Supplies, drugs & other prices at Delta County Memorial Hospital

Delta, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Admin hepatitis b vaccine (G0010) $34.65 $57.75 0.7×
Admin influenza virus vac (G0008) $34.65 $57.75 0.7×
Admin pneumococcal vaccine (G0009) $34.65 $57.75 0.7×
Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative Other Outpatient (0064U) $72 $120 2.3×
Catheterize for urine spec (P9612) $47.55 $79.25 5.1×
Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, CYP1A2, CYP2C19, CYP2C9,… (0029U) $890.72 $1,484.54 1.2×
Drug metabolism (warfarin drug response), targeted sequence analysis (ie, CYP2C9, CYP4F2, VKORC1, rs12777823) Other… (0030U) $493.10 $821.83 3.7×
Drug test def 1-7 classes (G0480) $137.32 $228.86 1.2×
Ekg tracing for initial prev (G0404) $45 $75 1.5×
Hep c screen high risk/other (G0472) $98.25 $163.75 2.1×
Hospital outpt clinic visit (G0463) $62.40 $104 0.4×
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) $89.40 $149 2.1×
Inj for sacroiliac jt anesth (G0260) $1,138.36 $1,897.26 1.5×
Mra w/cont, abd (C8900) $1,387.20 $2,312 3.8×
Mra w/cont, chest (C8909) $1,097.85 $1,829.75 3.0×
Mra w/cont, lwr ext (C8912) $1,118.85 $1,864.75 3.0×
Mra w/o cont, abd (C8901) $1,387.20 $2,312 5.5×
Mra w/o cont, chest (C8910) $1,097.85 $1,829.75 4.4×
Mra w/o cont, lwr ext (C8913) $1,118.85 $1,864.75 4.4×
Mra w/o fol w/cont, chest (C8911) $1,097.85 $1,829.75 3.0×
Mra w/o fol w/cont, lwr ext (C8914) $1,118.85 $1,864.75 3.0×
Mra, w/dye, upper extremity (C8934) $2,197.35 $3,662.25 6.0×
Mra, w/o dye, upper extr (C8935) $2,197.35 $3,662.25 8.7×
Mra, w/o&w/dye, upper extr (C8936) $2,197.35 $3,662.25 6.0×
Mri w/o fol w/cont, brst, un (C8905) $1,732.50 $2,887.50 4.7×
Oth resp proc, group (G0239) $115.20 $192 2.9×
Oth resp proc, indiv (G0238) $64.20 $107 2.1×
Prostate biopsy, any mthd (G0416) $353.17 $588.62 0.9×
Psa screening (G0103) $95.62 $159.38 5.0×
Tpmt nudt15 genes (0034U) $296.40 $494 0.6×
Trauma respons w/hosp criti (G0390) $1,617.15 $2,695.25 1.2×
Wet mounts/ w preparations (Q0111) $9 $15 0.5×