Supplies, drugs & other prices at Dupont Hospital LLC
Fort Wayne, IN · every code in this section with a posted price and a Medicare benchmark.
98 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2019-ncov diagnostic p (U0001) range across 3 matching MRF lines |
$6.75–$37.53 | $25–$139 | varies |
| 2d tee w or w/o fol w/con,in (C8925) | $1,303.02 | $4,826 | 1.6× |
| 2d tte w or w/o fol w/con,co (C8923) range across 3 matching MRF lines |
$951.75–$1,512 | $3,525–$5,600 | varies |
| 2d tte w or w/o fol w/con,fu (C8924) range across 3 matching MRF lines |
$738.18–$756.54 | $2,734–$2,802 | varies |
| Admin hepatitis b vaccine (G0010) range across 8 matching MRF lines |
$6.75–$54 | $25–$200 | varies |
| Admin influenza virus vac (G0008) range across 9 matching MRF lines |
$6.75–$66.96 | $25–$248 | varies |
| Admin pneumococcal vaccine (G0009) range across 10 matching MRF lines |
$6.75–$67.77 | $25–$251 | varies |
| Annual alcohol screen 15 min (G0442) range across 2 matching MRF lines |
$5.94–$6.75 | $22–$25 | varies |
| Behavior counsel obesity 15m (G0447) | $16.20 | $60 | 0.2× |
| Brief alcohol misuse counsel (G0443) | $16.20 | $60 | 0.2× |
| Ca screen;flexi sigmoidscope (G0104) range across 3 matching MRF lines |
$40.50–$66.15 | $150–$245 | varies |
| Ca screen;pelvic/breast exam (G0101) range across 3 matching MRF lines |
$12.96–$24.03 | $48–$89 | varies |
| Catheterize for urine spec (P9612) | $58.59 | $217 | 6.3× |
| Colon ca scrn not hi rsk ind (G0121) range across 7 matching MRF lines |
$111.78–$2,158.07 | $414–$7,992.87 | varies |
| Colorectal scrn; hi risk ind (G0105) range across 10 matching MRF lines |
$136.89–$2,036.75 | $507–$7,543.53 | varies |
| Depression screen annual (G0444) range across 2 matching MRF lines |
$5.94–$6.75 | $22–$25 | varies |
| Diab manage trn per indiv (G0108) range across 5 matching MRF lines |
$32.40–$82.35 | $120–$305 | varies |
| Diab manage trn ind/group (G0109) range across 7 matching MRF lines |
$9.99–$24.30 | $37–$90 | varies |
| Direct refer hospital observ (G0379) | $590.49 | $2,187 | 0.9× |
| Eia hiv-1/hiv-2 screen (G0432) | $30.51 | $113 | 1.6× |
| Ekg tracing for initial prev (G0404) | $9.99 | $37 | 0.3× |
| Elec stim other than wound (G0283) | $9.72 | $36 | 0.8× |
| Elec stim unattend for press (G0281) | $9.72 | $36 | 0.8× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $8,694.81 | $32,203 | 0.7× |
| Extrnl counterpulse, per tx (G0166) | $103.95 | $385 | 0.7× |
| Fecal blood scrn immunoassay (G0328) range across 7 matching MRF lines |
$14.58–$30.78 | $54–$114 | varies |
| Fecal microbiota prep instil (G0455) | $135 | $500 | 0.1× |
| Group mnt 2 or more 30 mins (G0271) | $51.30 | $190 | 3.0× |
| High inten beh couns std 30m (G0445) | $16.47 | $61 | 0.2× |
| Hiv combination assay (G0475) range across 4 matching MRF lines |
$46.71–$62.57 | $173–$231.75 | varies |
| Home sleep test/type 2 porta (G0398) | $43.74 | $162 | 0.2× |
