Supplies, drugs & other prices at Indiana University Health White Memorial Hospital
Monticello, IN · every code in this section with a posted price and a Medicare benchmark.
245 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,130.90 | $3,627 | 1.4× |
| 2d tte w or w/o fol w/con,co (C8923) range across 4 matching MRF lines |
$788.23–$1,051.08 | $2,528–$3,371 | varies |
| 2d tte w or w/o fol w/con,fu (C8924) | $601.15 | $1,928 | 1.6× |
| 3D contour simulaj trgt lvr les&mrgn micrwv ablt (0944T) | $353.89 | $1,135 | 1.4× |
| Ablation b9 thyroid nodule perq laser w/img gdn (0673T) | $3,682.05 | $11,809 | 2.1× |
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) | $878.34 | $2,817 | 0.4× |
| Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv (0442T) | $8,693.92 | $27,883 | 0.9× |
| Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) | $878.34 | $2,817 | 0.4× |
| Adm tocilizu covid-19 1st (M0249) | $921.68 | $2,956 | 2.0× |
| Adm tocilizu covid-19 2nd (M0250) | $921.68 | $2,956 | 2.0× |
| Admin hepatitis b vaccine (G0010) range across 2 matching MRF lines |
$31.49–$36.48 | $101–$117 | varies |
| Admin influenza virus vac (G0008) range across 2 matching MRF lines |
$31.49–$36.48 | $101–$117 | varies |
| Admin pneumococcal vaccine (G0009) range across 2 matching MRF lines |
$31.49–$36.48 | $101–$117 | varies |
| Alcohol/sub misuse assess (G2011) | $20.27 | $65 | 0.7× |
| Alcohol/subs interv 15-30mn (G0396) | $38.66 | $124 | 1.0× |
| Alcohol/subs interv >30 min (G0397) | $67.35 | $216 | 0.4× |
| Augmnt alys ch CT img data ild w/cncrnt CT exam (0878T) | $1,232.86 | $3,954 | 1.8× |
| Augmnt alys ch CT img data ild wo cncrnt CT exam (0877T) | $1,232.86 | $3,954 | 1.8× |
| Bia whole body composition assessment w/i&r (0358T) | $50.82 | $163 | 1.7× |
| Brief chkin, 5-10, non-e/m (G2251) | $29.31 | $94 | 2.1× |
| Ca screen;pelvic/breast exam (G0101) | $35.23 | $113 | 0.3× |
| Cardiac mri seg dys strain (C9762) | $870.86 | $2,793 | 1.5× |
| Cardiac mri seg dys stress (C9763) | $870.86 | $2,793 | 1.5× |
| Care manage beh svs 20mins (G0323) | $37.73 | $121 | 1.0× |
| Catheterize for urine spec (P9612) | $5.30 | $17 | 0.6× |
| Chemo extend iv infus w/pump (G0498) | $769.21 | $2,467 | 2.2× |
| Cptrizd oph alys monocular eye mvmt rta eye trck (1010T) | $439.33 | $1,409 | 3.1× |
| CT breast w/3d rendering bi with contrast (0637T) | $675.98 | $2,168 | 1.8× |
| CT breast w/3d rendering bi without contrast (0636T) | $612.69 | $1,965 | 2.4× |
| CT breast w/3d rendering uni with contrast (0634T) | $353.89 | $1,135 | 1.9× |
| CT breast w/3d rendering uni without contrast (0633T) | $290.29 | $931 | 2.6× |
| CT brst w/3d rendering bi wo cntrst flwd cntrst (0638T) | $644.49 | $2,067 | 1.7× |
| CT brst w/3d rendering uni wo cntrst flwd cntrst (0635T) | $322.40 | $1,034 | 1.7× |
| Cyp1a2 gene analysis common variants (0031U) | $276.57 | $887 | 1.6× |
| Cyp2d6 3' gene dup/mlt (0076U) | $573.09 | $1,838 | 1.3× |
| Cyp2d6 5' gene dup/mlt (0075U) | $573.09 | $1,838 | 1.3× |
