Supplies, drugs & other prices at Maimonides Medical Center
Brooklyn, NY · every code in this section with a posted price and a Medicare benchmark.
238 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d cephalometric image (D0340) | $303 | $303 | 2.8× |
| 2d tee w or w/o fol w/con,in (C8925) | $3,788 | $3,788 | 3.9× |
| 2d tte w or w/o fol w/con,co (C8923) | $3,788 | $3,788 | 3.9× |
| 2d tte w or w/o fol w/con,fu (C8924) | $2,537 | $2,537 | 5.8× |
| Ablation, irreversible electroporation; 1 or more tumors, including fluoroscopic and ultrasound guidance, when… (0601T) | $27,500 | $27,500 | 2.1× |
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) | $20,237 | $20,237 | 8.3× |
| Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) | $20,237 | $20,237 | 8.3× |
| Admin hepatitis b vaccine (G0010) | $198 | $198 | 3.4× |
| Admin influenza virus vac (G0008) range across 9 matching MRF lines |
$163–$259 | $163–$259 | varies |
| Admin pneumococcal vaccine (G0009) range across 6 matching MRF lines |
$163–$204 | $163–$204 | varies |
| Alcohol/subs interv 15-30mn (G0396) | $163 | $163 | 3.5× |
| Alveoloplasty not w/extracts (D7321) | $833 | $833 | 0.4× |
| Alveoloplasty w/extract 1-3 (D7311) | $528 | $528 | 0.3× |
| Alveoplasty w/ extraction (D7310) | $660 | $660 | 0.3× |
| Alveoplasty w/o extraction (D7320) | $1,007 | $1,007 | 0.5× |
| Amalgam 4 or > surfaces perm (D2161) | $549 | $549 | 0.7× |
| Amalgam one surface permanen (D2140) | $323 | $323 | 0.4× |
| Amalgam three surfaces perma (D2160) | $451 | $451 | 0.6× |
| Amalgam two surfaces permane (D2150) | $370 | $370 | 0.5× |
| Annual alcohol screen 15 min (G0442) | $163 | $163 | 3.5× |
| Ant resin-based cmpst crown (D2390) | $594 | $594 | 0.7× |
| Apexification/recalc final (D3353) | $1,109 | $1,109 | 1.4× |
| Apexification/recalc initial (D3351) | $396 | $396 | 0.5× |
| Apexification/recalc interim (D3352) | $352 | $352 | 0.4× |
| Apically positioned flap (D4245) | $1,159 | $1,159 | 0.6× |
| Apicoectomy - anterior (D3410) | $1,513 | $1,513 | 1.9× |
| Behavior counsel obesity 15m (G0447) | $378 | $378 | 3.0× |
| Bitewings - three images (D0273) | $143 | $143 | 0.5× |
| Bitewings four images (D0274) | $165 | $165 | 0.6× |
| Bone replce graft first site (D4263) | $1,430 | $1,430 | 1.8× |
| Brief alcohol misuse counsel (G0443) | $378 | $378 | 3.0× |
| Ca screen;flexi sigmoidscope (G0104) | $3,647 | $3,647 | 3.1× |
| Ca screen;pelvic/breast exam (G0101) range across 3 matching MRF lines |
$80–$378 | $80–$378 | varies |
| Chemo extend iv infus w/pump (G0498) | $1,980 | $1,980 | 4.8× |
| Closd rductn splint alveolus (D7670) | $1,326 | $1,326 | 0.3× |
| Colon ca scrn not hi rsk ind (G0121) | $3,960 | $3,960 | 3.4× |
| Colorectal scrn; hi risk ind (G0105) | $3,850 | $3,850 | 3.3× |
| Colpopexy, min/inv, ex-perit (C9778) likely a partial charge, not the full procedure |
$1,813 | $1,813 | 0.3× |
| Comprehensve oral evaluation (D0150) | $330 | $330 | 2.0× |
