure (D4268) $2,351 $2,351 3.5×
Surgical splint (D5988) $351 $351 0.5×
Therapeutic pulpotomy (D3220) $275.50 $275.50 0.4×
Tooth reimplantation (D7270) $431 $431 0.6×
Tooth root removal (D7250) $1,457 $1,457 2.2×
Tooth transplantation (D7272) $2,015 $2,015 3.0×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $33,187 $33,187 2.7×
Transseptal fiberotomy (D7291) $5,415 $5,415 8.0×
Trauma respons w/hosp criti (G0390) $8,723 $8,723 6.2×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $33,187 $33,187 2.7×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $33,187 $33,187 2.7×
Vestibuloplasty exten graft (D7350) $7,331 $7,331 1.2×