| Cyp2d6 full gene sequence (0071U) | $762.35 | $2,445 | 1.3× |
| Cyp2d6 gen cyp2d6-2d7 hybrid (0072U) | $573.09 | $1,838 | 1.3× |
| Cyp2d6 gen cyp2d7-2d6 hybrid (0073U) | $573.09 | $1,838 | 1.3× |
| Cyp2d6 nonduplicated gene (0074U) | $573.09 | $1,838 | 1.3× |
| Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater… (0419T) | $1,395.31 | $4,475 | 1.8× |
| Devlopment test interpt&rep (G0451) range across 2 matching MRF lines |
$132.83–$139.37 | $426–$447 | varies |
| Diab manage trn per indiv (G0108) | $49.89 | $160 | 0.9× |
| Diab manage trn ind/group (G0109) | $24.94 | $80 | 1.6× |
| Drug test def 1-7 classes (G0480) range across 91 matching MRF lines |
$19.96–$181.16 | $64–$581 | varies |
| Drug test def 15-21 classes (G0482) | $296.83 | $952 | 1.5× |
| Drug test def 22+ classes (G0483) | $368.55 | $1,182 | 1.5× |
| Drug test def 8-14 classes (G0481) | $247.88 | $795 | 1.6× |
| Drug test def simple all cl (G0659) | $106.95 | $343 | 1.7× |
| ECG algorithmically gen 12 ld rdcd ld trcg only (0904T) | $90.73 | $291 | 1.5× |
| Egd Flx Trnsorl Vol Adjmt Ntrgstr Bariatric Balo (0813T) | $819.72 | $2,629 | 0.9× |
| Elec Alys Cplx Prgrmg Iins Sp/Sac Nrv 4+Param (0789T) range across 2 matching MRF lines |
$177.73–$188.33 | $570–$604 | varies |
| Elec Alys Smpl Prgrmg Iins Sp/Sac Nrv 1-3 Param (0788T) range across 2 matching MRF lines |
$63.92–$177.73 | $205–$570 | varies |
| Elec stim other than wound (G0283) range across 4 matching MRF lines |
$28.06–$75.77 | $90–$243 | varies |
| Elec stim unattend for press (G0281) | $72.34 | $232 | 6.2× |
| Electrophysiologic Eval Icds W/Ss Electrode (0577T) | $508.23 | $1,630 | 0.4× |
| Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) unusually low: confirm this is the full procedure |
$17,569.93 | $56,350 | 0.4× |
| Esw integumentary wound healing initial wound (0512T) | $541.28 | $1,736 | 2.5× |
| Ev Catheter Dir Chem Abltj Incmptnt Xtr Vein (0524T) | $1,264.66 | $4,056 | 0.4× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $10,732.78 | $34,422 | 0.9× |
| Evacuation meibomian glands using heat bilateral (0563T) | $173.98 | $558 | 2.8× |
| Extraction erupted tooth/exr (D7140) | $1,354.46 | $4,344 | 2.0× |
| Extrnl counterpulse, per tx (G0166) | $197.06 | $632 | 1.4× |
| Fecal blood scrn immunoassay (G0328) | $86.68 | $278 | 4.8× |
| Fecal microbiota prep instil (G0455) range across 2 matching MRF lines |
$511.98–$1,467.95 | $1,642–$4,708 | varies |
| Fern test (Q0114) | $15.90 | $51 | 1.6× |
| Group mnt 2 or more 30 mins (G0271) range across 2 matching MRF lines |
$29.93–$30.56 | $96–$98 | varies |
| Group train w/o patient (G0543) range across 8 matching MRF lines |
$115.99–$187.70 | $372–$602 | varies |
| Hbot, full body chamber, 30m (G0277) | $653.22 | $2,095 | 4.5× |
| Histotripsy mal hepatocellular tiss w/img gdn (0686T) likely a partial charge, not the full procedure |
$5,410.04 | $17,351 | 0.3× |
| Home sleep test/type 2 porta (G0398) | $325.21 | $1,043 | 1.4× |
