Supplies, drugs & other prices at Evanston Regional Hospital

Evanston, WY · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $74.95 $124.92 2.1×
2d tte w or w/o fol w/con,fu (C8924) $557.97 $929.95 1.6×
Admin hepatitis b vaccine (G0010) $39.63 $66.05 0.8×
Admin influenza virus vac (G0008) $38.11 $63.52 0.8×
Admin pneumococcal vaccine (G0009) $40.62 $67.70 0.8×
Catheterize for urine spec (P9612) $105.06 $175.10 11.2×
Covid-19 lab test non-cdc (U0002) $107.08 $178.46 2.1×
Direct refer hospital observ (G0379) $879.70 $1,466.17 1.4×
Eia hiv-1/hiv-2 screen (G0432) $47.98 $79.96 2.5×
Elisa hiv-1/hiv-2 screen (G0433) $47.98 $79.96 2.6×
Hiv combination assay (G0475) $113.14 $188.56 4.7×
Inj for sacroiliac jt anesth (G0260) $649.64 $1,082.74 0.9×
Mra w/cont, abd (C8900) $1,597.49 $2,662.49 4.5×
Mra w/cont, chest (C8909) $1,185.34 $1,975.56 3.3×
Mra w/cont, lwr ext (C8912) $1,938.34 $3,230.57 5.4×
Mra w/cont, pelvis (C8918) $1,525.47 $2,542.45 4.3×
Mra w/o cont, abd (C8901) $1,279.50 $2,132.50 5.2×
Mra w/o cont, chest (C8910) $1,054.38 $1,757.30 4.3×
Mra w/o cont, lwr ext (C8913) $1,707.66 $2,846.11 7.0×
Mra w/o cont, pelvis (C8919) $1,412.07 $2,353.45 5.8×
Mra w/o fol w/cont, abd (C8902) $1,927.19 $3,211.99 5.4×
Mra w/o fol w/cont, chest (C8911) $1,674.57 $2,790.95 4.7×
Mra w/o fol w/cont, lwr ext (C8914) $2,467.82 $4,113.04 6.9×
Mra w/o fol w/cont, pelvis (C8920) $1,611.46 $2,685.76 4.5×
Mri w/o fol w/cont, breast, (C8908) $3,080.66 $5,134.43 8.6×
Oral hiv-1/hiv-2 screen (G0435) $186.71 $311.18 15.6×
Psa screening (G0103) $147.28 $245.47 7.6×
Trauma respons w/hosp criti (G0390) $4,234.98 $7,058.30 3.1×
Tte w or w/o fol w/con,stres (C8928) $852.58 $1,420.97 1.1×
Unsched dialysis esrd pt hos (G0257) $733.16 $1,221.93 1.0×