| Home sleep test/type 3 porta (G0399) | $153.36 | $568 | 0.7× |
| Hospital outpt clinic visit (G0463) range across 21 matching MRF lines |
$65.88–$1,373.49 | $244–$5,087 | varies |
| Initial preventive exam (G0402) range across 2 matching MRF lines |
$74.52–$96.93 | $276–$359 | varies |
| Inj for sacroiliac jt anesth (G0260) range across 8 matching MRF lines |
$968.50–$2,772.93 | $3,587.04–$10,270.11 | varies |
| Intens behave ther cardio dx (G0446) | $16.20 | $60 | 0.4× |
| Mnt subs tx for change dx (G0270) | $36.72 | $136 | 1.2× |
| Mra w/cont, abd (C8900) | $656.64 | $2,432 | 1.8× |
| Mra w/cont, chest (C8909) | $632.61 | $2,343 | 1.7× |
| Mra w/cont, lwr ext (C8912) | $668.52 | $2,476 | 1.8× |
| Mra w/cont, pelvis (C8918) | $656.64 | $2,432 | 1.8× |
| Mra w/o cont, abd (C8901) range across 4 matching MRF lines |
$770.04–$864.27 | $2,852–$3,201 | varies |
| Mra w/o cont, chest (C8910) | $614.79 | $2,277 | 2.4× |
| Mra w/o cont, lwr ext (C8913) | $1,098.90 | $4,070 | 4.4× |
| Mra w/o cont, pelvis (C8919) | $635.04 | $2,352 | 2.5× |
| Mra w/o fol w/cont, abd (C8902) range across 4 matching MRF lines |
$809.73–$1,124.01 | $2,999–$4,163 | varies |
| Mra w/o fol w/cont, chest (C8911) range across 2 matching MRF lines |
$809.73–$1,178.82 | $2,999–$4,366 | varies |
| Mra w/o fol w/cont, lwr ext (C8914) range across 6 matching MRF lines |
$976.23–$1,744.20 | $3,615.66–$6,460 | varies |
| Mra w/o fol w/cont, pelvis (C8920) range across 2 matching MRF lines |
$757.89–$889.38 | $2,807–$3,294 | varies |
| Mra, w/dye, spinal canal (C8931) | $668.52 | $2,476 | 1.8× |
| Mra, w/dye, upper extremity (C8934) range across 4 matching MRF lines |
$668.52–$855.36 | $2,476–$3,168 | varies |
| Mra, w/o dye, spinal canal (C8932) | $668.52 | $2,476 | 2.6× |
| Mra, w/o dye, upper extr (C8935) range across 4 matching MRF lines |
$668.52–$801.09 | $2,476–$2,967 | varies |
| Mra, w/o&w/dye, spinal canal (C8933) | $668.52 | $2,476 | 1.8× |
| Mra, w/o&w/dye, upper extr (C8936) range across 4 matching MRF lines |
$668.52–$1,152.09 | $2,476–$4,267 | varies |
| Mri w/cont, breast, bi (C8906) range across 2 matching MRF lines |
$1,149.93–$1,793.61 | $4,259–$6,643 | varies |
| Mri w/cont, breast, uni (C8903) range across 4 matching MRF lines |
$606.42–$980.64 | $2,246–$3,632 | varies |
| Mri w/o fol w/cont, breast, (C8908) range across 4 matching MRF lines |
$179.28–$1,533.06 | $664–$5,678 | varies |
| Mri w/o fol w/cont, brst, un (C8905) range across 4 matching MRF lines |
$792.99–$896.94 | $2,937–$3,322 | varies |
| Neuro csf prion prtn qual (0035U) | $730.35 | $2,705 | 1.4× |
| Njx bone sub matrl into subchondral bone defect (0707T) | $20,634.83 | $76,425.28 | 6.0× |
| Njx platelet plasma (0232T) | $15.39 | $57 | 0.0× |
| Obtaining screen pap smear (Q0091) range across 6 matching MRF lines |
$12.15–$13.77 | $45–$51 | varies |
| Oth resp proc, indiv (G0238) | $7.02 | $26 | 0.2× |
| Pathogen test for platelets (P9100) | $46.44 | $172 | 0.7× |
