Supplies, drugs & other prices at M Health Fairview Ridges Hospital

Burnsville, MN · every code in this section with a posted price and a Medicare benchmark.

70 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $814.63 $1,916.77 1.0×
2d tte w or w/o fol w/con,fu (C8924) $566.53 $1,333 1.6×
Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) $2,581.72 $6,074.62 1.3×
Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T) $7,574.35 $17,822 0.8×
Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) $2,597.18 $6,111 1.3×
Admin hepatitis b vaccine (G0010) $17 $40 0.4×
Admin influenza virus vac (G0008) $17 $40 0.4×
Admin pneumococcal vaccine (G0009) $17 $40 0.4×
Alcohol/subs interv 15-30mn (G0396) $408.43 $961 10.6×
Alcohol/subs interv >30 min (G0397) $388.88 $915 2.1×
Autolog prp not diab ulcer (G0460) $2,104.60 $4,952 1.0×
Ca screen;flexi sigmoidscope (G0104) $893.09 $2,101.38 0.9×
Chemo extend iv infus w/pump (G0498) $422.36 $993.78 1.2×
Collagen crosslinking cornea (0402T) $3,204.08 $7,539 1.3×
Colon ca scrn not hi rsk ind (G0121) $875.50 $2,060 0.9×
Colorectal scrn; hi risk ind (G0105) $926.88 $2,180.89 1.0×
Cyp2d6 gen com&slct rar vrnt (0070U) $597.13 $1,405 0.9×
Diab manage trn per indiv (G0108) $130.86 $307.90 2.3×
Diab manage trn ind/group (G0109) $88.12 $207.34 5.5×
Direct refer hospital observ (G0379) $325.68 $766.28 0.5×
Drug test def 1-7 classes (G0480) $69.49 $65.41 0.6×
Drug test def 15-21 classes (G0482) $4.25 $10 0.0×
Fecal microbiota prep instil (G0455) $256.49 $603.50 0.3×
Fern test (Q0114) $40.16 $94.50 4.1×
Home sleep test/type 3 porta (G0399) $329.80 $776 1.5×
Hospital outpt clinic visit (G0463) $158.10 $372 1.2×
Ig paraprotein qual bld/ur (0077U) $280.50 $660 6.5×
Inj for sacroiliac jt anesth (G0260) $859.57 $2,022.50 1.2×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $42,095.83 $99,049 1.3×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $37,965.25 $89,330 1.2×
Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode,… (0576T) $56.10 $132 1.5×
Ire Ablation 1+Tumors per Organ W/Img Gdn Perq (0600T) $11,879.18 $27,951 1.1×
Mri w/o fol w/cont, breast, (C8908) $1,008.50 $2,372.94 2.8×
Neuro csf prion prtn qual (0035U) $575.03 $1,353 1.1×
Obtaining screen pap smear (Q0091) $41.23 $97 1.4×
Onc merkel cell carc detcj antb serum reprtd +/- (0059U) $379.95 $894 1.2×
Onc Merkel Cll Carc Srm Quan (0058U) $379.95 $894 1.2×
Oth resp proc, group (G0239) $99.02 $232.99 2.6×
Oth resp proc, indiv (G0238) $65.03 $153 2.2×
Pattern erg w/i&r (0509T) $296.23 $697 1.3×
Pemivibart infusion (M0224) $375.28 $883 0.8×
Perc d-e cor revasc chro sin (C9607) $20,791.80 $48,921.88 1.1×
Perc d-e cor revasc t cabg s (C9604) $13,142.49 $30,923.50 1.1×
Perc d-e cor stent ather s (C9602) $20,724.22 $48,762.86 1.1×
Perc drug-el cor stent sing (C9600) $12,943.63 $30,455.59 1.1×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $12,942.53 $30,453 1.1×
Prgrmg Device Evaluation Cardiac Modulj System (0417T) $91.38 $215 2.4×
Psa screening (G0103) $55.25 $130 2.9×
Rbc DNA gnotyp 10 bld groups (0084U) $320.88 $755 0.4×
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) $415.94 $978.68 0.6×
Revasc intra lithotrip-ather (C9766) $16,594.98 $39,047 0.9×
Revasc intra lithotrip-stent (C9765) $16,594.98 $39,047 0.9×
Revasc intravasc lithotripsy (C9764) $9,090.70 $21,389.88 0.8×
Revasc lithotrip tibi/perone (C9772) $18,894.65 $44,458 1.6×
Rmvl&rplcmt substernal impltbl defibrillator pg (0614T) $27,201.28 $64,003 1.2×
Scr c/v cyto,thinlayer,rescr (G0145) $70.54 $165.96 2.7×
Screen cerv/vag thin layer (G0123) $51.69 $121.62 2.6×
Sim ang w/prs cath rad emb (C8004) $7,097.50 $16,700 0.6×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $21,774.45 $51,234 1.1×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $13,380.28 $31,483 0.7×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) $12,466.53 $29,333 0.6×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $3,280.15 $7,718 0.6×
Therapeutic procd strg endur (G0237) $73.94 $173.96 2.5×
Tomosynthesis, mammo (G0279) $45.48 $107 3.6×
Trauma respons w/hosp criti (G0390) $1,849.18 $4,351 1.3×
Trim nail(s) (G0127) $127.08 $299 2.1×
Tte w or w/o fol w/con,stres (C8928) $916.35 $2,156.11 1.1×
Tte w or wo fol wcon,doppler (C8929) $813.40 $1,913.87 1.0×
Unsched dialysis esrd pt hos (G0257) $794.26 $1,868.84 1.1×
Vasc emb/occ w/prs cath (C9797) $13,014.78 $30,623 0.7×