Supplies, drugs & other prices at Inova Mount Vernon Hospital

Alexandria, VA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $44.50 $89 1.2×
2d tee w or w/o fol w/con,in (C8925) $3,106.50 $6,213 3.7×
2d tte w or w/o fol w/con,co (C8923) $3,106.50 $6,213 3.7×
2d tte w or w/o fol w/con,fu (C8924) $2,195 $4,390 5.8×
Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T) $11,019 $22,038 2.6×
Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) $2,933.50 $5,867 1.4×
Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T) $7,681.50 $15,363 0.8×
Adm tocilizu covid-19 1st (M0249) $728.50 $1,457 1.5×
Adm tocilizu covid-19 2nd (M0250) $728.50 $1,457 1.5×
Admin hepatitis b vaccine (G0010) $17 $34 0.3×
Admin influenza virus vac (G0008) $22 $44 0.4×
Admin pneumococcal vaccine (G0009) $22 $44 0.4×
Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific… (1025T) $218.50 $437 1.5×
Autolog prp not diab ulcer (G0460) $2,517.50 $5,035 1.1×
Bdy surf activation mapg pm/cvdfb leads tm f/up (0696T) $39 $78 1.0×
Ca screen;pelvic/breast exam (G0101) $116 $232 1.1×
Cardiac mri seg dys stress (C9763) $716 $1,432 1.2×
Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s) Non-Facility… (0637T) $2,046.50 $4,093 5.4×
Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast material(s)… (0636T) $1,237 $2,474 4.8×
Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by contrast… (0638T) $2,046.50 $4,093 5.4×
Computed tomography, breast, including 3D rendering, when performed, unilateral; with contrast material(s) Non-Facility… (0634T) $562.50 $1,125 3.0×
Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material Non-Facility… (0633T) $343.50 $687 3.0×
Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast, followed by contrast… (0635T) $562.50 $1,125 3.0×
Comt gene analysis c.472g>a variant (0032U) $497.50 $995 2.8×
Covid-19 lab test non-cdc (U0002) $122 $244 2.4×
Diab manage trn per indiv (G0108) $143 $286 2.6×
Diab manage trn ind/group (G0109) $79 $158 4.9×
Direct refer hospital observ (G0379) $395 $790 0.6×
Drug test def 1-7 classes (G0480) $403 $806 3.5×
Drug test def 15-21 classes (G0482) $875.50 $1,751 4.4×
Drug test def 22+ classes (G0483) $1,087.50 $2,175 4.4×
Drug test def 8-14 classes (G0481) $621 $1,242 4.0×
Elec stim other than wound (G0283) $120 $240 9.5×
Elec stim unattend for press (G0281) $190 $380 16.3×
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) $62,596.50 $125,193 1.3×
Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein, open or… (0524T) $5,250.75 $10,501.50 1.5×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $17,084.50 $34,169 1.4×
Extrnl counterpulse, per tx (G0166) $768 $1,536 5.3×
Fecal blood scrn immunoassay (G0328) $71.50 $143 4.0×
Fecal microbiota prep instil (G0455) $493 $986 0.5×
Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume greater or equal to… (0072T) $15,884.50 $31,769 4.5×
Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume less than 200 cc of… (0071T) $15,884.50 $31,769 4.5×
Hbot, full body chamber, 30m (G0277) $901.50 $1,803 6.0×
Home sleep test/type 3 porta (G0399) $932.50 $1,865 4.0×
Home sleep test/type 4 porta (G0400) $593 $1,186 2.5×
Hopd mntl hlt, 15-29 min (C7900) $53 $106 1.3×
Hopd mntl hlt, 30-60 min (C7901) $135 $270 1.2×
Hopd mntl hlt, grp (C7903) $49 $98 1.2×
Hospital outpt clinic visit (G0463) $154 $308 1.1×
Ig paraprotein qual bld/ur (0077U) $65 $130 1.5×