| Home sleep test/type 3 porta (G0399) range across 2 matching MRF lines |
$466.14–$831.26 | $1,495–$2,666 | varies |
| Hopd mntl hlt, 15-29 min (C7900) | $30.56 | $98 | 0.8× |
| Hopd mntl hlt, 30-60 min (C7901) | $62.36 | $200 | 0.6× |
| Hospital outpt clinic visit (G0463) range across 22 matching MRF lines |
$43.03–$749.88 | $138–$2,405 | varies |
| Hpv combo assay ca screen (G0476) | $62.36 | $200 | 1.8× |
| Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) | $61.11 | $196 | 1.4× |
| Initial care training 30 m (G0539) | $69.22 | $222 | 1.3× |
| Initial preventive exam (G0402) | $40.85 | $131 | 0.3× |
| Inj for sacroiliac jt anesth (G0260) range across 6 matching MRF lines |
$1,152.41–$1,729.55 | $3,696–$5,547 | varies |
| Injection posterior chamber eye medication (0699T) | $423.74 | $1,359 | 0.2× |
| Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) | $1,061.06 | $3,403 | 1.1× |
| Insertion of substernal implantable defibrillator electrode (0572T) unusually low: confirm this is the full procedure |
$3,010.74 | $9,656 | 0.3× |
| Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging… (0786T) | $6,365.40 | $20,415 | 0.5× |
| Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging… (0784T) | $6,164.29 | $19,770 | 0.5× |
| Insertion/Replacement Complete Iims (0525T) likely a partial charge, not the full procedure |
$3,830.15 | $12,284 | 0.2× |
| Insertion/Replacement Iims Electrode Only (0526T) unusually low: confirm this is the full procedure |
$3,758.75 | $12,055 | 0.4× |
| Insertion/Replacement Iims Implantable Mntr Only (0527T) unusually low: confirm this is the full procedure |
$4,106.72 | $13,171 | 0.5× |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) likely a partial charge, not the full procedure |
$4,513.62 | $14,476 | 0.1× |
| Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) | $20,324.68 | $65,185 | 2.3× |
| Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) | $20,324.68 | $65,185 | 2.3× |
| Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) likely a partial charge, not the full procedure |
$4,513.62 | $14,476 | 0.2× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) likely a partial charge, not the full procedure |
$3,929.30 | $12,602 | 0.1× |
| Interro Device Evaluation Cardiac Modulj System (0418T) | $103.52 | $332 | 2.6× |
| Interrogation Dev Eval Icds W/Ss Eltrd In Person (0576T) | $70.16 | $225 | 1.8× |
| Interrogation device evaluation in person isdss (0685T) | $280 | $898 | 7.1× |
| Ire Abltj 1+Tum Organ Perq (0600T) | $5,667.28 | $18,176 | 0.5× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) | $238.84 | $766 | 2.0× |
| Lev 1 hosp type b ed visit (G0380) | $139.69 | $448 | 1.8× |
| Lev 2 hosp type b ed visit (G0381) | $226.99 | $728 | 2.3× |
| Lev 3 hosp type b ed visit (G0382) | $408.15 | $1,309 | 2.2× |
| Lev 4 hosp type b ed visit (G0383) | $549.70 | $1,763 | 2.0× |
| Lev 5 hosp type b ed visit (G0384) | $877.72 | $2,815 | 2.0× |
| Liver Dis 10 Assays Serum Algorithm W/Nash (0003M) | $796.03 | $2,553 | 1.6× |
