Supplies, drugs & other prices at Lutheran Downtown Hospital
Fort Wayne, IN · every code in this section with a posted price and a Medicare benchmark.
96 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2019-ncov diagnostic p (U0001) range across 3 matching MRF lines |
$6–$31.92 | $25–$133 | varies |
| 2d tee w or w/o fol w/con,in (C8925) | $1,080 | $4,500 | 1.3× |
| 2d tte w or w/o fol w/con,co (C8923) range across 3 matching MRF lines |
$798–$846 | $3,325–$3,525 | varies |
| 2d tte w or w/o fol w/con,fu (C8924) range across 2 matching MRF lines |
$672.24–$672.48 | $2,801–$2,802 | varies |
| Adm tocilizu covid-19 1st (M0249) | $272.64 | $1,136 | 0.6× |
| Adm tocilizu covid-19 2nd (M0250) | $272.64 | $1,136 | 0.6× |
| Admin hepatitis b vaccine (G0010) range across 16 matching MRF lines |
$6–$48 | $25–$200 | varies |
| Admin influenza virus vac (G0008) range across 21 matching MRF lines |
$6–$39.12 | $25–$163 | varies |
| Admin pneumococcal vaccine (G0009) range across 21 matching MRF lines |
$6–$58.08 | $25–$242 | varies |
| Annual alcohol screen 15 min (G0442) range across 2 matching MRF lines |
$5.28–$6 | $22–$25 | varies |
| Behavior counsel obesity 15m (G0447) | $14.40 | $60 | 0.1× |
| Brief alcohol misuse counsel (G0443) | $14.40 | $60 | 0.1× |
| Ca screen;flexi sigmoidscope (G0104) range across 4 matching MRF lines |
$58.80–$1,200 | $150–$5,000 | varies |
| Ca screen;pelvic/breast exam (G0101) range across 3 matching MRF lines |
$11.52–$21.36 | $48–$89 | varies |
| Catheterize for urine spec (P9612) range across 4 matching MRF lines |
$2.88–$3.12 | $12–$13 | varies |
| Colon ca scrn not hi rsk ind (G0121) range across 7 matching MRF lines |
$99.36–$1,812.65 | $414–$7,552.71 | varies |
| Colorectal scrn; hi risk ind (G0105) range across 10 matching MRF lines |
$121.68–$1,628.67 | $507–$6,786.12 | varies |
| Depression screen annual (G0444) range across 2 matching MRF lines |
$5.28–$6 | $22–$25 | varies |
| Diab manage trn per indiv (G0108) range across 3 matching MRF lines |
$28.80–$50.88 | $120–$212 | varies |
| Diab manage trn ind/group (G0109) range across 4 matching MRF lines |
$8.88–$50.88 | $37–$212 | varies |
| Direct refer hospital observ (G0379) range across 3 matching MRF lines |
$414.48–$509.28 | $1,727–$2,122 | varies |
| Eia hiv-1/hiv-2 screen (G0432) range across 11 matching MRF lines |
$2.13–$134.40 | $8.89–$560 | varies |
| Ekg tracing for initial prev (G0404) | $8.88 | $37 | 0.3× |
| Elec stim other than wound (G0283) range across 16 matching MRF lines |
$8.64–$72.48 | $36–$302 | varies |
| Elec stim unattend for press (G0281) | $8.64 | $36 | 0.7× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $12,194.64 | $50,811 | 1.0× |
| Extrnl counterpulse, per tx (G0166) | $92.40 | $385 | 0.7× |
| Fecal blood scrn immunoassay (G0328) range across 9 matching MRF lines |