Iliac Atherectomy (0238T) $14,892.50 $29,785 0.7×
Inj for sacroiliac jt anesth (G0260) $1,022 $2,044 1.3×
Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) $6,228 $12,456 6.5×
Insertion of substernal implantable defibrillator electrode (0572T) $13,101.50 $26,203 1.5×
Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming,… (0517T) $9,813 $19,626 0.9×
Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial… (0526T) $9,813 $19,626 1.1×
Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial… (0525T) $13,091.50 $26,183 0.6×
Insertion wrls car stimulator lv pacg compl sys (0515T) $29,150 $58,300 1.2×
Insertion/replacement iims implantable mntr only (0527T) $9,813 $19,626 1.1×
Insj Wcs Lv Eltrd Only (0516T) $9,813 $19,626 0.9×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $59,854.50 $119,709 1.8×
Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) $21,179 $42,358 2.4×
Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) $21,179 $42,358 2.4×
Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) $59,854.50 $119,709 2.5×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $49,379 $98,758 1.5×
Interro Device Evaluation Cardiac Modulj System (0418T) $70 $140 1.7×
Interrog dev eval wcs ip (0521T) $17.50 $35 0.6×
Ire Ablation 1+Tumors per Organ W/Img Gdn Perq (0600T) $17,286 $34,572 1.5×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) $515 $1,030 4.2×
Liver Dis 10 Assays W/Nash (0003M) $1,150.50 $2,301 2.3×
Mra w/cont, abd (C8900) $776 $1,552 2.1×
Mra w/cont, chest (C8909) $776 $1,552 2.1×
Mra w/cont, lwr ext (C8912) $776 $1,552 2.1×
Mra w/cont, pelvis (C8918) $776 $1,552 2.1×
Mra w/o cont, abd (C8901) $730 $1,460 2.8×
Mra w/o cont, chest (C8910) $730 $1,460 2.8×
Mra w/o cont, lwr ext (C8913) $730 $1,460 2.8×
Mra w/o cont, pelvis (C8919) $730 $1,460 2.8×
Mra w/o fol w/cont, abd (C8902) $1,058.50 $2,117 2.8×
Mra w/o fol w/cont, chest (C8911) $1,058.50 $2,117 2.8×
Mra w/o fol w/cont, lwr ext (C8914) $1,058.50 $2,117 2.8×
Mra w/o fol w/cont, pelvis (C8920) $1,110 $2,220 2.9×
Mra, w/dye, upper extremity (C8934) $774 $1,548 2.0×
Mra, w/o dye, upper extr (C8935) $715.50 $1,431 2.8×
Mra, w/o&w/dye, spinal canal (C8933) $715 $1,430 1.9×
Mra, w/o&w/dye, upper extr (C8936) $864 $1,728 2.3×
Neuro csf prion prtn qual (0035U) $802 $1,604 1.5×
Nfct ds bact&fng org id bld cul rrna fish 6+trgt (0086U) $474 $948 2.4×
Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) $6,228 $12,456 6.5×
Obtaining screen pap smear (Q0091) $45.50 $91 1.5×
Onc aml DNA gntyp int tandem dup detcj/nondetcj (0023U) $644.50 $1,289 2.6×
Oth resp proc, group (G0239) $137 $274 3.4×
Oth resp proc, indiv (G0238) $137 $274 4.4×
Pathogen test for platelets (P9100) $115.50 $231 1.8×
Pattern erg w/i&r (0509T) $265.50 $531 1.1×
Pemivibart infusion (M0224) $709 $1,418 1.5×
Perc d-e cor revasc chro sin (C9607) $17,162.50 $34,325 0.9×
Perc d-e cor revasc t cabg s (C9604) $17,162.50 $34,325 1.4×
Perc d-e cor stent ather s (C9602) $17,162.50 $34,325 0.9×
Perc drug-el cor stent sing (C9600) $21,200.50 $42,401 1.7×
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0629T) $27,672.50 $55,345 2.0×
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) $27,672.50 $55,345 2.0×
Perq Sacral Augmt Bilat Inj (0201T) $7,380 $14,760 0.9×
Perq Sacral Augmt Unilat Inj (0200T) $10,450.50 $20,901 1.3×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $9,477.50 $18,955 0.8×