| Mnt subs tx for change dx (G0270) | $28.06 | $90 | 0.9× |
| Motorized ab interno trephination sclera/trab mw (1012T) | $13,638.76 | $43,742 | 3.1× |
| Mra w/cont, abd (C8900) | $675.98 | $2,168 | 1.8× |
| Mra w/cont, chest (C8909) | $675.98 | $2,168 | 1.8× |
| Mra w/cont, lwr ext (C8912) range across 3 matching MRF lines |
$675.98–$1,014.29 | $2,168–$3,253 | varies |
| Mra w/cont, pelvis (C8918) | $675.98 | $2,168 | 1.8× |
| Mra w/o cont, abd (C8901) | $404.09 | $1,296 | 1.6× |
| Mra w/o cont, chest (C8910) | $404.09 | $1,296 | 1.6× |
| Mra w/o cont, lwr ext (C8913) range across 3 matching MRF lines |
$404.09–$605.83 | $1,296–$1,943 | varies |
| Mra w/o cont, pelvis (C8919) | $404.09 | $1,296 | 1.6× |
| Mra w/o fol w/cont, abd (C8902) | $675.98 | $2,168 | 1.8× |
| Mra w/o fol w/cont, chest (C8911) | $675.98 | $2,168 | 1.8× |
| Mra w/o fol w/cont, lwr ext (C8914) range across 3 matching MRF lines |
$404.09–$1,014.29 | $1,296–$3,253 | varies |
| Mra w/o fol w/cont, pelvis (C8920) | $675.98 | $2,168 | 1.8× |
| Mra, w/dye, spinal canal (C8931) | $675.98 | $2,168 | 1.8× |
| Mra, w/dye, upper extremity (C8934) range across 3 matching MRF lines |
$675.98–$1,014.29 | $2,168–$3,253 | varies |
| Mra, w/o dye, spinal canal (C8932) | $404.09 | $1,296 | 1.6× |
| Mra, w/o dye, upper extr (C8935) range across 3 matching MRF lines |
$404.09–$605.83 | $1,296–$1,943 | varies |
| Mra, w/o&w/dye, spinal canal (C8933) | $675.98 | $2,168 | 1.8× |
| Mra, w/o&w/dye, upper extr (C8936) range across 3 matching MRF lines |
$675.98–$1,014.29 | $2,168–$3,253 | varies |
| Mri w/cont, breast, bi (C8906) | $675.98 | $2,168 | 1.8× |
| Mri w/cont, breast, uni (C8903) | $353.89 | $1,135 | 1.9× |
| Mri w/o fol w/cont, breast, (C8908) | $1,908.84 | $6,122 | 5.2× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,272.46 | $4,081 | 3.4× |
| N-invas artl plaq alys quan strux&compos vsl wal (0712T) | $261.60 | $839 | 1.1× |
| N-invas augmnt arrhyt alys (0897T) | $2,325.40 | $7,458 | 2.6× |
| N-Invas Detcj Heart Failure Drv Augmnt Alys Echo (0932T) | $355.76 | $1,141 | 1.1× |
| Neuro csf prion prtn qual (0035U) | $512.60 | $1,644 | 0.9× |
| Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) | $1,061.06 | $3,403 | 1.1× |
| Njx platelet plasma (0232T) | $348.59 | $1,118 | 0.7× |
| No pt prsnt train initial 30 (G0541) range across 2 matching MRF lines |
$69.22–$149.98 | $222–$481 | varies |
| Obtaining screen pap smear (Q0091) | $38.04 | $122 | 1.2× |
| Onc merkel cell carc detcj antb serum reprtd +/- (0059U) | $446.19 | $1,431 | 1.4× |
| Onc Merkel Cll Carc Srm Quan (0058U) | $454.29 | $1,457 | 1.4× |
| Onc prst8 mrna gen xprs prfl 17 gen alg rsk scor (0047U) | $4,921.76 | $15,785 | 1.3× |
| Onc thyr 10 microrna seq +/- rslt mod hi rsk mal (0018U) | $4,146.32 | $13,298 | 1.4× |
| Onc Thyr Dna&Mrna 112 Genes Fna Ndul Alg Alys (0026U) | $4,971.96 | $15,946 | 1.4× |
| Oth resp proc, group (G0239) | $161.82 | $519 | 4.1× |
| Oth resp proc, indiv (G0238) | $112.56 | $361 | 3.7× |