| Cone beam ct interp both jaw (D0367) | $385 | $385 | 3.0× |
| Cone beam ct interprete man (D0365) | $495 | $495 | 3.8× |
| Core build-up incl any pins (D2950) | $550 | $550 | 0.7× |
| Coronectomy (D7251) | $1,000 | $1,000 | 0.5× |
| Covid-19 lab test non-cdc (U0002) | $190 | $190 | 3.7× |
| Crown full cast base metal (D2791) | $2,640 | $2,640 | 3.3× |
| Crown full cast high noble m (D2790) | $2,849 | $2,849 | 3.5× |
| Crown full cast noble metal (D2792) | $2,750 | $2,750 | 3.4× |
| Crown lengthen hard tissue (D4249) | $1,870 | $1,870 | 2.3× |
| Crown porcelain fused base m (D2751) | $2,640 | $2,640 | 3.3× |
| Crown porcelain w/ noble met (D2752) | $2,750 | $2,750 | 3.4× |
| Crown porcelain/ceramic (D2740) | $2,640 | $2,640 | 3.3× |
| Crown repair (D2980) | $616 | $616 | 0.8× |
| Cysto, litho, vacuum kidney (C9761) | $16,000 | $16,000 | 1.4× |
| Dental bitewing single image (D0270) | $88 | $88 | 0.8× |
| Dental bitewings two images (D0272) | $127 | $127 | 1.2× |
| Dental prophylaxis adult (D1110) | $300 | $300 | 1.8× |
| Depression screen annual (G0444) | $163 | $163 | 3.5× |
| Devlopment test interpt&rep (G0451) | $385 | $385 | 3.0× |
| Diab manage trn per indiv (G0108) range across 3 matching MRF lines |
$155–$165 | $155–$165 | varies |
| Diab manage trn ind/group (G0109) range across 3 matching MRF lines |
$45–$72 | $45–$72 | varies |
| Direct refer hospital observ (G0379) | $2,754 | $2,754 | 3.7× |
| Drug test def 1-7 classes (G0480) | $220 | $220 | 1.9× |
| Ekg tracing for initial prev (G0404) | $97 | $97 | 2.7× |
| Elec stim other than wound (G0283) | $162 | $162 | 12.8× |
| Electromagntic tx for ulcers (G0329) | $87 | $87 | 8.1× |
| End thxpy, anterior tooth (D3310) | $1,617 | $1,617 | 2.0× |
| End thxpy, molar tooth (D3330) | $2,596 | $2,596 | 3.2× |
| End thxpy, premolar tooth (D3320) | $1,925 | $1,925 | 2.4× |
| Esd endoscopy or colonoscopy (C9779) | $2,972 | $2,972 | 0.6× |
| Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie,… (0184T) unusually low: confirm this is the full procedure |
$2,310 | $2,310 | 0.3× |
| Exposure of unerupted tooth (D7280) | $1,540 | $1,540 | 1.9× |
| Extensv oral eval prob focus (D0160) | $292 | $292 | 1.8× |
| Extraction coronal remnants (D7111) | $176 | $176 | 0.2× |
| Extraction erupted tooth/exr (D7140) | $550 | $550 | 0.7× |
| Extraoral 2d project image (D0250) | $275 | $275 | 2.5× |
| Extrnl counterpulse, per tx (G0166) | $611 | $611 | 3.7× |
| Fecal microbiota prep instil (G0455) | $3,934 | $3,934 | 3.4× |
| Fern test (Q0114) | $73 | $73 | 7.5× |
| Fixed bilat space maint, man (D1517) | $1,276 | $1,276 | 1.6× |
| Fixed bilat space maint, max (D1516) | $1,276 | $1,276 | 1.6× |
| Full mouth debridement (D4355) | $402 | $402 | 0.5× |
| Gi myoelectrical activity study stmch-colon i&r (0779T) | $1,870 | $1,870 | 4.0× |
| Gingivectomy/plasty 1 to 3 (D4211) | $574 | $574 | 0.1× |
| Gingivectomy/plasty 4 or mor (D4210) | $1,287 | $1,287 | 0.3× |
| Gngvl flap w rootplan 1-3 th (D4241) | $1,001 | $1,001 | 0.5× |