$12.96–$38.88 | $54–$162 | varies |
| Fecal microbiota prep instil (G0455) | $120 | $500 | 0.1× |
| Hbot, full body chamber, 30m (G0277) | $152.88 | $637 | 1.1× |
| High inten beh couns std 30m (G0445) | $14.64 | $61 | 0.1× |
| Hiv combination assay (G0475) range across 33 matching MRF lines |
$2.40–$75.36 | $3.23–$314 | varies |
| Home sleep test/type 2 porta (G0398) | $38.88 | $162 | 0.2× |
| Home sleep test/type 3 porta (G0399) | $136.32 | $568 | 0.6× |
| Hospital outpt clinic visit (G0463) range across 38 matching MRF lines |
$33.36–$1,221.12 | $139–$5,088 | varies |
| Initial preventive exam (G0402) range across 2 matching MRF lines |
$66.24–$86.16 | $276–$359 | varies |
| Intens behave ther cardio dx (G0446) | $14.40 | $60 | 0.4× |
| Mra w/cont, abd (C8900) | $470.70 | $1,961.25 | 1.3× |
| Mra w/cont, chest (C8909) | $562.32 | $2,343 | 1.5× |
| Mra w/cont, lwr ext (C8912) | $594.24 | $2,476 | 1.6× |
| Mra w/cont, pelvis (C8918) | $594.24 | $2,476 | 1.6× |
| Mra w/o cont, abd (C8901) | $564.72 | $2,353 | 2.2× |
| Mra w/o cont, chest (C8910) | $546.72 | $2,278 | 2.2× |
| Mra w/o cont, lwr ext (C8913) | $447.18 | $1,863.25 | 1.8× |
| Mra w/o cont, pelvis (C8919) | $564.72 | $2,353 | 2.2× |
| Mra w/o fol w/cont, abd (C8902) | $999.12 | $4,163 | 2.7× |
| Mra w/o fol w/cont, chest (C8911) | $1,047.84 | $4,366 | 2.8× |
| Mra w/o fol w/cont, lwr ext (C8914) range across 3 matching MRF lines |
$912.72–$1,550.40 | $3,803–$6,460 | varies |
| Mra w/o fol w/cont, pelvis (C8920) | $673.68 | $2,807 | 1.8× |
| Mra, w/dye, spinal canal (C8931) | $470.70 | $1,961.25 | 1.3× |
| Mra, w/dye, upper extremity (C8934) | $583.92 | $2,433 | 1.6× |
| Mra, w/o dye, spinal canal (C8932) | $447.18 | $1,863.25 | 1.8× |
| Mra, w/o dye, upper extr (C8935) | $564.72 | $2,353 | 2.2× |
| Mra, w/o&w/dye, spinal canal (C8933) | $912.72 | $3,803 | 2.5× |
| Mra, w/o&w/dye, upper extr (C8936) | $912.72 | $3,803 | 2.5× |
| Mri w/cont, breast, bi (C8906) | $1,594.56 | $6,644 | 4.3× |
| Mri w/cont, breast, uni (C8903) | $539.04 | $2,246 | 2.9× |
| Mri w/o fol w/cont, breast, (C8908) range across 2 matching MRF lines |
$85.55–$1,673.76 | $356.45–$6,974 | varies |
| Mri w/o fol w/cont, brst, un (C8905) | $704.88 | $2,937 | 1.9× |
| Njx platelet plasma (0232T) | $13.68 | $57 | 0.0× |
| Obtaining screen pap smear (Q0091) range across 6 matching MRF lines |
$10.80–$12.24 | $45–$51 | varies |
| Oth resp proc, group (G0239) range across 4 matching MRF lines |
$118.32–$226.32 | $493–$943 | varies |
| Oth resp proc, indiv (G0238) range across 6 matching MRF lines |
$6.24–$54 | $26–$225 | varies |
| Pathogen test for platelets (P9100) | $41.28 | $172 | 0.7× |
| Perc d-e cor revasc chro sin (C9607) range across 4 matching MRF lines |
$8,281.44–$10,240.56 | $34,506–$42,669 | varies |
| Perc d-e cor revasc t cabg s (C9604) range across 4 matching MRF lines |