| Pathogen test for platelets (P9100) | $40.85 | $131 | 0.7× |
| Pattern erg w/i&r (0509T) | $315.85 | $1,013 | 1.4× |
| Pemivibart infusion (M0224) | $940.70 | $3,017 | 2.0× |
| Perc d-e cor revasc chro sin (C9607) range across 10 matching MRF lines |
$9,843.21–$12,303.32 | $31,569–$39,459 | varies |
| Perc d-e cor revasc t cabg s (C9604) range across 5 matching MRF lines |
$8,559.22–$10,699.73 | $27,451–$34,316 | varies |
| Perc d-e cor stent ather s (C9602) range across 5 matching MRF lines |
$8,559.22–$9,842.90 | $27,451–$31,568 | varies |
| Perc drug-el cor stent sing (C9600) range across 5 matching MRF lines |
$9,843.21–$12,303.32 | $31,569–$39,459 | varies |
| Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart… (0632T) unusually low: confirm this is the full procedure |
$7,223.78 | $23,168 | 0.4× |
| Perq njx algc cell &/prdct uni/bi fluor lmbr 1st (0627T) | $14,912.46 | $47,827 | 1.1× |
| Perq njx algc cell&/prdct uni/bi CT lmbr 1st (0629T) | $14,912.46 | $47,827 | 1.1× |
| Perq Sacral Augmt Bilat Inj (0201T) unusually low: confirm this is the full procedure |
$2,305.14 | $7,393 | 0.3× |
| Perq Sacral Augmt Unilat Inj (0200T) likely a partial charge, not the full procedure |
$1,152.41 | $3,696 | 0.2× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) | $12,303.32 | $39,459 | 1.0× |
| Place device/marker, non pro (C9728) | $530.68 | $1,702 | 0.4× |
| Place endorectal app (C9725) | $2,836.76 | $9,098 | 2.9× |
| Post op service lvrs min 6 (G0305) | $2,245.58 | $7,202 | 5.7× |
| Ppps, initial visit (G0438) range across 8 matching MRF lines |
$72.65–$124.72 | $233–$400 | varies |
| Ppps, subseq visit (G0439) range across 14 matching MRF lines |
$57.06–$110.07 | $183–$353 | varies |
| Pre-op service lvrs 1-9 dos (G0304) | $1,621.05 | $5,199 | 4.1× |
| Pre-op service lvrs 10-15dos (G0303) | $1,122.79 | $3,601 | 4.9× |
| Pre-op service lvrs complete (G0302) | $934.78 | $2,998 | 2.4× |
| Prgrmg dev eval ldls pm single car chamber ip (0826T) | $334.56 | $1,073 | 8.5× |
| Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) | $334.56 | $1,073 | 8.5× |
| Programming dev eval icds w/ss eltrd in person (0575T) | $149.04 | $478 | 3.8× |
| Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of… (0683T) | $300.26 | $963 | 7.6× |
| Prostate biopsy, any mthd (G0416) range across 2 matching MRF lines |
$82.32–$451.17 | $264–$1,447 | varies |
| Psa screening (G0103) | $33.05 | $106 | 1.7× |
| Qmrcp W/Diagnostic MRI Same Anatomy (0724T) | $760.17 | $2,438 | 0.8× |
| Qmrcp W/O Diagnostic MRI Sm Anatomy Drg Sm Sess (0723T) | $760.17 | $2,438 | 0.8× |
| Qtc interval augmnt alg alys xtrnl mobile ECG (0902T) | $928.85 | $2,979 | 6.6× |
| Quan CT tiss charac i&r w/cncrnt CT exam (0722T) | $1,232.86 | $3,954 | 1.8× |
| Quan CT tiss charac w/o CT (0721T) | $1,232.86 | $3,954 | 1.8× |
| Quan mr alys tiss compj w/o MRI same sess 1orgn (0648T) | $760.17 | $2,438 | 0.8× |
| Quan mr alys tiss composition w/MRI 1orgn (0649T) | $760.17 | $2,438 | 0.8× |
