Supplies, drugs & other prices at Dallas Medical Center

Dallas, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $783 $2,584.13 1.0×
Admin hepatitis b vaccine (G0010) $46 $43.44 1.0×
Admin influenza virus vac (G0008) $46 $173.77 1.0×
Admin pneumococcal vaccine (G0009) $46 $173.77 1.0×
Ca screen;flexi sigmoidscope (G0104) $929 $835.86 1.0×
Ca screen;pelvic/breast exam (G0101) $101 $81.52 1.0×
Colon ca scrn not hi rsk ind (G0121) $929 $3,968.25 1.0×
Colorectal scrn; hi risk ind (G0105) $929 $2,507.57 1.0×
Diab manage trn per indiv (G0108) $55 $256 1.0×
Diab manage trn ind/group (G0109) $16 $121.08 1.0×
Direct refer hospital observ (G0379) $595 $2,007.20 1.0×
Drug test def 1-7 classes (G0480) $114 $114.43 1.0×
Elec stim other than wound (G0283) $12 $121.20 0.9×
Fern test (Q0114) $9 $135.20 0.9×
Group mnt 2 or more 30 mins (G0271) $12 $79.02 0.7×
Hbot, full body chamber, 30m (G0277) $137 $1,795.40 1.0×
Hep c screen high risk/other (G0472) $46 $260 1.0×
Hospital outpt clinic visit (G0463) $133 $637.54 1.0×
Inj for sacroiliac jt anesth (G0260) $705 $1,689.33 1.0×
Liver dis 10 assays w/nash (0003M) $503 $2,517 1.0×
Mnt subs tx for change dx (G0270) $22 $98 0.7×
Mra w/cont, chest (C8909) $348 $3,016 1.0×
Mra w/cont, lwr ext (C8912) $348 $3,086.18 1.0×
Mra w/cont, pelvis (C8918) $348 $5,000 1.0×
Mra w/o fol w/cont, abd (C8902) $348 $7,000 1.0×
Mra, w/dye, spinal canal (C8931) $348 $3,638 1.0×
Mra, w/dye, upper extremity (C8934) $348 $4,399.20 1.0×
Mri w/o fol w/cont, breast, (C8908) $348 $2,742.50 1.0×
Njx pltlt plasma w/img harvest/preparation (0232T) $446 $1,821.96 1.0×
Perc d-e cor revasc t cabg s (C9604) $11,539 $10,061.10 1.0×
Perc drug-el cor stent sing (C9600) $11,539 $50,305.30 1.0×
Perq Sacral Augmt Bilat Inj (0201T) $7,253 $32,713.60 1.0×
Perq Sacral Augmt Unilat Inj (0200T) $7,253 $32,713.60 1.0×
Post op service lvrs min 6 (G0305) $373 $918.45 1.0×
Potassium hydroxide preps (Q0112) $5 $141.45 0.9×
Psa screening (G0103) $19 $299.78 1.0×
Revasc intra lithotrip-stent (C9765) $18,324 $16,036.70 1.0×
Trauma respons w/hosp criti (G0390) $8,000
Trim nail(s) (G0127) $58 $279.70 1.0×
Tte w or w/o fol w/con,stres (C8928) $783 $2,522.66 1.0×
Tte w or w/o fol w/cont, com (C8921) $783 $2,522.66 1.0×
Tte w or wo fol wcon,doppler (C8929) $783 $3,597.10 1.0×
Unsched dialysis esrd pt hos (G0257) $686 $3,826.69 1.0×