Supplies, drugs & other prices at Jefferson Community Health & Life
Fairbury, NE · every code in this section with a posted price and a Medicare benchmark.
10 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin hepatitis b vaccine (G0010) | $27 | $36 | 0.6× |
| Admin influenza virus vac (G0008) | $27 | $36 | 0.6× |
| Admin pneumococcal vaccine (G0009) | $27 | $36 | 0.6× |
| Ca screen;pelvic/breast exam (G0101) | $53.25 | $71 | 0.5× |
| Depression screen annual (G0444) | $24.75 | $33 | 0.6× |
| Hepb screen high risk indiv (G0499) | $62.25 | $83 | 2.2× |
| Initial preventive exam (G0402) | $234 | $312 | 1.7× |
| Obtaining screen pap smear (Q0091) | $54 | $72 | 1.8× |
| Ppps, initial visit (G0438) | $232.50 | $310 | 1.3× |
| Ppps, subseq visit (G0439) | $168.75 | $225 | 1.2× |