Supplies, drugs & other prices at Iredell Memorial Hospital
Statesville, NC · every code in this section with a posted price and a Medicare benchmark.
57 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $605.30 | $2,241.85 | 0.8× |
| 2d tte w or w/o fol w/con,fu (C8924) | $549.45 | $2,035 | 1.6× |
| Admin hepatitis b vaccine (G0010) | $5 | $18.54 | 0.1× |
| Admin influenza virus vac (G0008) | $9.70 | $35.91 | 0.2× |
| Admin pneumococcal vaccine (G0009) | $44.82 | $166 | 1.0× |
| Catheterize for urine spec (P9612) | $5.29 | $19.60 | 0.6× |
| Chemo extend iv infus w/pump (G0498) | $93.09 | $344.76 | 0.3× |
| Diab manage trn per indiv (G0108) | $17.28 | $64 | 0.3× |
| Diab manage trn ind/group (G0109) | $12.69 | $47 | 0.8× |
| Direct refer hospital observ (G0379) | $405 | $1,500 | 0.7× |
| Drug test def 1-7 classes (G0480) | $65.88 | $244 | 0.6× |
| Elec stim other than wound (G0283) | $47.25 | $175 | 3.7× |
| Fecal microbiota prep instil (G0455) | $2,288.25 | $8,475 | 2.5× |
| Group mnt 2 or more 30 mins (G0271) | $11.23 | $41.60 | 0.7× |
| Hbot, full body chamber, 30m (G0277) | $123.12 | $456 | 0.9× |
| Hospital outpt clinic visit (G0463) | $56.43 | $209 | 0.4× |
| Inj for sacroiliac jt anesth (G0260) | $643.14 | $2,382 | 0.9× |
| Mnt subs tx for change dx (G0270) | $12.80 | $47.40 | 0.4× |
| Mra w/cont, abd (C8900) | $636.37 | $2,356.92 | 1.9× |
| Mra w/cont, chest (C8909) | $634.76 | $2,350.95 | 1.9× |
| Mra w/cont, lwr ext (C8912) | $679.19 | $2,515.50 | 2.0× |
| Mra w/cont, pelvis (C8918) | $907.23 | $3,360.10 | 2.7× |
| Mra w/o cont, abd (C8901) | $704.58 | $2,609.57 | 3.0× |
| Mra w/o cont, chest (C8910) | $738.71 | $2,735.95 | 3.2× |
| Mra w/o cont, lwr ext (C8913) | $634.76 | $2,350.95 | 2.7× |
| Mra w/o cont, pelvis (C8919) | $634.77 | $2,351 | 2.7× |
| Mra w/o fol w/cont, abd (C8902) | $721.71 | $2,673 | 2.1× |
| Mra w/o fol w/cont, chest (C8911) | $770.53 | $2,853.81 | 2.3× |
| Mra w/o fol w/cont, lwr ext (C8914) | $644.22 | $2,386 | 1.9× |
| Mra w/o fol w/cont, pelvis (C8920) | $726.43 | $2,690.49 | 2.1× |
| Mra, w/dye, upper extremity (C8934) | $761.74 | $2,821.25 | 2.2× |
| Mra, w/o dye, upper extr (C8935) | $745.23 | $2,760.10 | 3.2× |
| Mra, w/o&w/dye, upper extr (C8936) | $842.31 | $3,119.65 | 2.5× |
| Mri w/cont, breast, bi (C8906) | $601.76 | $2,228.75 | 1.8× |
| Mri w/cont, breast, uni (C8903) | $547.29 | $2,027 | 3.2× |
| Mri w/o fol w/cont, brst, un (C8905) | $607.30 | $2,249.27 | 1.8× |
| Oth resp proc, group (G0239) | $31.32 | $116 | 0.9× |
| Oth resp proc, indiv (G0238) | $41.67 | $154.32 | 1.5× |
| Perc d-e cor revasc chro sin (C9607) unusually low: confirm this is the full procedure |
$8,848.17 | $32,771 | 0.5× |
| Perc d-e cor revasc t cabg s (C9604) unusually low: confirm this is the full procedure |
$5,284.98 | $19,574 | 0.5× |
| Perc d-e cor stent ather s (C9602) unusually low: confirm this is the full procedure |
$8,674.56 | $32,128 | 0.5× |
| Perc drug-el cor stent sing (C9600) | $7,425 | $27,500 | 0.7× |
| Place device/marker, non pro (C9728) | $1,620 | $6,000 | 1.2× |
| Prostate biopsy, any mthd (G0416) | $223 | $825.92 | 0.6× |
| Psa screening (G0103) | $63.18 | $234 | 3.3× |
| Real-time fluorescence wound imaging with clinical darkness, to identify location of bacterial wound pathogens and… (0598T) | $287.28 | $1,064 | 1.4× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $16,200 | $60,000 | 0.9× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) | $18,900 | $70,000 | 1.0× |
| Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) | $18,900 | $70,000 | 1.0× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $18,900 | $70,000 | 1.0× |
| Therapeutic procd strg endur (G0237) | $39.42 | $146 | 1.4× |
| Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) unusually low: confirm this is the full procedure |
$5,173.20 | $19,160 | 0.5× |
| Trluml Perip Athrc Renal Art (0234T) unusually low: confirm this is the full procedure |
$5,173.20 | $19,160 | 0.5× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) unusually low: confirm this is the full procedure |
$5,173.20 | $19,160 | 0.5× |
| Trluml peripheral atherectomy iliac artery ea (0238T) likely a partial charge, not the full procedure |
$5,173.20 | $19,160 | 0.3× |
| Tte w or w/o fol w/con,stres (C8928) | $549.45 | $2,035 | 0.7× |
| Unsched dialysis esrd pt hos (G0257) | $677.97 | $2,511 | 1.0× |