Supplies, drugs & other prices at Jefferson Davis Community Hospital

Prentiss, MS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Admin hepatitis b vaccine (G0010) $49.55 $141.57 1.2×
Admin influenza virus vac (G0008) $49.98 $142.78 1.2×
Admin pneumococcal vaccine (G0009) $49.98 $142.78 1.2×
Autolog prp not diab ulcer (G0460) $567.92 $1,622.61 0.3×
Catheterize for urine spec (P9612) $134.68 $384.78 14.4×
Diab manage trn per indiv (G0108) $39.39 $112.53 0.7×
Diab manage trn ind/group (G0109) $15.25 $43.56 1.0×
Direct refer hospital observ (G0379) $322.29 $920.81 0.6×
Elec stim other than wound (G0283) $41.08 $117.37 3.2×
Fecal microbiota prep instil (G0455) $144.42 $412.61 0.2×
Hbot, full body chamber, 30m (G0277) $241.40 $689.70 2.0×
Hospital outpt clinic visit (G0463) $126.21 $360.58 1.1×
Inj for sacroiliac jt anesth (G0260) $396.82 $1,133.77 0.7×
Mra w/cont, abd (C8900) $1,137.53 $3,250.06 3.8×
Mra w/cont, lwr ext (C8912) $1,217.57 $3,478.75 4.0×
Mra w/cont, pelvis (C8918) $1,035.89 $2,959.66 3.4×
Mra w/o cont, abd (C8901) $1,096.45 $3,132.69 5.3×
Mra w/o cont, chest (C8910) $575.96 $1,645.60 2.8×
Mra w/o cont, lwr ext (C8913) $1,156.58 $3,304.51 5.6×
Mra w/o cont, pelvis (C8919) $1,062.14 $3,034.68 5.2×
Mra w/o fol w/cont, abd (C8902) $1,259.49 $3,598.54 4.2×
Mra w/o fol w/cont, chest (C8911) $777.97 $2,222.77 2.6×
Mra w/o fol w/cont, lwr ext (C8914) $1,283.63 $3,667.51 4.3×
Mra w/o fol w/cont, pelvis (C8920) $1,270.08 $3,628.79 4.2×
Mra, w/dye, upper extremity (C8934) $1,270.50 $3,630 4.2×
Mra, w/o dye, upper extr (C8935) $1,145.15 $3,271.84 5.6×
Mra, w/o&w/dye, upper extr (C8936) $1,397.55 $3,993 4.6×
Mri w/o fol w/cont, breast, (C8908) $1,498.77 $4,282.19 5.0×
Obtaining screen pap smear (Q0091) $66.92 $191.18 2.7×
Oth resp proc, group (G0239) $46.59 $133.10 1.4×
Oth resp proc, indiv (G0238) $49.55 $141.57 2.0×
Perq Sacral Augmt Bilat Inj (0201T) $3,762.80 $10,750.85 0.6×
Perq Sacral Augmt Unilat Inj (0200T)
unusually low: confirm this is the full procedure
$2,895.47 $8,272.77 0.5×
Pinworm examinations (Q0113) $16.10 $45.98 3.8×
Place device/marker, non pro (C9728) $1,389.94 $3,971.22 1.2×
Potassium hydroxide preps (Q0112) $19.49 $55.66 3.3×
Prolonged iv inf, req pump (C8957) $144.42 $412.61 0.8×
Prostate biopsy, any mthd (G0416) $877.28 $2,506.52 2.8×
Psa screening (G0103) $35.58 $101.64 1.8×
Therapeutic procd strg endur (G0237) $49.55 $141.57 2.0×
Tomosynthesis, mammo (G0279) $33.88 $96.80 2.7×
Transcatheter Renal Sympath Denervation Bilat (0339T) $6,518.94 $18,625.53 1.3×
Transcatheter renal sympath denervation unilat (0338T) $4,402.29 $12,577.95 0.9×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $5,682.95 $16,236.99 0.6×
Trauma respons w/hosp criti (G0390) $2,765.24 $7,900.70 2.4×
Trluml Perip Athrc Renal Art (0234T) $5,682.95 $16,236.99 0.6×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $5,682.95 $16,236.99 0.6×
Trluml peripheral atherectomy iliac artery ea (0238T)
unusually low: confirm this is the full procedure
$5,879.03 $16,797.22 0.4×
Unsched dialysis esrd pt hos (G0257) $500.16 $1,429.01 0.8×