Supplies, drugs & other prices at Faith Health
Norfolk, NE · every code in this section with a posted price and a Medicare benchmark.
66 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $2,433.26 | $3,887 | 3.0× |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,068.27 | $1,706.50 | 2.9× |
| Admin hepatitis b vaccine (G0010) | $47.58 | $76 | 1.0× |
| Admin influenza virus vac (G0008) | $74.80 | $119.50 | 1.5× |
| Admin pneumococcal vaccine (G0009) | $75.74 | $121 | 1.6× |
| Blind interatrial shunt ide (C9758) | $28,758.44 | $45,940 | 1.6× |
| Ca screen;pelvic/breast exam (G0101) | $141.48 | $226 | 1.3× |
| Catheterize for urine spec (P9612) | $32.24 | $51.50 | 3.5× |
| Colon ca scrn not hi rsk ind (G0121) | $1,967.52 | $3,143 | 2.0× |
| Colorectal scrn; hi risk ind (G0105) | $2,302.43 | $3,678 | 2.4× |
| Cystoscopy prostatic imp 1-3 (C9739) likely a partial charge, not the full procedure |
$970.93 | $1,551 | 0.2× |
| Direct refer hospital observ (G0379) | $715.83 | $1,143.50 | 1.2× |
| Drug test def 1-7 classes (G0480) | $82.01 | $131 | 0.7× |
| Drug test def 8-14 classes (G0481) | $202.82 | $324 | 1.3× |
| Elec stim other than wound (G0283) | $67.30 | $107.50 | 5.3× |
| Fecal blood scrn immunoassay (G0328) | $30.05 | $48 | 1.7× |
| Fecal microbiota prep instil (G0455) | $335.54 | $536 | 0.3× |
| Hbot, full body chamber, 30m (G0277) | $1,502.40 | $2,400 | 10.5× |
| Home sleep test/type 3 porta (G0399) | $396.88 | $634 | 1.8× |
| Home sleep test/type 4 porta (G0400) | $512.07 | $818 | 2.3× |
| Hospital outpt clinic visit (G0463) | $238.50 | $381 | 1.7× |
| Injection(s), bone substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion,… (0707T) | $2,459.98 | $3,929.68 | 0.7× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) | $250.40 | $400 | 2.1× |
| Mra w/cont, abd (C8900) | $2,013.22 | $3,216 | 5.6× |
| Mra w/o cont, abd (C8901) | $2,013.22 | $3,216 | 8.1× |
| Mra w/o cont, lwr ext (C8913) | $1,447.94 | $2,313 | 5.8× |
| Mra w/o fol w/cont, abd (C8902) | $1,965.33 | $3,139.50 | 5.4× |
| Mra w/o fol w/cont, chest (C8911) | $3,202.62 | $5,116 | 8.8× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,413.51 | $2,258 | 3.9× |
| Mra w/o fol w/cont, pelvis (C8920) | $2,013.22 | $3,216 | 5.6× |
| Mri w/cont, breast, bi (C8906) | $2,627.95 | $4,198 | 7.3× |
| Mri w/cont, breast, uni (C8903) | $1,688.32 | $2,697 | 9.3× |
| Mri w/o fol w/cont, breast, (C8908) | $2,835.46 | $4,529.50 | 7.8× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $1,907.84 | $3,047.67 | 4.1× |
| Obtaining screen pap smear (Q0091) | $37.56 | $60 | 1.3× |
| Onc Merkel Cll Carc Srm Quan (0058U) | $244.77 | $391 | 0.8× |
| Oth resp proc, group (G0239) | $103.92 | $166 | 2.7× |
| Oth resp proc, indiv (G0238) | $106.42 | $170 | 3.5× |
| Pathogen test for platelets (P9100) | $97.66 | $156 | 1.6× |
| Perc d-e cor revasc chro sin (C9607) | $26,866.04 | $42,917 | 1.4× |
| Perc d-e cor revasc t cabg s (C9604) | $18,636.02 | $29,770 | 1.6× |
| Perc d-e cor stent ather s (C9602) | $22,117.83 | $35,332 | 1.2× |
| Perc drug-el cor stent sing (C9600) | $16,429.68 | $26,245.50 | 1.4× |
| Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) likely a partial charge, not the full procedure |
$1,416.64 | $2,263 | 0.1× |
| Perq Sacral Augmt Bilat Inj (0201T) | $11,739.38 | $18,753 | 1.6× |
| Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) | $9,369.34 | $14,967 | 0.8× |
| Prostate biopsy, any mthd (G0416) | $1,461.40 | $2,334.50 | 3.9× |
| Psa screening (G0103) | $90.14 | $144 | 4.7× |
| Revasc intra lithotrip-ather (C9766) | $29,507.76 | $47,137 | 1.6× |
| Revasc intra lithotrip-stent (C9765) | $22,832.72 | $36,474 | 1.2× |
| Revasc intravasc lithotripsy (C9764) | $14,296.59 | $22,838 | 1.2× |
| Revasc lith-sten-ath tib/per (C9775) | $29,507.76 | $47,137 | 1.6× |
| Revasc lithotr-ather tib/per (C9774) | $29,507.76 | $47,137 | 1.6× |
| Revasc lithotr-stent tib/per (C9773) | $34,826.88 | $55,634 | 1.8× |
| Revasc lithotrip tibi/perone (C9772) | $20,831.72 | $33,277.50 | 1.7× |
| Revasc lithotrip-stent-ather (C9767) | $27,521.46 | $43,964 | 1.4× |
| Tee w or w/o fol w/cont, mon (C8927) | $1,605.06 | $2,564 | 2.0× |
| Therapeutic procd strg endur (G0237) | $106.42 | $170 | 3.5× |
| Tomosynthesis, mammo (G0279) | $40.69 | $65 | 3.2× |
| Trauma respons w/hosp criti (G0390) | $1,367.50 | $2,184.50 | 1.0× |
| Trluml peripheral atherectomy iliac artery ea (0238T) | $29,507.76 | $47,137 | 1.6× |
| Tte w or w/o contr, cont ecg (C8930) | $2,009.15 | $3,209.50 | 2.5× |
| Tte w or wo fol wcon,doppler (C8929) | $2,160.32 | $3,451 | 2.7× |
| Unsched dialysis esrd pt hos (G0257) | $1,380.33 | $2,205 | 1.9× |
| Visit esketamine 56m or less (G2082) | $1,891.15 | $3,021 | 1.8× |
| Visit esketamine, > 56m (G2083) | $2,223.55 | $3,552 | 1.3× |