Supplies, drugs & other prices at Holmes Regional Medical Center
Melbourne, FL · every code in this section with a posted price and a Medicare benchmark.
39 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) | $18.50 | $74 | 0.4× |
| Admin pneumococcal vaccine (G0009) | $22.50 | $90 | 0.5× |
| Catheterize for urine spec (P9612) | $16.10 | $64.40 | 1.7× |
| Direct refer hospital observ (G0379) | $14.50 | $58 | 0.0× |
| Drug test def 1-7 classes (G0480) | $85.75 | $343 | 0.7× |
| Elec stim other than wound (G0283) | $41.75 | $167 | 3.3× |
| Home sleep test/type 3 porta (G0399) | $294.25 | $1,177 | 1.3× |
| Hospital outpt clinic visit (G0463) | $70.25 | $281 | 0.5× |
| Insj/rplc car modulj sys ventr electrode only (0411T) | $19,761 | $79,044 | 2.3× |
| Insj/rplc cardiac modulj sys (0408T) | $19,761 | $79,044 | 0.6× |
| Insj/rplc cardiac modulj sys atr electrode only (0410T) | $19,761 | $79,044 | 2.3× |
| Insj/rplc cardiac modulj sys pls generator only (0409T) | $19,761 | $79,044 | 0.9× |
| Mra w/cont, chest (C8909) | $387 | $1,548 | 1.1× |
| Mra w/cont, pelvis (C8918) | $370 | $1,480 | 1.0× |
| Mra w/o cont, chest (C8910) | $316.75 | $1,267 | 1.3× |
| Mra w/o cont, lwr ext (C8913) | $823.25 | $3,293 | 3.3× |
| Mra w/o cont, pelvis (C8919) | $250.25 | $1,001 | 1.0× |
| Mra w/o fol w/cont, abd (C8902) | $976.50 | $3,906 | 2.7× |
| Mra w/o fol w/cont, chest (C8911) | $1,019.75 | $4,079 | 2.8× |
| Mra w/o fol w/cont, pelvis (C8920) | $750.75 | $3,003 | 2.1× |
| Mra, w/dye, upper extremity (C8934) | $311.50 | $1,246 | 0.9× |
| Mra, w/o dye, upper extr (C8935) | $244.50 | $978 | 1.0× |
| Mra, w/o&w/dye, upper extr (C8936) | $696.25 | $2,785 | 1.9× |
| Perc d-e cor revasc chro sin (C9607) likely a partial charge, not the full procedure |
$5,020 | $20,080 | 0.3× |
| Perc d-e cor revasc t cabg s (C9604) unusually low: confirm this is the full procedure |
$5,020 | $20,080 | 0.4× |
| Perc d-e cor stent ather s (C9602) likely a partial charge, not the full procedure |
$5,020 | $20,080 | 0.3× |
| Perc drug-el cor stent sing (C9600) unusually low: confirm this is the full procedure |
$5,020 | $20,080 | 0.4× |
| Psa screening (G0103) | $14.50 | $58 | 0.8× |
| Reloc skin pocket pls gen (0416T) | $19,761 | $79,044 | 9.2× |
| Removal cardiac modulj sys pls generator only (0412T) | $19,761 | $79,044 | 5.1× |
| Removal cardiac modulj sys transvenous electrode (0413T) | $19,761 | $79,044 | 5.1× |
| Repos Cardiac Modulj Transvenous Electrode (0415T) | $19,761 | $79,044 | 30.2× |
| Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) | $19,761 | $79,044 | 0.9× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) | $11,366.50 | $45,466 | 0.6× |
| Tcat insj perm dual chamber ldls pm compl sys (0795T) | $11,366.50 | $45,466 | 0.6× |
| Transcatheter renal sympath denervation bilat (0339T) unusually low: confirm this is the full procedure |
$2,780 | $11,120 | 0.5× |
| Trauma respons w/hosp criti (G0390) | $3,024 | $12,095.98 | 2.2× |
| Tte w or wo fol wcon,doppler (C8929) | $414.50 | $1,658 | 0.5× |
| Unsched dialysis esrd pt hos (G0257) | $1,125.50 | $4,502 | 1.6× |