Supplies, drugs & other prices at Franciscan Healthcare
West Point, NE · every code in this section with a posted price and a Medicare benchmark.
17 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin influenza virus vac (G0008) | $95 | $95 | 2.0× |
| Admin pneumococcal vaccine (G0009) | $95 | $95 | 2.0× |
| Diab manage trn per indiv (G0108) | $30 | $30 | 0.5× |
| Direct refer hospital observ (G0379) | $322 | $322 | 0.5× |
| Elec stim other than wound (G0283) | $114 | $114 | 9.0× |
| Group train w/o patient (G0543) | $56 | $56 | 1.9× |
| Home sleep test/type 3 porta (G0399) | $578 | $578 | 2.6× |
| Hospital outpt clinic visit (G0463) | $369 | $369 | 2.7× |
| Inj for sacroiliac jt anesth (G0260) | $1,826.50 | $1,826.50 | 2.5× |
| No pt prsnt train initial 30 (G0541) | $110 | $110 | 3.7× |
| Oth resp proc, group (G0239) | $90 | $90 | 2.3× |
| Oth resp proc, indiv (G0238) | $152 | $152 | 5.1× |
| Pemivibart infusion (M0224) | $1,251 | $1,251 | 2.7× |
| Psa screening (G0103) | $204 | $204 | 10.6× |
| Therapeutic procd strg endur (G0237) | $125 | $125 | 4.2× |
| Tomosynthesis, mammo (G0279) | $71 | $71 | 5.6× |
| Trauma respons w/hosp criti (G0390) | $1,769 | $1,769 | 1.3× |