Supplies, drugs & other prices at CHRISTUS Santa Rosa Medical Center
San Antonio, TX · every code in this section with a posted price and a Medicare benchmark.
53 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2019-ncov diagnostic p (U0001) | $135.30 | $410 | 3.8× |
| 2d tee w or w/o fol w/con,in (C8925) | $658.02 | $1,994 | 0.8× |
| 2d tte w or w/o fol w/con,co (C8923) | $773.85 | $2,345 | 1.0× |
| 2d tte w or w/o fol w/con,fu (C8924) | $379.83 | $1,151 | 1.1× |
| Adm tocilizu covid-19 1st (M0249) | $331.48 | $1,004.50 | 0.7× |
| Adm tocilizu covid-19 2nd (M0250) | $323.90 | $981.50 | 0.7× |
| Admin hepatitis b vaccine (G0010) | $71.78 | $217.50 | 1.5× |
| Admin influenza virus vac (G0008) | $38.61 | $117 | 0.8× |
| Admin pneumococcal vaccine (G0009) | $55.60 | $168.50 | 1.2× |
| Autolog prp not diab ulcer (G0460) | $1,379.40 | $4,180 | 0.7× |
| Ca screen;flexi sigmoidscope (G0104) | $1,315.71 | $3,987 | 1.4× |
| Catheterize for urine spec (P9612) | $63.03 | $191 | 6.7× |
| Colon ca scrn not hi rsk ind (G0121) | $1,172.32 | $3,552.50 | 1.3× |
| Colorectal scrn; hi risk ind (G0105) | $1,385.34 | $4,198 | 1.5× |
| Covid-19 lab test non-cdc (U0002) | $135.30 | $410 | 2.6× |
| Diab manage trn per indiv (G0108) | $77.88 | $236 | 1.4× |
| Diab manage trn ind/group (G0109) | $69.63 | $211 | 4.3× |
| Direct refer hospital observ (G0379) | $183.15 | $555 | 0.3× |
| Drug test def 1-7 classes (G0480) | $218.79 | $663 | 1.9× |
| Drug test def 8-14 classes (G0481) | $175.89 | $533 | 1.1× |
| Hbot, full body chamber, 30m (G0277) | $610.83 | $1,851 | 4.4× |
| Hep c screen high risk/other (G0472) | $73.26 | $222 | 1.6× |
| Hepb screen high risk indiv (G0499) | $70.62 | $214 | 2.5× |
| Home sleep test/type 3 porta (G0399) | $771.21 | $2,337 | 3.6× |
| Inj for sacroiliac jt anesth (G0260) | $980.43 | $2,971 | 1.4× |
| Insert cv cath inf & sup app (C9780) | $7,559.31 | $22,907 | 0.9× |
| Mri w/cont, breast, bi (C8906) | $1,138.66 | $3,450.50 | 3.2× |
| Mri w/cont, breast, uni (C8903) | $1,057.48 | $3,204.50 | 6.0× |
| Non-ophthalmic fva (C9733) | $301.29 | $913 | 0.9× |
| Oth resp proc, group (G0239) | $193.38 | $586 | 5.2× |
| Oth resp proc, indiv (G0238) | $17 | $51.50 | 0.6× |
| Perc d-e cor revasc chro sin (C9607) likely a partial charge, not the full procedure |
$5,019.63 | $15,211 | 0.3× |
| Perc d-e cor revasc t cabg s (C9604) unusually low: confirm this is the full procedure |
$4,630.23 | $14,031 | 0.4× |
| Perc d-e cor stent ather s (C9602) unusually low: confirm this is the full procedure |
$6,054.51 | $18,347 | 0.3× |
| Perc drug-el cor stent sing (C9600) unusually low: confirm this is the full procedure |
$4,630.23 | $14,031 | 0.4× |
| Prostate biopsy, any mthd (G0416) | $1.32 | $4 | 0.0× |
| Psa screening (G0103) | $72.60 | $220 | 3.8× |
| Revasc intra lithotrip-ather (C9766) | $13,582.80 | $41,160 | 0.7× |
| Revasc intra lithotrip-stent (C9765) | $9,248.58 | $28,026 | 0.5× |
| Revasc intravasc lithotripsy (C9764) unusually low: confirm this is the full procedure |
$4,623.96 | $14,012 | 0.4× |
| Revasc lith-sten-ath tib/per (C9775) | $13,553.10 | $41,070 | 0.7× |
| Revasc lithotr-ather tib/per (C9774) | $13,553.10 | $41,070 | 0.7× |
| Revasc lithotr-stent tib/per (C9773) | $13,553.10 | $41,070 | 0.7× |
| Revasc lithotrip tibi/perone (C9772) unusually low: confirm this is the full procedure |
$4,623.96 | $14,012 | 0.4× |
| Revasc lithotrip-stent-ather (C9767) | $14,878.38 | $45,086 | 0.8× |
| Tee w or w/o fol w/cont,cong (C8926) | $851.73 | $2,581 | 1.1× |
| Therapeutic procd strg endur (G0237) | $50.82 | $154 | 1.7× |
| Trauma respons w/hosp criti (G0390) | $2,402.90 | $7,281.50 | 1.8× |
| Tte w or w/o contr, cont ecg (C8930) | $851.73 | $2,581 | 1.1× |
| Tte w or w/o fol w/con,stres (C8928) | $904.53 | $2,741 | 1.1× |
| Tte w or w/o fol w/cont, com (C8921) | $691.68 | $2,096 | 0.9× |
| Tte w or wo fol wcon,doppler (C8929) | $780.45 | $2,365 | 1.0× |
| Unsched dialysis esrd pt hos (G0257) | $1,036.70 | $3,141.50 | 1.5× |