Supplies, drugs & other prices at D.W. McMillan Memorial Hospital
Brewton, AL · every code in this section with a posted price and a Medicare benchmark.
26 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) | $30 | $50 | 0.7× |
| Admin influenza virus vac (G0008) | $15.60 | $26 | 0.4× |
| Admin pneumococcal vaccine (G0009) | $15.60 | $26 | 0.4× |
| Autolog prp not diab ulcer (G0460) | $1,950 | $3,250 | 1.0× |
| Behavior counsel obesity 15m (G0447) | $18.60 | $31 | 0.2× |
| Ca screen;pelvic/breast exam (G0101) | $27.60 | $46 | 0.3× |
| Colon ca scrn not hi rsk ind (G0121) | $330 | $550 | 0.4× |
| Colorectal scrn; hi risk ind (G0105) | $330 | $550 | 0.4× |
| Depression screen annual (G0444) | $13.20 | $22 | 0.4× |
| Devlopment test interpt&rep (G0451) | $13.50 | $22.50 | 0.1× |
| Diab manage trn per indiv (G0108) | $24 | $40 | 0.4× |
| Diab manage trn ind/group (G0109) | $43.80 | $73 | 2.7× |
| Direct refer hospital observ (G0379) | $801.60 | $1,336 | 1.5× |
| Drug test def 1-7 classes (G0480) | $27.30 | $45.50 | 0.2× |
| Drug test def 8-14 classes (G0481) | $45.60 | $76 | 0.3× |
| Home sleep test/type 3 porta (G0399) | $463.20 | $772 | 2.4× |
| Hospital outpt clinic visit (G0463) | $87.60 | $146 | 0.7× |
| Initial preventive exam (G0402) | $88.80 | $148 | 0.7× |
| Inj for sacroiliac jt anesth (G0260) | $1,984.80 | $3,308 | 3.1× |
| Mnt subs tx for change dx (G0270) | $37.20 | $62 | 1.2× |
| Ppps, initial visit (G0438) | $132.60 | $221 | 0.8× |
| Ppps, subseq visit (G0439) | $92.40 | $154 | 0.7× |
| Psa screening (G0103) | $62.40 | $104 | 3.2× |
| Tomosynthesis, mammo (G0279) | $86.40 | $144 | 6.8× |
| Trauma respons w/hosp criti (G0390) | $5,292 | $8,820 | 4.4× |
| Trim nail(s) (G0127) | $66 | $110 | 1.2× |