24 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Admin hepatitis b vaccine (G0010) |
$38.40 |
$60 |
0.8× |
| Admin influenza virus vac (G0008) |
$50.56 |
$79 |
1.0× |
| Admin pneumococcal vaccine (G0009) |
$33.60 |
$52.50 |
0.7× |
| Bia whole body composition assessment w/i&r (0358T) |
$41.60 |
$65 |
1.4× |
| Ca screen;flexi sigmoidscope (G0104) |
$83.20 |
$130 |
0.1× |
| Ca screen;pelvic/breast exam (G0101) |
$108.80 |
$170 |
1.0× |
| Colon ca scrn not hi rsk ind (G0121) |
$723.20 |
$1,130 |
0.8× |
| Colorectal scrn; hi risk ind (G0105) |
$723.20 |
$1,130 |
0.8× |
| Diab manage trn per indiv (G0108) |
$133.76 |
$209 |
2.4× |
| Diab manage trn ind/group (G0109) |
$78.72 |
$123 |
4.9× |
| Ekg tracing for initial prev (G0404) |
$145.28 |
$227 |
4.9× |
| Hbot, full body chamber, 30m (G0277) |
$584.96 |
$914 |
4.1× |
| Ig paraprotein qual bld/ur (0077U) |
$188.16 |
$294 |
4.3× |
| Initial preventive exam (G0402) |
$268.80 |
$420 |
2.0× |
| Injection(s), bone substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion,… (0707T) |
$256 |
$400 |
0.1× |
| Intens behave ther cardio dx (G0446) |
$83.84 |
$131 |
2.2× |
| Mnt subs tx for change dx (G0270) |
$68.48 |
$107 |
2.2× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$480 |
$750 |
1.0× |
| Oth resp proc, indiv (G0238) |
$120.32 |
$188 |
4.0× |
| Ppps, initial visit (G0438) |
$275.20 |
$430 |
1.6× |
| Ppps, subseq visit (G0439) |
$169.60 |
$265 |
1.2× |
| Psa screening (G0103) |
$142.72 |
$223 |
7.4× |
| Trauma respons w/hosp criti (G0390) |
$735.36 |
$1,149 |
0.5× |
| Visit to determ ldct elig (G0296) |
$70.40 |
$110 |
0.7× |