Supplies, drugs & other prices at Ellett Memorial Hospital
Appleton City, MO · every code in this section with a posted price and a Medicare benchmark.
21 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin hepatitis b vaccine (G0010) | $41.25 | $55 | 0.9× |
| Admin influenza virus vac (G0008) | $18 | $24 | 0.4× |
| Admin pneumococcal vaccine (G0009) | $18 | $24 | 0.4× |
| Ca screen;pelvic/breast exam (G0101) | $143.25 | $191 | 1.4× |
| Colon ca scrn not hi rsk ind (G0121) | $702.94 | $937.25 | 0.8× |
| Colorectal scrn; hi risk ind (G0105) | $702.94 | $937.25 | 0.8× |
| Diab manage trn per indiv (G0108) | $87.56 | $116.75 | 1.6× |
| Diab manage trn ind/group (G0109) | $22.50 | $30 | 1.4× |
| Direct refer hospital observ (G0379) | $162.38 | $216.50 | 0.3× |
| Elec stim other than wound (G0283) | $22.88 | $30.50 | 1.8× |
| Group mnt 2 or more 30 mins (G0271) | $22.12 | $29.50 | 1.3× |
| Home sleep test/type 3 porta (G0399) | $300 | $400 | 1.4× |
| Hospital outpt clinic visit (G0463) | $129 | $172 | 1.0× |
| Hpv combo assay ca screen (G0476) | $152.25 | $203 | 4.3× |
| Initial preventive exam (G0402) | $152.25 | $203 | 1.1× |
| Mnt subs tx for change dx (G0270) | $37.88 | $50.50 | 1.2× |
| Obtaining screen pap smear (Q0091) | $44.25 | $59 | 1.5× |
| Ppps, initial visit (G0438) | $152.25 | $203 | 0.9× |
| Ppps, subseq visit (G0439) | $109.50 | $146 | 0.8× |
| Psa screening (G0103) | $79.31 | $105.75 | 4.1× |
| Screen pap by tech w md supv (P3000) | $31.22 | $41.62 | 1.7× |