| Perc d-e cor revasc chro sin (C9607) | $11,520.36 | $42,668 | 0.6× |
| Perc d-e cor revasc t cabg s (C9604) | $11,520.36 | $42,668 | 0.9× |
| Perc d-e cor stent ather s (C9602) | $11,520.36 | $42,668 | 0.6× |
| Perc drug-el cor stent sing (C9600) | $11,520.36 | $42,668 | 0.9× |
| Perq Sacral Augmt Bilat Inj (0201T) unusually low: confirm this is the full procedure |
$2,904.12 | $10,756 | 0.4× |
| Perq Sacral Augmt Unilat Inj (0200T) range across 6 matching MRF lines |
$2,937.56–$3,300.75 | $10,879.84–$12,225 | varies |
| Ppps, initial visit (G0438) range across 3 matching MRF lines |
$95.04–$117.99 | $352–$437 | varies |
| Ppps, subseq visit (G0439) range across 4 matching MRF lines |
$63.45–$79.65 | $235–$295 | varies |
| Prostate biopsy, any mthd (G0416) | $229.50 | $850 | 0.6× |
| Psa screening (G0103) range across 2 matching MRF lines |
$18.09–$68.31 | $67–$253 | varies |
| Revasc intra lithotrip-ather (C9766) | $12,837.42 | $47,546 | 0.7× |
| Revasc intra lithotrip-stent (C9765) range across 5 matching MRF lines |
$12,110.85–$12,837.42 | $44,855–$47,546 | varies |
| Revasc intravasc lithotripsy (C9764) range across 8 matching MRF lines |
$5,977.53–$6,336.09 | $22,139–$23,467 | varies |
| Revasc lith-sten-ath tib/per (C9775) | $19,511.01 | $72,263 | 1.0× |
| Revasc lithotr-ather tib/per (C9774) range across 6 matching MRF lines |
$18,406.71–$19,511.01 | $68,173–$72,263 | varies |
| Revasc lithotr-stent tib/per (C9773) | $19,511.28 | $72,264 | 1.0× |
| Revasc lithotrip tibi/perone (C9772) | $12,197.79 | $45,177 | 1.0× |
| Revasc lithotrip-stent-ather (C9767) range across 6 matching MRF lines |
$18,406.71–$19,511.01 | $68,173–$72,263 | varies |
| Scr c/v cyto,thinlayer,rescr (G0145) | $61.56 | $228 | 2.3× |
| Screen cerv/vag thin layer (G0123) | $71.82 | $266 | 3.5× |
| Screen pap by tech w md supv (P3000) | $9.72 | $36 | 0.5× |
| Tee w or w/o fol w/cont, mon (C8927) | $1,264.95 | $4,685 | 1.5× |
| Tee w or w/o fol w/cont,cong (C8926) | $1,264.95 | $4,685 | 1.5× |
| Therapeutic procd strg endur (G0237) | $7.02 | $26 | 0.2× |
| Tomosynthesis, mammo (G0279) | $28.62 | $106 | 2.3× |
| Trim nail(s) (G0127) | $5.67 | $21 | 0.1× |
| Trluml Perip Athrc Brchiocph (0237T) likely a partial charge, not the full procedure |
$320.22 | $1,186 | 0.0× |
| Trluml Perip Athrc Iliac Art (0238T) range across 5 matching MRF lines |
$1,822.50–$77,118.85 | $6,750–$285,625.37 | varies |
| Tte w or w/o contr, cont ecg (C8930) | $1,464.21 | $5,423 | 1.8× |
| Tte w or w/o fol w/cont, com (C8921) range across 2 matching MRF lines |
$885.33–$1,475.28 | $3,279–$5,464 | varies |
| Tte w or w/o fol w/cont, f/u (C8922) | $951.21 | $3,523 | 1.1× |
| Tte w or wo fol wcon,doppler (C8929) range across 3 matching MRF lines |
$844.02–$1,618.11 | $3,126–$5,993 | varies |
| Unsched dialysis esrd pt hos (G0257) | $1,121.31 | $4,153 | 1.5× |
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.