21 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) |
$13 |
$18 |
0.3× |
| Admin pneumococcal vaccine (G0009) |
$13 |
$18 |
0.3× |
| Ca screen;pelvic/breast exam (G0101) |
$200 |
$285 |
2.0× |
| Colon ca scrn not hi rsk ind (G0121) |
$2,035 |
$2,907 |
2.2× |
| Colorectal scrn; hi risk ind (G0105) |
$2,285 |
$3,264 |
2.4× |
| Direct refer hospital observ (G0379) |
$1,126 |
$1,608 |
1.9× |
| Drug test def 1-7 classes (G0480) |
$44 |
$63 |
0.4× |
| Elec stim other than wound (G0283) |
$57 |
$81 |
4.5× |
| Fern test (Q0114) |
$28 |
$40 |
2.9× |
| Initial preventive exam (G0402) |
$277 |
$396 |
2.1× |
| Obtaining screen pap smear (Q0091) |
$61 |
$87 |
2.1× |
| Oth resp proc, group (G0239) |
$107 |
$153 |
2.9× |
| Oth resp proc, indiv (G0238) |
$107 |
$153 |
3.7× |
| Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0629T) |
$32,130 |
$45,900 |
2.5× |
| Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) |
$32,130 |
$45,900 |
2.5× |
| Ppps, initial visit (G0438) |
$376 |
$537 |
2.2× |
| Ppps, subseq visit (G0439) |
$256 |
$366 |
1.9× |
| Psa screening (G0103) |
$115 |
$165 |
6.0× |
| Therapeutic procd strg endur (G0237) |
$107 |
$153 |
3.7× |
| Trauma respons w/hosp criti (G0390) |
$2,797 |
$3,996 |
2.1× |
| Trim nail(s) (G0127) |
$127 |
$181.50 |
2.1× |