Supplies, drugs & other prices at Iowa Specialty Hospital - Belmond
Belmond, IA · every code in this section with a posted price and a Medicare benchmark.
47 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2019-ncov diagnostic p (U0001) | $469.20 | $782 | 13.1× |
| Adm of soc dtr assess 5-15 m (G0136) | $26.40 | $44 | 0.7× |
| Admin hepatitis b vaccine (G0010) | $44.40 | $74 | 1.0× |
| Admin influenza virus vac (G0008) | $44.40 | $74 | 1.0× |
| Admin pneumococcal vaccine (G0009) | $44.40 | $74 | 1.0× |
| Annual alcohol screen 15 min (G0442) | $24 | $40 | 0.7× |
| Antibody treponema pallidum total & rpr ia qual (0064U) | $87 | $145 | 2.8× |
| Behavior counsel obesity 15m (G0447) | $35.40 | $59 | 0.4× |
| Bia whole body composition assessment w/i&r (0358T) | $24 | $40 | 0.9× |
| Ca screen;flexi sigmoidscope (G0104) | $672.60 | $1,121 | 0.8× |
| Ca screen;pelvic/breast exam (G0101) | $52.80 | $88 | 0.5× |
| Colon ca scrn not hi rsk ind (G0121) | $672.60 | $1,121 | 0.8× |
| Colorectal scrn; hi risk ind (G0105) | $771 | $1,285 | 0.9× |
| Covid-19 lab test non-cdc (U0002) range across 2 matching MRF lines |
$141.60–$469.20 | $236–$782 | varies |
| Cysto, litho, vacuum kidney (C9761) | $12,000 | $20,000 | 1.3× |
| Depression screen annual (G0444) | $24 | $40 | 0.7× |
| Diab manage trn per indiv (G0108) | $102.60 | $171 | 1.8× |
| Diab manage trn ind/group (G0109) | $57.60 | $96 | 3.6× |
| Direct refer hospital observ (G0379) | $514.20 | $857 | 0.9× |
| Drug test def 1-7 classes (G0480) range across 6 matching MRF lines |
$44.40–$225 | $74–$375 | varies |
| Drug test def 15-21 classes (G0482) | $446.40 | $744 | 2.2× |
| Drug test def 22+ classes (G0483) | $441 | $735 | 1.8× |
| Drug test def 8-14 classes (G0481) | $315.60 | $526 | 2.0× |
| Ekg tracing for initial prev (G0404) | $96.60 | $161 | 3.5× |
| Followup eval of foot pt lop (G0246) | $54 | $90 | 0.4× |
| Group mnt 2 or more 30 mins (G0271) | $46.20 | $77 | 2.7× |
| Home sleep test/type 3 porta (G0399) range across 2 matching MRF lines |
$114–$622.80 | $190–$1,038 | varies |
| Home sleep test/type 4 porta (G0400) | $568.80 | $948 | 2.7× |
| Hospital outpt clinic visit (G0463) | $160.20 | $267 | 1.3× |
| Initial foot exam pt lops (G0245) | $88.20 | $147 | 0.7× |
| Initial preventive exam (G0402) | $165 | $275 | 1.3× |
| Inj for sacroiliac jt anesth (G0260) | $315 | $525 | 0.5× |
| Intens behave ther cardio dx (G0446) | $34.80 | $58 | 1.0× |
| Mnt subs tx for change dx (G0270) | $52.80 | $88 | 1.7× |
| Njx bone sub matrl into subchondral bone defect (0707T) | $4,802.40 | $8,004 | 1.5× |
| Obtaining screen pap smear (Q0091) | $30 | $50 | 1.1× |
| Oth resp proc, group (G0239) | $136.20 | $227 | 3.8× |
| Oth resp proc, indiv (G0238) | $94.20 | $157 | 3.4× |
| Ppps, initial visit (G0438) | $215.40 | $359 | 1.2× |
| Ppps, subseq visit (G0439) | $178.80 | $298 | 1.3× |
| Prostate biopsy, any mthd (G0416) | $3,090 | $5,150 | 9.0× |
| Psa screening (G0103) | $133.20 | $222 | 6.9× |
| Routine footcare pt w lops (G0247) | $97.20 | $162 | 0.5× |
| Therapeutic procd strg endur (G0237) range across 2 matching MRF lines |
$96.60–$97.20 | $161–$162 | varies |
| Tomosynthesis, mammo (G0279) | $57.60 | $96 | 4.5× |
| Trauma respons w/hosp criti (G0390) | $4,360.80 | $7,268 | 3.4× |
| Trim nail(s) (G0127) | $38.40 | $64 | 0.7× |
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.