21 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) |
$12.54 |
$22 |
0.3× |
| Admin influenza virus vac (G0008) |
$11.97 |
$21 |
0.3× |
| Admin pneumococcal vaccine (G0009) |
$11.97 |
$21 |
0.3× |
| Ca screen;flexi sigmoidscope (G0104) |
$2,009.25 |
$3,525 |
2.1× |
| Colon ca scrn not hi rsk ind (G0121) |
$2,009.25 |
$3,525 |
2.1× |
| Colorectal scrn; hi risk ind (G0105) |
$2,009.25 |
$3,525 |
2.1× |
| Diab manage trn per indiv (G0108) |
$90.92 |
$159.50 |
1.6× |
| Diab manage trn ind/group (G0109) |
$30.21 |
$53 |
1.9× |
| Drug test def 1-7 classes (G0480) |
$78.66 |
$138 |
0.7× |
| Ekg tracing for initial prev (G0404) |
$100.32 |
$176 |
3.4× |
| Esophag muc integ w/eso egd (C9777) |
$3,426.56 |
$6,011.50 |
0.9× |
| Exome (ie, somatic mutations), paired formalin-fixed paraffin-embedded tumor tissue and normal specimen, sequence… (0036U) |
$375.63 |
$659 |
0.1× |
| Group mnt 2 or more 30 mins (G0271) |
$36.48 |
$64 |
2.1× |
| Hospital outpt clinic visit (G0463) |
$56.72 |
$99.50 |
0.4× |
| Ig paraprotein qual bld/ur (0077U) |
$169.29 |
$297 |
3.9× |
| Liver dis 10 assays w/nash (0003M) |
$510.44 |
$895.50 |
1.0× |
| Mnt subs tx for change dx (G0270) |
$50.73 |
$89 |
1.6× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$1,491.98 |
$2,617.50 |
3.3× |
| Oth resp proc, group (G0239) |
$93.48 |
$164 |
2.4× |
| Psa screening (G0103) |
$110.01 |
$193 |
5.7× |
| Trauma respons w/hosp criti (G0390) |
$3,193.71 |
$5,603 |
2.3× |