Supplies, drugs & other prices at EvergreenHealth Medical Center

Kirkland, WA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2d tte w or w/o fol w/con,fu (C8924) $1,012.80 $1,266 2.5×
Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) $4,535.20 $5,669 2.0×
Admin hepatitis b vaccine (G0010) $133.60 $167 2.5×
Admin influenza virus vac (G0008) $73.60 $92 1.4×
Admin pneumococcal vaccine (G0009) $73.60 $92 1.4×
Ca screen;flexi sigmoidscope (G0104) $2,003.20 $2,504 1.9×
Ca screen;pelvic/breast exam (G0101) $213.60 $267 1.8×
Colon ca scrn not hi rsk ind (G0121) $2,208.80 $2,761 2.0×
Colorectal scrn; hi risk ind (G0105) $2,208.80 $2,761 2.0×
Covid-19 lab test non-cdc (U0002) $210.40 $263 4.1×
Depression screen annual (G0444) $71.20 $89 1.6×
Diab manage trn per indiv (G0108) $179.20 $224 3.2×
Diab manage trn ind/group (G0109) $75.20 $94 4.7×
Direct refer hospital observ (G0379) $1,046.40 $1,308 1.5×
Drug test def 1-7 classes (G0480) $224.80 $281 2.0×
Drug test def 22+ classes (G0483) $597.60 $747 2.4×
Drug test def 8-14 classes (G0481) $340 $425 2.2×
Egd Flx Trnsorl Vol Adjmt Ntrgstr Bariatric Balo (0813T) $1,788.80 $2,236 1.7×
Elec stim other than wound (G0283) $107.20 $134 8.4×
Esd endoscopy or colonoscopy (C9779) $9,539.20 $11,924 2.1×
Fecal microbiota prep instil (G0455) $2,276 $2,845 2.1×
Fern test (Q0114) $92.80 $116 9.5×
Glyca nuc mr spectroscopy quantitative (0024U) $66.40 $83 1.9×
Home sleep test/type 3 porta (G0399) $672 $840 2.7×
Hospital outpt clinic visit (G0463) $288 $360 1.9×
Iliac Atherectomy (0238T) $36,397.60 $45,497 1.7×
Initial preventive exam (G0402) $124 $155 0.8×
Inj for sacroiliac jt anesth (G0260) $2,295.20 $2,869 2.8×
Intens cardiac rehab no exer (G0423) $262.40 $328 1.8×
Intens cardiac rehab w/exerc (G0422) $262.40 $328 1.8×
Mnt subs tx for change dx (G0270) $113.60 $142 3.6×
Mra w/cont, chest (C8909) $1,816.80 $2,271 4.5×
Mra w/o fol w/cont, chest (C8911) $2,282.40 $2,853 5.6×
Mra, w/o&w/dye, spinal canal (C8933) $3,532 $4,415 8.7×
Mra, w/o&w/dye, upper extr (C8936) $810.40 $1,013 2.0×
Mri w/o fol w/cont, breast, (C8908) $3,064 $3,830 7.6×
Njx pltlt plasma w/img harvest/preparation (0232T) $612.80 $766 1.2×
Obtaining screen pap smear (Q0091) $77.60 $97 2.3×
Oth resp proc, group (G0239) $162.40 $203 3.7×
Oth resp proc, indiv (G0238) $65.60 $82 2.0×
Pathogen test for platelets (P9100) $108 $135 1.6×
Pemivibart infusion (M0224) $981.60 $1,227 1.9×
Perc d-e cor revasc chro sin (C9607) $17,531.20 $21,914 0.8×
Perc d-e cor revasc t cabg s (C9604) $15,002.40 $18,753 1.1×
Perc d-e cor stent ather s (C9602) $15,260.80 $19,076 0.7×
Perc drug-el cor stent sing (C9600) $15,873.60 $19,842 1.2×
Perq Sacral Augmt Bilat Inj (0201T) $10,477.60 $13,097 1.2×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $12,692 $15,865 0.9×
Place device/marker, non pro (C9728) $4,982.40 $6,228 3.1×
Ppps, subseq visit (G0439) $144 $180 1.0×
Prgrmg dev eval ldls pm single car chamber ip (0826T) $74.40 $93 1.7×
Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) $86.40 $108 2.0×
Revasc intra lithotrip-ather (C9766) $39,972.80 $49,966 1.9×
Revasc intra lithotrip-stent (C9765) $39,972.80 $49,966 1.9×
Revasc intravasc lithotripsy (C9764) $25,244.80 $31,556 1.9×
Revasc lith-sten-ath tib/per (C9775) $39,972.80 $49,966 1.9×
Revasc lithotr-ather tib/per (C9774) $39,972.80 $49,966 1.9×
Revasc lithotr-stent tib/per (C9773) $39,972.80 $49,966 1.9×
Revasc lithotrip tibi/perone (C9772) $22,835.20 $28,544 1.7×
Revasc lithotrip-stent-ather (C9767) $39,972.80 $49,966 1.9×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $44,735.20 $55,919 2.0×
Therapeutic procd strg endur (G0237) $65.60 $82 2.0×
Tomosynthesis, mammo (G0279) $50.40 $63 4.0×
Tpmt nudt15 gene analysis common variants (0034U) $788 $985 1.7×
Trauma respons w/hosp criti (G0390) $3,896.80 $4,871 2.5×
Trim nail(s) (G0127) $155.20 $194 2.3×
Tte w or w/o contr, cont ecg (C8930) $1,852 $2,315 2.0×
Tte w or wo fol wcon,doppler (C8929) $2,299.20 $2,874 2.5×
Unsched dialysis esrd pt hos (G0257) $2,198.40 $2,748 2.8×
Visit to determ ldct elig (G0296) $132 $165 1.1×
Xenograft implantation into the articular surface Non-Facility (0737T) $29,817.60 $37,272 2.0×