Supplies, drugs & other prices at Jennie M Melham Memorial Medical Center
Broken Bow, NE · every code in this section with a posted price and a Medicare benchmark.
13 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin influenza virus vac (G0008) | $20 | $20 | 0.4× |
| Admin pneumococcal vaccine (G0009) | $20 | $20 | 0.4× |
| Colon ca scrn not hi rsk ind (G0121) | $3,883.98 | $3,883.98 | 4.0× |
| Colorectal scrn; hi risk ind (G0105) | $4,011.67 | $4,011.67 | 4.2× |
| Diab manage trn per indiv (G0108) | $100 | $100 | 1.8× |
| Diab manage trn ind/group (G0109) | $60 | $60 | 3.7× |
| Ig paraprotein qual bld/ur (0077U) | $148.62 | $148.62 | 3.4× |
| Oth resp proc, group (G0239) | $220 | $220 | 5.7× |
| Oth resp proc, indiv (G0238) | $140 | $140 | 4.7× |
| Psa screening (G0103) | $131.50 | $131.50 | 6.8× |
| Therapeutic procd strg endur (G0237) | $70 | $70 | 2.3× |
| Tomosynthesis, mammo (G0279) | $90 | $90 | 7.1× |
| Trauma respons w/hosp criti (G0390) | $4,000 | $4,000 | 2.9× |