Supplies, drugs & other prices at Freeman Hospital West
Joplin, MO · every code in this section with a posted price and a Medicare benchmark.
67 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $2,229 | $3,715 | 2.8× |
| 2d tte w or w/o fol w/con,co (C8923) | $990 | $1,650 | 1.3× |
| 2d tte w or w/o fol w/con,fu (C8924) | $610.20 | $1,017 | 1.7× |
| Adm tocilizu covid-19 1st (M0249) | $348 | $580 | 0.8× |
| Adm tocilizu covid-19 2nd (M0250) | $348 | $580 | 0.8× |
| Admin hepatitis b vaccine (G0010) | $45.60 | $76 | 1.0× |
| Admin influenza virus vac (G0008) | $30.38 | $50.62 | 0.6× |
| Admin pneumococcal vaccine (G0009) | $45.60 | $76 | 1.0× |
| Catheterize for urine spec (P9612) | $30.90 | $51.50 | 3.3× |
| Diab manage trn per indiv (G0108) | $99 | $165 | 1.8× |
| Diab manage trn ind/group (G0109) | $68.70 | $114.50 | 4.3× |
| Direct refer hospital observ (G0379) | $551.10 | $918.50 | 0.9× |
| Drug test def 1-7 classes (G0480) | $162 | $270 | 1.4× |
| Ekg tracing for initial prev (G0404) | $258 | $430 | 8.9× |
| Elec stim other than wound (G0283) | $111 | $185 | 8.7× |
| Fecal blood scrn immunoassay (G0328) | $120.60 | $201 | 6.7× |
| Fecal microbiota prep instil (G0455) | $4,080.60 | $6,801 | 4.4× |
| Hepb screen high risk indiv (G0499) | $426 | $710 | 15.1× |
| Home sleep test/type 3 porta (G0399) | $1,148.85 | $1,914.75 | 5.3× |
| Home sleep test/type 4 porta (G0400) | $1,263.90 | $2,106.50 | 5.8× |
| Hospital outpt clinic visit (G0463) | $223.35 | $372.25 | 1.7× |
| Hpv combo assay ca screen (G0476) | $241.20 | $402 | 6.9× |
| Inj for sacroiliac jt anesth (G0260) | $456.30 | $760.50 | 0.6× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) | $16,985.10 | $28,308.50 | 0.5× |
| Mra w/cont, abd (C8900) | $2,556 | $4,260 | 7.3× |
| Mra w/cont, chest (C8909) | $1,725.45 | $2,875.75 | 4.9× |
| Mra w/cont, lwr ext (C8912) | $1,831.20 | $3,052 | 5.2× |
| Mra w/o cont, abd (C8901) | $2,958.15 | $4,930.25 | 12.4× |
| Mra w/o cont, chest (C8910) | $1,725.45 | $2,875.75 | 7.2× |
| Mra w/o cont, lwr ext (C8913) | $2,014.05 | $3,356.75 | 8.4× |
| Mra w/o fol w/cont, abd (C8902) | $2,958.15 | $4,930.25 | 8.5× |
| Mra, w/dye, upper extremity (C8934) | $573.90 | $956.50 | 1.6× |
| Mri w/cont, breast, bi (C8906) | $3,262.20 | $5,437 | 9.3× |
| Mri w/cont, breast, uni (C8903) | $4,374.45 | $7,290.75 | 24.9× |
| Mri w/o fol w/cont, breast, (C8908) | $4,374.45 | $7,290.75 | 12.5× |
| Mri w/o fol w/cont, brst, un (C8905) | $4,374.45 | $7,290.75 | 12.5× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $1,023 | $1,705 | 1.9× |
| Oth resp proc, group (G0239) | $113.70 | $189.50 | 3.0× |
| Perc d-e cor revasc chro sin (C9607) | $17,150.10 | $28,583.50 | 0.9× |
| Perc d-e cor revasc t cabg s (C9604) | $14,656.35 | $24,427.25 | 1.3× |
| Perc d-e cor stent ather s (C9602) | $9,389.10 | $15,648.50 | 0.5× |
| Perc drug-el cor stent sing (C9600) | $15,179.40 | $25,299 | 1.3× |
| Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) | $7,596.60 | $12,661 | 0.7× |
| Prolonged iv inf, req pump (C8957) | $348.15 | $580.25 | 1.6× |
| Prostate biopsy, any mthd (G0416) | $180 | $300 | 0.5× |
| Psa screening (G0103) | $97.42 | $162.38 | 5.0× |
| Revasc intra lithotrip-ather (C9766) | $23,337.75 | $38,896.25 | 1.3× |
| Revasc intra lithotrip-stent (C9765) | $23,337.75 | $38,896.25 | 1.3× |
| Revasc intravasc lithotripsy (C9764) | $14,005.65 | $23,342.75 | 1.2× |
| Revasc lith-sten-ath tib/per (C9775) | $23,337.75 | $38,896.25 | 1.3× |
| Revasc lithotr-ather tib/per (C9774) | $23,337.75 | $38,896.25 | 1.3× |
| Revasc lithotr-stent tib/per (C9773) | $23,337.75 | $38,896.25 | 1.3× |
| Revasc lithotrip tibi/perone (C9772) | $14,005.65 | $23,342.75 | 1.2× |
| Revasc lithotrip-stent-ather (C9767) | $23,337.75 | $38,896.25 | 1.3× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $127.20 | $212 | 4.8× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $3,076.95 | $5,128.25 | 0.5× |
| Therapeutic procd strg endur (G0237) | $100.35 | $167.25 | 3.5× |
| Tomosynthesis, mammo (G0279) | $49.50 | $82.50 | 3.9× |
| Tpmt Nudt15 Gene Analysis Common Variants (0034U) | $831.60 | $1,386 | 1.8× |
| Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) | $8,326.95 | $13,878.25 | 0.7× |
| Trauma respons w/hosp criti (G0390) | $2,066.40 | $3,444 | 1.5× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $10,503.90 | $17,506.50 | 0.9× |
| Trluml peripheral atherectomy iliac artery ea (0238T) | $12,517.35 | $20,862.25 | 0.7× |
| Tte w or w/o contr, cont ecg (C8930) | $1,596 | $2,660 | 2.0× |
| Tte w or w/o fol w/cont, com (C8921) | $1,087.80 | $1,813 | 1.4× |
| Tte w or w/o fol w/cont, f/u (C8922) | $621 | $1,035 | 0.8× |
| Tte w or wo fol wcon,doppler (C8929) | $2,158.80 | $3,598 | 2.7× |