Place device/marker, non pro (C9728) $5,246 $10,492 3.5×
Post op service lvrs min 6 (G0305) $1,616.50 $3,233 4.0×
Pre-op service lvrs 1-9 dos (G0304) $1,691 $3,382 4.2×
Pre-op service lvrs 10-15dos (G0303) $3,720 $7,440 15.9×
Pre-op service lvrs complete (G0302) $5,072 $10,144 12.5×
Prgrmg dev eval wcs ip (0522T) $36 $72 0.9×
Prgrmg Device Evaluation Cardiac Modulj System (0417T) $70 $140 1.7×
Prostate biopsy, any mthd (G0416) $1,397 $2,794 3.6×
Psa screening (G0103) $118.50 $237 6.1×
Quan MRI alys brain with diagnostic MRI (0866T) $363.50 $727 1.4×
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) $1,197.50 $2,395 1.7×
Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) $4,456 $8,912 2.0×
Removal Cardiac Modulj Sys Pls Generator Only (0412T) $7,224 $14,448 1.8×
Removal Cardiac Modulj Sys Transvenous Electrode (0413T) $8,937.50 $17,875 2.2×
Removal complete iims (0530T) $4,148.50 $8,297 1.0×
Removal iims electrode only (0531T) $3,976.50 $7,953 1.0×
Removal iims implt mntr only (0532T) $3,976.50 $7,953 1.0×
Repos Cardiac Modulj Transvenous Electrode (0415T) $1,406.50 $2,813 2.1×
Revasc intra lithotrip-ather (C9766) $17,228.50 $34,457 0.9×
Revasc intra lithotrip-stent (C9765) $18,060 $36,120 0.9×
Revasc intravasc lithotripsy (C9764) $9,663 $19,326 0.8×
Revasc lith-sten-ath tib/per (C9775) $20,865.50 $41,731 1.0×
Revasc lithotr-ather tib/per (C9774) $20,865.50 $41,731 1.0×
Revasc lithotr-stent tib/per (C9773) $20,865.50 $41,731 1.0×
Revasc lithotrip tibi/perone (C9772) $13,045 $26,090 1.0×
Revasc lithotrip-stent-ather (C9767) $20,865.50 $41,731 1.0×
Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) $59,854.50 $119,709 2.5×
Scr c/v cyto,thinlayer,rescr (G0144) $115 $230 2.6×
Scr c/v cyto,thinlayer,rescr (G0145) $143 $286 5.4×
Screen cerv/vag thin layer (G0123) $108.50 $217 5.4×
Screen pap by tech w md supv (P3000) $78.50 $157 4.2×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $29,245.50 $58,491 1.4×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $29,245.50 $58,491 1.4×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $29,245.50 $58,491 1.4×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $29,245.50 $58,491 1.4×
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $4,982.50 $9,965 1.5×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $6,438.50 $12,877 1.0×
Tee w or w/o fol w/cont,cong (C8926) $2,187 $4,374 2.6×
Therapeutic procd strg endur (G0237) $137 $274 4.4×
Tomosynthesis, mammo (G0279) $86.50 $173 6.8×
Tpmt nudt15 gene analysis common variants (0034U) $470.50 $941 1.0×
Transcatheter Renal Sympath Denervation Bilat (0339T) $13,443 $26,886 2.2×
Transcatheter renal sympath denervation unilat (0338T) $9,522.50 $19,045 1.5×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $14,274.50 $28,549 1.1×
Trauma respons w/hosp criti (G0390) $7,552.25 $15,104.50 5.2×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $14,274.50 $28,549 1.1×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $14,274.50 $28,549 1.1×
Tte w or w/o contr, cont ecg (C8930) $3,082 $6,164 3.6×
Tte w or w/o fol w/con,stres (C8928) $2,187 $4,374 2.6×
Tte w or w/o fol w/cont, com (C8921) $3,062 $6,124 3.6×
Tte w or w/o fol w/cont, f/u (C8922) $2,180.50 $4,361 2.6×
Tte w or wo fol wcon,doppler (C8929) $3,082 $6,164 3.6×
Visit to determ ldct elig (G0296) $50.50 $101 0.5×