Supplies, drugs & other prices at King’s Daughters Medical Center
Brookhaven, MS · every code in this section with a posted price and a Medicare benchmark.
69 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $807.30 | $2,691 | 1.2× |
| 2d tte w or w/o fol w/con,co (C8923) | $807.30 | $2,691 | 1.2× |
| 2d tte w or w/o fol w/con,fu (C8924) | $807.30 | $2,691 | 2.7× |
| Admin hepatitis b vaccine (G0010) | $15 | $50 | 0.4× |
| Admin influenza virus vac (G0008) | $46.20 | $154 | 1.1× |
| Admin pneumococcal vaccine (G0009) | $46.20 | $154 | 1.1× |
| Arthro/shoul surg; w/spacer (C9781) likely a partial charge, not the full procedure |
$805.50 | $2,685 | 0.1× |
| Ca screen;flexi sigmoidscope (G0104) | $700.80 | $2,336 | 0.9× |
| Colon ca scrn not hi rsk ind (G0121) | $700.80 | $2,336 | 0.9× |
| Colorectal scrn; hi risk ind (G0105) | $700.80 | $2,336 | 0.9× |
| Comprehensve oral evaluation (D0150) | $370.80 | $1,236 | 3.2× |
| Cysto impl 4 or more (C9740) | $6,862.20 | $22,874 | 0.8× |
| Cysto, litho, vacuum kidney (C9761) | $5,292 | $17,640 | 0.6× |
| Dental bitewings two images (D0272) | $472.50 | $1,575 | 6.3× |
| Diab manage trn per indiv (G0108) | $47.10 | $157 | 0.8× |
| Diab manage trn ind/group (G0109) | $12.60 | $42 | 0.8× |
| Direct refer hospital observ (G0379) | $204.90 | $683 | 0.4× |
| Drug test def 1-7 classes (G0480) | $88.20 | $294 | 0.8× |
| Drug test def 22+ classes (G0483) | $138 | $460 | 0.6× |
| Drug test def 8-14 classes (G0481) | $75.60 | $252 | 0.5× |
| Eia hiv-1/hiv-2 screen (G0432) | $21 | $70 | 1.1× |
| Elec stim other than wound (G0283) | $19.50 | $65 | 1.5× |
| Extraction erupted tooth/exr (D7140) | $472.50 | $1,575 | 0.8× |
| Hbot, full body chamber, 30m (G0277) | $236.25 | $787.50 | 2.0× |
| Hep c screen high risk/other (G0472) | $87 | $290 | 1.9× |
| Hepb screen high risk indiv (G0499) | $30 | $100 | 1.1× |
| Hiv combination assay (G0475) | $66.60 | $222 | 2.8× |
| Home sleep test/type 3 porta (G0399) | $159.30 | $531 | 0.9× |
| Hospital outpt clinic visit (G0463) | $93.15 | $310.50 | 0.8× |
| Inj for sacroiliac jt anesth (G0260) | $789.30 | $2,631 | 1.3× |
| Intraoral periapical first (D0220) | $9.30 | $31 | 0.1× |
| Mra w/cont, abd (C8900) | $782.70 | $2,609 | 2.6× |
| Mra w/cont, lwr ext (C8912) | $880.05 | $2,933.50 | 2.9× |
| Mra w/o cont, abd (C8901) | $680.40 | $2,268 | 3.3× |
| Mra w/o fol w/cont, abd (C8902) | $819 | $2,730 | 2.7× |
| Mra w/o fol w/cont, chest (C8911) | $850.50 | $2,835 | 2.8× |
| Mra w/o fol w/cont, lwr ext (C8914) | $320.10 | $1,067 | 1.1× |
| Mra w/o fol w/cont, pelvis (C8920) | $320.10 | $1,067 | 1.1× |
| Mra, w/o&w/dye, upper extr (C8936) | $860.10 | $2,867 | 2.9× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $255.90 | $853 | 0.5× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $274.50 | $915 | 0.7× |
| Non-ophthalmic fva (C9733) | $195.90 | $653 | 0.7× |
| Oth resp proc, indiv (G0238) | $11.10 | $37 | 0.4× |
| Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral… (0627T) unusually low: confirm this is the full procedure |
$4,500 | $15,000 | 0.4× |
| Post 1 srfc resinbased cmpst (D2391) | $62.70 | $209 | 0.1× |
| Post 2 srfc resinbased cmpst (D2392) | $81.60 | $272 | 0.1× |
| Post 3 srfc resinbased cmpst (D2393) | $472.50 | $1,575 | 0.8× |
| Prefab porc/ceram crown pri (D2929) | $38.70 | $129 | 0.1× |
| Prefab steel crown primary (D2934) | $136.20 | $454 | 0.2× |
| Prefab stnlss steel crown pe (D2931) | $198 | $660 | 0.4× |
| Prefab stnlss steel crwn pri (D2930) | $232.20 | $774 | 0.4× |
| Prolonged iv inf, req pump (C8957) | $897.75 | $2,992.50 | 4.9× |
| Prostate biopsy, any mthd (G0416) | $194.23 | $647.42 | 0.6× |
| Psa screening (G0103) | $116.70 | $389 | 6.0× |
| Rem imp tooth w mucoper flp (D7210) | $472.50 | $1,575 | 0.4× |
| Resin 4/> surf or w incis an (D2335) | $198 | $660 | 0.4× |
| Resin one surface-anterior (D2330) | $53.70 | $179 | 0.1× |
| Resin three surfaces-anterio (D2332) | $83.70 | $279 | 0.2× |
| Resin two surfaces-anterior (D2331) | $198 | $660 | 0.4× |
| Space maintainer fxd unilat (D1510) | $945 | $3,150 | 1.7× |
| Tee w or w/o fol w/cont,cong (C8926) | $807.30 | $2,691 | 1.2× |
| Therapeutic pulpotomy (D3220) | $68.70 | $229 | 0.1× |
| Tomosynthesis, mammo (G0279) | $58.35 | $194.50 | 4.6× |
| Trauma respons w/hosp criti (G0390) | $542.40 | $1,808 | 0.5× |
| Tte w or w/o contr, cont ecg (C8930) | $807.30 | $2,691 | 1.2× |
| Tte w or w/o fol w/cont, com (C8921) | $807.30 | $2,691 | 1.2× |
| Tte w or w/o fol w/cont, f/u (C8922) | $807.30 | $2,691 | 1.2× |
| Tte w or wo fol wcon,doppler (C8929) | $807.30 | $2,691 | 1.2× |
| Unsched dialysis esrd pt hos (G0257) | $515.70 | $1,719 | 0.9× |