| Group mnt 2 or more 30 mins (G0271) | $370 | $370 | 21.7× |
| Hbot, full body chamber, 30m (G0277) | $715 | $715 | 4.2× |
| Hdr electronic brachytherapy ntrstl/intrcav (0395T) | $4,162 | $4,162 | 4.8× |
| Heart Symp Image Plnr (0331T) | $5,524 | $5,524 | 3.4× |
| Home sleep test/type 2 porta (G0398) | $795 | $795 | 2.9× |
| Home sleep test/type 3 porta (G0399) | $835 | $835 | 3.1× |
| Hospital outpt clinic visit (G0463) range across 118 matching MRF lines |
$323–$825 | $323–$825 | varies |
| I&d absc intraoral soft tiss (D7510) | $440 | $440 | 0.5× |
| Impact tooth remov comp bony (D7240) | $1,650 | $1,650 | 2.0× |
| Impact tooth remov part bony (D7230) | $1,430 | $1,430 | 1.8× |
| Impact tooth remov soft tiss (D7220) | $1,040 | $1,040 | 1.3× |
| Initial preventive exam (G0402) | $603 | $603 | 3.6× |
| Inj for sacroiliac jt anesth (G0260) | $2,376 | $2,376 | 2.7× |
| Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) range across 2 matching MRF lines |
$2,800–$3,733 | $2,800–$3,733 | varies |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) | $99,999 | $99,999 | 2.6× |
| Instlj fecal microbiota ssp (0780T) | $1,650 | $1,650 | 9.9× |
| Intens behave ther cardio dx (G0446) range across 2 matching MRF lines |
$163–$171 | $163–$171 | varies |
| Internal root repair (D3333) | $798 | $798 | 1.0× |
| Intraor comprehensive series (D0210) | $429 | $429 | 1.4× |
| Intraoral occlusal film (D0240) | $138 | $138 | 1.3× |
| Intraoral periapical first (D0220) | $99 | $99 | 0.9× |
| Ire Abltj 1+Tum Organ Perq (0600T) | $27,500 | $27,500 | 2.1× |
| Labial veneer porc indirect (D2962) | $2,035 | $2,035 | 2.5× |
| Limit oral eval problm focus (D0140) | $237 | $237 | 1.4× |
| Localized delivery antimicro (D4381) | $297 | $297 | 0.4× |
| Magnetically controlled capsule endoscopy w/i&r (0651T) | $2,200 | $2,200 | 1.9× |
| Mnt subs tx for change dx (G0270) | $370 | $370 | 11.7× |
| Mra w/cont, abd (C8900) range across 2 matching MRF lines |
$1,320–$1,595 | $1,320–$1,595 | varies |
| Mra w/cont, chest (C8909) range across 2 matching MRF lines |
$1,870–$1,980 | $1,870–$1,980 | varies |
| Mra w/cont, lwr ext (C8912) range across 2 matching MRF lines |
$2,097–$2,796 | $2,097–$2,796 | varies |
| Mra w/cont, pelvis (C8918) range across 2 matching MRF lines |
$1,540–$1,549 | $1,540–$1,549 | varies |
| Mra w/o cont, abd (C8901) range across 2 matching MRF lines |
$1,015–$1,354 | $1,015–$1,354 | varies |
| Mra w/o cont, chest (C8910) range across 2 matching MRF lines |
$1,221–$1,540 | $1,221–$1,540 | varies |
| Mra w/o cont, lwr ext (C8913) range across 2 matching MRF lines |
$1,066–$1,422 | $1,066–$1,422 | varies |
| Mra w/o cont, pelvis (C8919) range across 2 matching MRF lines |
$1,051–$1,354 | $1,051–$1,354 | varies |
| Mra w/o fol w/cont, abd (C8902) range across 2 matching MRF lines |
$2,640–$3,300 | $2,640–$3,300 | varies |
| Mra w/o fol w/cont, chest (C8911) range across 2 matching MRF lines |
$2,420–$3,080 | $2,420–$3,080 | varies |
