20 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Colon ca scrn not hi rsk ind (G0121) |
$1,287.50 |
$2,575 |
1.3× |
| Colorectal scrn; hi risk ind (G0105) |
$1,287.50 |
$2,575 |
1.3× |
| Drug test def 1-7 classes (G0480) |
$125 |
$250 |
1.1× |
| Followup eval of foot pt lop (G0246) |
$34 |
$68 |
0.2× |
| Home sleep test/type 3 porta (G0399) |
$366.50 |
$733 |
1.6× |
| Hospital outpt clinic visit (G0463) |
$74 |
$148 |
0.5× |
| Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) |
$84 |
$168 |
1.9× |
| Initial foot exam pt lops (G0245) |
$58.50 |
$117 |
0.4× |
| Inj for sacroiliac jt anesth (G0260) |
$740.50 |
$1,481 |
1.0× |
| JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15 Other… (0027U) |
$279 |
$558 |
2.3× |
| Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin,… (0003M) |
$602.75 |
$1,205.50 |
1.2× |
| Mri w/o fol w/cont, breast, (C8908) |
$1,990 |
$3,980 |
5.4× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$1,000.25 |
$2,000.50 |
2.1× |
| Oth resp proc, group (G0239) |
$119 |
$238 |
3.0× |
| Oth resp proc, indiv (G0238) |
$38 |
$76 |
1.2× |
| Psa screening (G0103) |
$129 |
$258 |
6.7× |
| Routine footcare pt w lops (G0247) |
$67 |
$134 |
0.3× |
| Therapeutic procd strg endur (G0237) |
$38 |
$76 |
1.2× |
| Trauma respons w/hosp criti (G0390) |
$2,514.25 |
$5,028.50 |
1.8× |
| Tte w or wo fol wcon,doppler (C8929) |
$1,214.75 |
$2,429.50 |
1.5× |