17 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) |
$4,480 |
$5,600 |
2.0× |
| Cardiokymography (Q0035) |
$95.20 |
$119 |
2.2× |
| Catheterize for urine spec (P9612) |
$32.80 |
$41 |
3.5× |
| Drug test def 1-7 classes (G0480) |
$297.60 |
$372 |
2.6× |
| Drug test def 8-14 classes (G0481) |
$376 |
$470 |
2.4× |
| Hep c screen high risk/other (G0472) |
$208 |
$260 |
4.5× |
| Hpv combo assay ca screen (G0476) |
$157.60 |
$197 |
4.5× |
| Ig paraprotein qual bld/ur (0077U) |
$195.20 |
$244 |
4.5× |
| Insertion of anterior segment aqueous drainage device, without extraocular reservoir, internal approach, into the… (0253T) |
$9,360 |
$11,700 |
2.0× |
| Mri w/o fol w/cont, breast, (C8908) |
$2,640 |
$3,300 |
6.5× |
| Mri w/o fol w/cont, brst, un (C8905) |
$1,840 |
$2,300 |
4.5× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$960 |
$1,200 |
1.9× |
| Onc thyr 10 microrna seq +/- rslt mod hi rsk mal (0018U) |
$13,502.40 |
$16,878 |
4.5× |
| Place device/marker, non pro (C9728) |
$3,200 |
$4,000 |
2.0× |
| Prostate biopsy, any mthd (G0416) |
$713.60 |
$892 |
1.7× |
| Psa screening (G0103) |
$100.80 |
$126 |
5.2× |
| Tomosynthesis, mammo (G0279) |
$56 |
$70 |
4.4× |