Supplies, drugs & other prices at Great Plains Health

North Platte, NE · every code in this section with a posted price and a Medicare benchmark.

68 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $130 $216 3.6×
2d tee w or w/o fol w/con,in (C8925) $2,105 $3,508 2.6×
2d tte w or w/o fol w/con,co (C8923) $2,405 $4,009 3.0×
2d tte w or w/o fol w/con,fu (C8924) $1,009 $1,682 2.8×
Admin hepatitis b vaccine (G0010) $47.50 $113 1.0×
Admin influenza virus vac (G0008) $47.50 $113 1.0×
Admin pneumococcal vaccine (G0009) $49 $115 1.0×
Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative Other Outpatient (0064U) $169 $282 5.4×
Behavior counsel obesity 15m (G0447) $123.50 $241 1.2×
Covid-19 lab test non-cdc (U0002) $185 $308 3.6×
Diab manage trn per indiv (G0108) $91 $219 1.6×
Direct refer hospital observ (G0379) $827 $1,379 1.3×
Elec stim other than wound (G0283) $46.50 $94 3.7×
Group behave couns 2-10 (G0473) $30.50 $66 0.8×
Group mnt 2 or more 30 mins (G0271) $42 $70 2.5×
Hbot, full body chamber, 30m (G0277) $373 $621 2.6×
Ig paraprotein qual bld/ur (0077U) $104 $174 2.4×
Inj for sacroiliac jt anesth (G0260) $2,122 $3,536 2.9×
Instlj fecal microbiota ssp (0780T) $362.50 $631.50 2.6×
Intens behave ther cardio dx (G0446) $37 $93 1.0×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) $658 $1,097 5.4×
Liver dis 10 assays w/nash (0003M) $2,719 $4,531 5.4×
Mnt subs tx for change dx (G0270) $62.50 $139.50 2.0×
Mra w/cont, abd (C8900) $2,645 $4,409 7.3×
Mra w/cont, lwr ext (C8912) $2,645 $4,409 7.3×
Mra w/o cont, abd (C8901) $2,171 $3,618 8.8×
Mra w/o cont, lwr ext (C8913) $2,713.50 $4,522.50 11.0×
Mra w/o cont, pelvis (C8919) $2,171 $3,618 8.8×
Mra w/o fol w/cont, abd (C8902) $2,645 $4,409 7.3×
Mra w/o fol w/cont, chest (C8911) $2,645 $4,409 7.3×
Mra w/o fol w/cont, lwr ext (C8914) $3,306.50 $5,511.50 9.1×
Mra w/o fol w/cont, pelvis (C8920) $2,645 $4,409 7.3×
Mra, w/dye, upper extremity (C8934) $2,645 $4,409 7.3×
Mra, w/o dye, upper extr (C8935) $2,171 $3,618 8.8×
Mri w/o fol w/cont, breast, (C8908) $2,645 $4,409 7.3×
Mri w/o fol w/cont, brst, un (C8905) $2,645 $4,409 7.3×
Onc Merkel Cll Carc Srm Quan (0058U) $775 $1,292 2.4×
Oth resp proc, group (G0239) $53 $88 1.4×
Oth resp proc, indiv (G0238) $33 $55 1.1×
Pemivibart infusion (M0224) $541 $901 1.2×
Perc d-e cor revasc chro sin (C9607) $32,663 $54,438 1.7×
Perc d-e cor revasc t cabg s (C9604) $27,320 $45,533 2.3×
Perc d-e cor stent ather s (C9602) $32,663 $54,438 1.7×
Perc drug-el cor stent sing (C9600) $27,320 $45,533 2.3×
Perq Sacral Augmt Bilat Inj (0201T) $6,997.50 $14,114 0.9×
Prgrmg dev eval ldls pm single car chamber ip (0826T) $96.50 $201 2.5×
Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) $82 $175 2.1×
Psa screening (G0103) $103 $172 5.3×
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) $3,888 $6,480 5.4×
Revasc intra lithotrip-ather (C9766) $32,663 $54,438 1.7×
Revasc intra lithotrip-stent (C9765) $32,663 $54,438 1.7×
Revasc intravasc lithotripsy (C9764) $27,320 $45,533 2.3×
Revasc lith-sten-ath tib/per (C9775) $32,663 $54,438 1.7×
Revasc lithotr-ather tib/per (C9774) $32,663 $54,438 1.7×
Revasc lithotr-stent tib/per (C9773) $32,663 $54,438 1.7×
Revasc lithotrip tibi/perone (C9772) $27,320 $45,533 2.3×
Revasc lithotrip-stent-ather (C9767) $32,663 $54,438 1.7×
Rx Metab Advrs Trgt Seq Alys (0029U) $1,781 $2,969 2.4×
Syphilis test, non-treponemal antibody, immunoassay, qualitative (RPR) Other Outpatient (0065U) $98 $163 5.4×
Therapeutic procd strg endur (G0237) $33 $55 1.1×
Tomosynthesis, mammo (G0279) $57 $166.50 4.5×
Tpmt Nudt15 Gene Analysis Common Variants (0034U) $2,518 $4,196 5.4×
Trauma respons w/hosp criti (G0390) $1,410.50 $2,350.50 1.0×
Tte w or w/o fol w/con,stres (C8928) $2,405 $4,009 3.0×
Tte w or wo fol wcon,doppler (C8929) $2,246 $3,744 2.8×
Unsched dialysis esrd pt hos (G0257) $940 $1,567 1.3×
Visit esketamine 56m or less (G2082) $1,898 $3,164 1.8×
Visit esketamine, > 56m (G2083) $2,393 $3,989 1.4×