Supplies, drugs & other prices at Legacy Salmon Creek Medical Center
Vancouver, WA · every code in this section with a posted price and a Medicare benchmark.
48 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,978.60 | $3,044 | 2.3× |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,144.65 | $1,761 | 2.9× |
| Adm tocilizu covid-19 1st (M0249) | $345.80 | $532 | 0.7× |
| Adm tocilizu covid-19 2nd (M0250) | $345.80 | $532 | 0.7× |
| Direct refer hospital observ (G0379) | $527.15 | $811 | 0.8× |
| Drug test def 1-7 classes (G0480) | $126.24 | $194.22 | 1.1× |
| Fern test (Q0114) | $22.10 | $34 | 2.3× |
| Hospital outpt clinic visit (G0463) | $172.58 | $265.50 | 1.2× |
| Iliac Atherectomy (0238T) | $25,848.55 | $39,767 | 1.3× |
| Insertion of substernal implantable defibrillator electrode (0572T) | $7,127.25 | $10,965 | 0.8× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) | $38,341.55 | $58,987 | 1.1× |
| Lev 1 hosp type b ed visit (G0380) | $271.05 | $417 | 3.3× |
| Lev 2 hosp type b ed visit (G0381) | $490.10 | $754 | 4.7× |
| Lev 3 hosp type b ed visit (G0382) | $889.20 | $1,368 | 4.6× |
| Lev 4 hosp type b ed visit (G0383) | $1,539.20 | $2,368 | 5.2× |
| Lev 5 hosp type b ed visit (G0384) | $2,268.50 | $3,490 | 5.0× |
| Liver Dis 10 Assays W/Nash (0003M) | $370.30 | $569.70 | 0.7× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,125.15 | $1,731 | 2.9× |
| Neuro csf prion prtn qual (0035U) | $461.52 | $710.02 | 0.9× |
| Oth resp proc, group (G0239) | $318.50 | $490 | 7.7× |
| Oth resp proc, indiv (G0238) | $160.55 | $247 | 5.0× |
| Pemivibart infusion (M0224) | $729.30 | $1,122 | 1.5× |
| Perq Sacral Augmt Bilat Inj (0201T) | $7,948.85 | $12,229 | 1.0× |
| Perq Sacral Augmt Unilat Inj (0200T) | $7,948.85 | $12,229 | 1.0× |
| Prostate biopsy, any mthd (G0416) | $694.52 | $1,068.50 | 1.7× |
| Provide inr test mater/equip (G0249) | $310.70 | $478 | 2.1× |
| Psa screening (G0103) | $24.70 | $38 | 1.3× |
| Removal of substernal implantable defibrillator electrode (0573T) | $3,007.55 | $4,627 | 0.7× |
| Repos prev impl ss impltbl dfb pacing eltrd (0574T) | $3,007.55 | $4,627 | 0.7× |
| Revasc intra lithotrip-ather (C9766) | $22,074.65 | $33,961 | 1.1× |
| Revasc intra lithotrip-stent (C9765) | $19,056.05 | $29,317 | 0.9× |
| Revasc intravasc lithotripsy (C9764) | $9,168.90 | $14,106 | 0.7× |
| Revasc lith-sten-ath tib/per (C9775) | $14,337.70 | $22,058 | 0.7× |
| Revasc lithotr-ather tib/per (C9774) | $14,337.70 | $22,058 | 0.7× |
| Revasc lithotr-stent tib/per (C9773) | $14,337.70 | $22,058 | 0.7× |
| Revasc lithotrip tibi/perone (C9772) | $8,967.40 | $13,796 | 0.7× |
| Revasc lithotrip-stent-ather (C9767) | $30,355.65 | $46,701 | 1.5× |
| Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) | $3,007.55 | $4,627 | 0.7× |
| Therapeutic procd strg endur (G0237) | $160.55 | $247 | 5.0× |
| Therapeutic ultrafiltration (0692T) | $1,430.65 | $2,201 | 0.8× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $11,816.35 | $18,179 | 1.9× |
| Transcatheter renal sympath denervation unilat (0338T) | $7,820.80 | $12,032 | 1.2× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) | $16,762.85 | $25,789 | 1.3× |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) | $16,762.85 | $25,789 | 1.3× |
| Tte w or w/o contr, cont ecg (C8930) | $2,774.85 | $4,269 | 3.2× |
| Tte w or w/o fol w/cont, com (C8921) | $2,023.45 | $3,113 | 2.3× |
| Tte w or w/o fol w/cont, f/u (C8922) | $988.65 | $1,521 | 1.1× |
| Tte w or wo fol wcon,doppler (C8929) | $2,463.50 | $3,790 | 2.8× |