Supplies, drugs & other prices at Golden Valley Memorial Healthcare
Clinton, MO · every code in this section with a posted price and a Medicare benchmark.
34 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin influenza virus vac (G0008) | $32.40 | $54 | 0.7× |
| Admin pneumococcal vaccine (G0009) | $33 | $55 | 0.7× |
| Behavior counsel obesity 15m (G0447) | $120.58 | $200.97 | 1.2× |
| Ca screen;flexi sigmoidscope (G0104) | $1,710 | $2,850 | 1.8× |
| Colon ca scrn not hi rsk ind (G0121) | $1,956.70 | $3,261.17 | 2.1× |
| Colorectal scrn; hi risk ind (G0105) | $1,680 | $2,800 | 1.8× |
| Diab manage trn per indiv (G0108) | $62.58 | $104.30 | 1.1× |
| Diab manage trn ind/group (G0109) | $125.76 | $209.60 | 7.8× |
| Direct refer hospital observ (G0379) | $247.20 | $412 | 0.4× |
| Drug test def 1-7 classes (G0480) | $205.97 | $343.29 | 1.8× |
| Drug test def 8-14 classes (G0481) | $372.72 | $621.20 | 2.4× |
| Extraction coronal remnants (D7111) | $825.43 | $1,375.72 | 1.3× |
| Extraction erupted tooth/exr (D7140) | $777.08 | $1,295.14 | 1.2× |
| Group mnt 2 or more 30 mins (G0271) | $42.24 | $70.40 | 2.5× |
| Hiv combination assay (G0475) | $58.99 | $98.31 | 2.4× |
| Home sleep test/type 3 porta (G0399) | $635.24 | $1,058.73 | 2.9× |
| Hospital outpt clinic visit (G0463) | $76.80 | $128 | 0.6× |
| Inj for sacroiliac jt anesth (G0260) | $992.40 | $1,654 | 1.4× |
| Mnt subs tx for change dx (G0270) | $18 | $30 | 0.6× |
| Oth resp proc, group (G0239) | $86.69 | $144.48 | 2.3× |
| Oth resp proc, indiv (G0238) | $128.74 | $214.56 | 4.4× |
| Place direct restoration (D2940) | $707.44 | $1,179.06 | 1.1× |
| Post 1 srfc resinbased cmpst (D2391) | $644.59 | $1,074.31 | 1.0× |
| Post 2 srfc resinbased cmpst (D2392) | $1,197.09 | $1,995.15 | 1.8× |
| Post 3 srfc resinbased cmpst (D2393) | $1,197.09 | $1,995.15 | 1.8× |
| Prefab porc/ceram crown pri (D2929) | $751.96 | $1,253.26 | 1.2× |
| Prefab steel crown primary (D2934) | $751.96 | $1,253.26 | 1.2× |
| Prefab stnlss steel crwn pri (D2930) | $777.08 | $1,295.14 | 1.2× |
| Prostate biopsy, any mthd (G0416) | $259.56 | $432.60 | 0.7× |
| Psa screening (G0103) | $78 | $130 | 4.0× |
| Resin two surfaces-anterior (D2331) | $777.08 | $1,295.14 | 1.2× |
| Therapeutic procd strg endur (G0237) | $64.37 | $107.28 | 2.2× |
| Tomosynthesis, mammo (G0279) | $83.87 | $139.78 | 6.6× |
| Tte w or wo fol wcon,doppler (C8929) | $1,728.58 | $2,880.97 | 2.2× |