$10,240.56–$11,077.92 | $42,669–$46,158 | varies |
| Perc d-e cor stent ather s (C9602) range across 4 matching MRF lines |
$10,240.56–$10,777.20 | $42,669–$44,905 | varies |
| Perc drug-el cor stent sing (C9600) range across 4 matching MRF lines |
$10,240.56–$10,777.92 | $42,669–$44,908 | varies |
| Perq Sacral Augmt Unilat Inj (0200T) unusually low: confirm this is the full procedure |
$2,363.28 | $9,847 | 0.3× |
| Ppps, initial visit (G0438) range across 3 matching MRF lines |
$84.48–$104.88 | $352–$437 | varies |
| Ppps, subseq visit (G0439) range across 4 matching MRF lines |
$56.40–$70.80 | $235–$295 | varies |
| Prolonged iv inf, req pump (C8957) | $1,008 | $4,200 | 4.5× |
| Prostate biopsy, any mthd (G0416) range across 2 matching MRF lines |
$196.08–$204 | $817–$850 | varies |
| Psa screening (G0103) range across 9 matching MRF lines |
$1.08–$84.96 | $4.50–$354 | varies |
| Revasc intra lithotrip-ather (C9766) | $11,411.04 | $47,546 | 0.6× |
| Revasc intra lithotrip-stent (C9765) | $11,411.04 | $47,546 | 0.6× |
| Revasc intravasc lithotripsy (C9764) unusually low: confirm this is the full procedure |
$5,632.08 | $23,467 | 0.5× |
| Revasc lithotr-ather tib/per (C9774) | $17,343.12 | $72,263 | 0.9× |
| Revasc lithotrip tibi/perone (C9772) | $10,842.48 | $45,177 | 0.9× |
| Revasc lithotrip-stent-ather (C9767) | $17,343.12 | $72,263 | 0.9× |
| Scr c/v cyto,thinlayer,rescr (G0145) range across 2 matching MRF lines |
$56.40–$61.68 | $235–$257 | varies |
| Screen cerv/vag thin layer (G0123) range across 2 matching MRF lines |
$61.68–$72.72 | $257–$303 | varies |
| Screen pap by tech w md supv (P3000) | $8.64 | $36 | 0.5× |
| Tee w or w/o fol w/cont, mon (C8927) | $969.36 | $4,039 | 1.2× |
| Tee w or w/o fol w/cont,cong (C8926) | $1,263.36 | $5,264 | 1.5× |
| Therapeutic procd strg endur (G0237) range across 2 matching MRF lines |
$6.24–$53.52 | $26–$223 | varies |
| Tomosynthesis, mammo (G0279) range across 12 matching MRF lines |
$6.08–$25.44 | $25.32–$106 | varies |
| Trauma respons w/hosp criti (G0390) range across 7 matching MRF lines |
$891.36–$3,277.44 | $3,714–$13,656 | varies |
| Trim nail(s) (G0127) | $5.04 | $21 | 0.1× |
| Trluml Perip Athrc Brchiocph (0237T) likely a partial charge, not the full procedure |
$284.64 | $1,186 | 0.0× |
| Trluml Perip Athrc Iliac Art (0238T) likely a partial charge, not the full procedure |
$1,620 | $6,750 | 0.1× |
| Tte w or w/o fol w/con,stres (C8928) | $1,181.28 | $4,922 | 1.4× |
| Tte w or w/o fol w/cont, com (C8921) | $1,156.80 | $4,820 | 1.4× |
| Tte w or w/o fol w/cont, f/u (C8922) | $672.24 | $2,801 | 0.8× |
| Tte w or wo fol wcon,doppler (C8929) range across 3 matching MRF lines |
$172–$1,432.56 | $716.66–$5,969 | varies |
| Unsched dialysis esrd pt hos (G0257) | $853.44 | $3,556 | 1.2× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.