Supplies, drugs & other prices at Citizens Memorial Hospital
Bolivar, MO · every code in this section with a posted price and a Medicare benchmark.
57 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) range across 3 matching MRF lines |
$2,351.80–$3,280.80 | $2,939.75–$4,101 | varies |
| 2d tte w or w/o fol w/con,co (C8923) range across 2 matching MRF lines |
$1,668.40–$1,668.80 | $2,085.50–$2,086 | varies |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,710.60 | $2,138.25 | 4.9× |
| Admin hepatitis b vaccine (G0010) range across 2 matching MRF lines |
$27.20–$57.40 | $34–$71.75 | varies |
| Admin influenza virus vac (G0008) range across 3 matching MRF lines |
$27.20–$53.80 | $34–$67.25 | varies |
| Admin pneumococcal vaccine (G0009) range across 3 matching MRF lines |
$27.20–$53.80 | $34–$67.25 | varies |
| Ca screen;flexi sigmoidscope (G0104) | $1,640.60 | $2,050.75 | 1.8× |
| Catheterize for urine spec (P9612) | $28.80 | $36 | 3.1× |
| Colon ca scrn not hi rsk ind (G0121) range across 4 matching MRF lines |
$1,436–$3,716.80 | $1,795–$4,646 | varies |
| Colorectal scrn; hi risk ind (G0105) | $1,640.60 | $2,050.75 | 1.8× |
| Cysto impl 4 or more (C9740) range across 2 matching MRF lines |
$2,626–$7,153.60 | $3,282.50–$8,942 | varies |
| Cystoscopy prostatic imp 1-3 (C9739) range across 2 matching MRF lines |
$3,931.20–$3,978.60 | $4,914–$4,973.25 | varies |
| Diab manage trn per indiv (G0108) | $121.20 | $151.50 | 2.2× |
| Diab manage trn ind/group (G0109) | $27.80 | $34.75 | 1.7× |
| Direct refer hospital observ (G0379) range across 2 matching MRF lines |
$200.80–$211 | $251–$263.75 | varies |
| Drug test def 1-7 classes (G0480) range across 4 matching MRF lines |
$115.20–$647.60 | $144–$809.50 | varies |
| Drug test def 8-14 classes (G0481) | $98.40 | $123 | 0.6× |
| Elec stim other than wound (G0283) range across 3 matching MRF lines |
$99.80–$104.80 | $124.75–$131 | varies |
| Group mnt 2 or more 30 mins (G0271) | $24.80 | $31 | 1.5× |
| Hbot, full body chamber, 30m (G0277) | $193.60 | $242 | 1.4× |
| Home sleep test/type 3 porta (G0399) range across 2 matching MRF lines |
$691.40–$726 | $864.25–$907.50 | varies |
| Hospital outpt clinic visit (G0463) range across 7 matching MRF lines |
$68.80–$167.60 | $86–$209.50 | varies |
| Hpv combo assay ca screen (G0476) | $162.40 | $203 | 4.6× |
| Inj for sacroiliac jt anesth (G0260) range across 4 matching MRF lines |
$536.80–$3,255.10 | $671–$4,068.87 | varies |
| Mnt subs tx for change dx (G0270) | $42.60 | $53.25 | 1.3× |
| Mra w/cont, abd (C8900) | $2,886.60 | $3,608.25 | 8.3× |
| Mra w/cont, lwr ext (C8912) | $3,397 | $4,246.25 | 9.7× |
| Mra w/o cont, abd (C8901) | $1,969.40 | $2,461.75 | 8.2× |
| Mra w/o cont, lwr ext (C8913) | $659.20 | $824 | 2.8× |
| Mra w/o fol w/cont, abd (C8902) | $3,134.60 | $3,918.25 | 9.0× |
| Mri w/o fol w/cont, breast, (C8908) | $3,929.40 | $4,911.75 | 11.2× |
| Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) | $430.40 | $538 | 0.5× |
| Njx platelet plasma (0232T) range across 4 matching MRF lines |
$375.20–$3,830.40 | $469–$4,788 | varies |
| Obtaining screen pap smear (Q0091) | $78.40 | $98 | 2.7× |
| Oth resp proc, indiv (G0238) range across 2 matching MRF lines |
$66.60–$70 | $83.25–$87.50 | varies |
| Perc d-e cor revasc chro sin (C9607) range across 3 matching MRF lines |
$11,364.80–$22,729.60 | $14,206–$28,412 | varies |
| Perc d-e cor revasc t cabg s (C9604) | $13,364.80 | $16,706 | 1.2× |
| Perc d-e cor stent ather s (C9602) range across 2 matching MRF lines |
$26,049–$27,351.60 | $32,561.25–$34,189.50 | varies |
| Perc drug-el cor stent sing (C9600) range across 3 matching MRF lines |
$14,562–$15,290.20 | $18,202.50–$19,112.75 | varies |
| Prostate biopsy, any mthd (G0416) range across 2 matching MRF lines |
$667.20–$700.60 | $834–$875.75 | varies |
| Psa screening (G0103) range across 4 matching MRF lines |
$80–$215.80 | $100–$269.75 | varies |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) range across 3 matching MRF lines |
$308–$572.20 | $385–$715.25 | varies |
| Revasc intra lithotrip-ather (C9766) | $16,503.20 | $20,629 | 0.9× |
| Revasc intra lithotrip-stent (C9765) range across 3 matching MRF lines |
$16,503.20–$17,328.40 | $20,629–$21,660.50 | varies |
| Revasc intravasc lithotripsy (C9764) | $9,081.40 | $11,351.75 | 0.8× |
| Revasc lith-sten-ath tib/per (C9775) | $16,503.20 | $20,629 | 0.9× |
| Revasc lithotr-ather tib/per (C9774) | $16,503.20 | $20,629 | 0.9× |
| Revasc lithotr-stent tib/per (C9773) | $16,503.20 | $20,629 | 0.9× |
| Revasc lithotrip tibi/perone (C9772) | $8,648.80 | $10,811 | 0.7× |
| Revasc lithotrip-stent-ather (C9767) | $16,503.20 | $20,629 | 0.9× |
| Screen pap by tech w md supv (P3000) range across 2 matching MRF lines |
$33.60–$34.80 | $42–$43.50 | varies |
| Therapeutic procd strg endur (G0237) range across 2 matching MRF lines |
$108–$514 | $135–$642.50 | varies |
| Tomosynthesis, mammo (G0279) | $126.40 | $158 | 10.0× |
| Trim nail(s) (G0127) | $50.40 | $63 | 0.9× |
| Trluml Perip Athrc Iliac Art (0238T) | $20,560.40 | $25,700.50 | 1.1× |
| Tte w or w/o fol w/con,stres (C8928) range across 2 matching MRF lines |
$2,253.40–$2,366.20 | $2,816.75–$2,957.75 | varies |
| Tte w or wo fol wcon,doppler (C8929) range across 2 matching MRF lines |
$2,588.60–$2,718.20 | $3,235.75–$3,397.75 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.