| Quan mr alys tiss composition w/MRI mlt organs (0698T) | $353.89 | $1,135 | 0.4× |
| Quan MRI alys brain w/o diagnostic MRI same sess (0865T) | $187.39 | $601 | 0.7× |
| Quan MRI alys brain with diagnostic MRI (0866T) | $187.39 | $601 | 0.7× |
| Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) | $4,284.13 | $13,740 | 2.0× |
| Relocation pg wcs lv pacg battery component only (0862T) | $2,824.91 | $9,060 | 1.3× |
| Relocation pg wcs lv pacg transmittr compnt only (0863T) | $2,824.91 | $9,060 | 1.3× |
| Remot img sub by pt, non e/m (G2250) | $20.89 | $67 | 1.6× |
| Removal pg wcs lv pacing both components (0861T) | $1,840.24 | $5,902 | 0.5× |
| Removal Ss Dfb Electrode (0573T) | $2,907.85 | $9,326 | 0.7× |
| Repos Cardiac Modulj Transvenous Electrode (0415T) | $2,618.50 | $8,398 | 3.9× |
| Repos prev impl ss impltbl dfb pacing eltrd (0574T) | $2,722.95 | $8,733 | 0.7× |
| Revasc intra lithotrip-ather (C9766) | $10,732.78 | $34,422 | 0.6× |
| Revasc intra lithotrip-stent (C9765) | $10,732.78 | $34,422 | 0.6× |
| Revasc intravasc lithotripsy (C9764) | $9,953.28 | $31,922 | 0.8× |
| Revasc lith-sten-ath tib/per (C9775) | $15,978.50 | $51,246 | 0.8× |
| Revasc lithotr-ather tib/per (C9774) range across 2 matching MRF lines |
$10,083.30–$10,146.60 | $32,339–$32,542 | varies |
| Revasc lithotr-stent tib/per (C9773) range across 2 matching MRF lines |
$10,146.60–$15,978.50 | $32,542–$51,246 | varies |
| Revasc lithotrip tibi/perone (C9772) range across 2 matching MRF lines |
$10,083.30–$10,640.80 | $32,339–$34,127 | varies |
| Revasc lithotrip-stent-ather (C9767) | $15,978.50 | $51,246 | 0.8× |
| Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator (0787T) | $1,657.53 | $5,316 | 0.4× |
| Revj/Rmvl Nstim Eltrd Ra Spi W/Integrated Nstim (0785T) | $1,657.53 | $5,316 | 0.4× |
| Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) likely a partial charge, not the full procedure |
$4,513.62 | $14,476 | 0.2× |
| Rmvl Car Modulj Tranvns Elt (0413T) | $7,556.78 | $24,236 | 1.9× |
| Rmvl Cardiac Modulj Pls Gen (0412T) | $7,556.78 | $24,236 | 1.9× |
| Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) | $1,840.24 | $5,902 | 0.5× |
| Rmvl&Rplcmt Substernal Impltbl Defibrillator Pg (0614T) | $13,251.19 | $42,499 | 0.6× |
| Safety plan interven (G0560) | $34.92 | $112 | 0.8× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $46.46 | $149 | 1.8× |
| Screen cerv/vag thin layer (G0123) | $36.17 | $116 | 1.8× |
| Screen pap by tech w md supv (P3000) | $24.01 | $77 | 1.3× |
| Semen analysis (G0027) | $12.16 | $39 | 1.9× |
| Sim ang w/prs cath rad emb (C8004) | $7,845.82 | $25,163 | 0.6× |
| Tcat implt wrls l atr prs snr l-t l atr prs mntr (0933T) | $10,050.87 | $32,235 | 2.9× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) likely a partial charge, not the full procedure |
$5,457.12 | $17,502 | 0.3× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) likely a partial charge, not the full procedure |
$5,509.82 | $17,671 | 0.3× |
| Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) likely a partial charge, not the full procedure |
$5,509.82 | $17,671 | 0.3× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) likely a partial charge, not the full procedure |
$5,509.82 | $17,671 | 0.3× |
| Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) | $613.62 | $1,968 | 0.2× |
| Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) | $901.73 | $2,892 | 0.3× |
| Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) | $901.73 | $2,892 | 0.3× |
| Tcat Rmvl Perm Dual Chamber Ldls Pm Compl Sys (0798T) | $901.73 | $2,892 | 0.3× |
| Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) unusually low: confirm this is the full procedure |
$6,177.38 | $19,812 | 0.3× |
| Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T) likely a partial charge, not the full procedure |
$5,509.82 | $17,671 | 0.3× |
| Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) likely a partial charge, not the full procedure |
$5,509.82 | $17,671 | 0.3× |
| Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) likely a partial charge, not the full procedure |
$5,509.82 | $17,671 | 0.3× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $4,766.17 | $15,286 | 0.8× |
| Tee w or w/o fol w/cont,cong (C8926) | $1,143.37 | $3,667 | 1.4× |
| Therapeutic procd strg endur (G0237) | $112.56 | $361 | 3.7× |
| Tomosynthesis, mammo (G0279) | $67.04 | $215 | 5.3× |
| Tpmt and Nudt15 Genotype (0034U) | $737.41 | $2,365 | 1.6× |
| Trabeculostomy ab interno by laser (0621T) | $202.67 | $650 | 0.0× |
| Train for caregiver add 15 (G0540) | $31.80 | $102 | 1.2× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $4,406.98 | $14,134 | 0.7× |
| Transcatheter renal sympath denervation unilat (0338T) | $4,406.98 | $14,134 | 0.7× |
| Trauma respons w/hosp criti (G0390) range across 4 matching MRF lines |
$3,379.60–$10,799.82 | $10,839–$34,637 | varies |
| Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) | $4,833.84 | $15,503 | 1.4× |
| Trim nail(s) (G0127) | $88.86 | $285 | 1.4× |
| Trluml perip athrc abd aorta (0236T) unusually low: confirm this is the full procedure |
$5,468.35 | $17,538 | 0.4× |
| Trluml Perip Athrc Brchiocph (0237T) | $8,505.90 | $27,280 | 0.7× |
| Trluml Perip Athrc Iliac Art (0238T) likely a partial charge, not the full procedure |
$3,914.65 | $12,555 | 0.2× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $8,741.31 | $28,035 | 0.7× |
| Tte w or w/o contr, cont ecg (C8930) range across 2 matching MRF lines |
$1,215.71–$1,621.05 | $3,899–$5,199 | varies |
| Tte w or w/o fol w/con,stres (C8928) | $964.09 | $3,092 | 1.2× |
| Tte w or w/o fol w/cont, com (C8921) | $1,418.07 | $4,548 | 1.7× |
| Tte w or w/o fol w/cont, f/u (C8922) | $1,023.02 | $3,281 | 1.2× |
| Tte w or wo fol wcon,doppler (C8929) | $1,102.52 | $3,536 | 1.3× |
| Unsched dialysis esrd pt hos (G0257) | $201.73 | $647 | 0.3× |
| Vasc emb/occ w/prs cath (C9797) | $10,073.63 | $32,308 | 0.5× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.