| Mra w/o fol w/cont, lwr ext (C8914) range across 2 matching MRF lines |
$2,195–$2,663 | $2,195–$2,663 | varies |
| Mra w/o fol w/cont, pelvis (C8920) range across 2 matching MRF lines |
$2,530–$3,190 | $2,530–$3,190 | varies |
| Mra, w/dye, spinal canal (C8931) range across 2 matching MRF lines |
$2,200–$2,663 | $2,200–$2,663 | varies |
| Mra, w/dye, upper extremity (C8934) range across 2 matching MRF lines |
$1,279–$1,549 | $1,279–$1,549 | varies |
| Mra, w/o dye, spinal canal (C8932) | $1,422 | $1,422 | 4.8× |
| Mra, w/o dye, upper extr (C8935) | $1,421 | $1,421 | 4.8× |
| Mra, w/o&w/dye, spinal canal (C8933) range across 2 matching MRF lines |
$1,279–$1,549 | $1,279–$1,549 | varies |
| Mra, w/o&w/dye, upper extr (C8936) | $2,191 | $2,191 | 5.0× |
| Mri w/cont, breast, bi (C8906) range across 2 matching MRF lines |
$2,530–$3,299 | $2,530–$3,299 | varies |
| Mri w/cont, breast, uni (C8903) range across 2 matching MRF lines |
$1,161–$1,546 | $1,161–$1,546 | varies |
| Mri w/o fol w/cont, breast, (C8908) range across 2 matching MRF lines |
$2,492–$3,299 | $2,492–$3,299 | varies |
| Mri w/o fol w/cont, brst, un (C8905) range across 2 matching MRF lines |
$2,199–$2,796 | $2,199–$2,796 | varies |
| Myocrd Symp Innervaj Img Plnr Qual&Quant W/Spect (0332T) | $5,524 | $5,524 | 3.4× |
| Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) range across 2 matching MRF lines |
$2,800–$3,733 | $2,800–$3,733 | varies |
| Obtaining screen pap smear (Q0091) | $92 | $92 | 2.5× |
| Occ guard, hard, full arch (D9944) | $174 | $174 | 0.2× |
| Occ guard, soft, full arch (D9945) | $174 | $174 | 0.2× |
| Occlusion analysis (D9950) | $497 | $497 | 0.6× |
| Oral hiv-1/hiv-2 screen (G0435) | $56 | $56 | 4.7× |
| Oral/facial photo images (D0350) | $176 | $176 | 1.6× |
| Osseous surgery 4 or more (D4260) unusually low: confirm this is the full procedure |
$2,681 | $2,681 | 0.4× |
| Other tmj images by report (D0321) | $440 | $440 | 4.1× |
| Panoramic image (D0330) | $336 | $336 | 1.1× |
| Part pulp for apexogenesis (D3222) | $396 | $396 | 0.5× |
| Pathogen test for platelets (P9100) | $375 | $375 | 5.1× |
| Perc d-e cor revasc chro sin (C9607) | $88,967 | $88,967 | 3.9× |
| Perc d-e cor revasc t cabg s (C9604) | $58,369 | $58,369 | 4.1× |
| Perc d-e cor stent ather s (C9602) | $99,999 | $99,999 | 4.4× |
| Perc drug-el cor stent sing (C9600) | $58,369 | $58,369 | 4.1× |
| Periodic oral evaluation (D0120) | $146 | $146 | 0.9× |
| Periodontal maint procedures (D4910) | $193 | $193 | 0.2× |
| Periodontal scaling & root (D4341) | $1,074 | $1,074 | 1.3× |
| Periodontal scaling 1-3teeth (D4342) | $297 | $297 | 0.4× |
| Perq Sacral Augmt Bilat Inj (0201T) | $24,518 | $24,518 | 2.7× |
| Perq Sacral Augmt Unilat Inj (0200T) | $24,518 | $24,518 | 2.7× |
| Place direct restoration (D2940) | $220 | $220 | 0.3× |
| Post 1 srfc resinbased cmpst (D2391) | $347 | $347 | 0.4× |
| Post 2 srfc resinbased cmpst (D2392) | $424 | $424 | 0.5× |
| Post 3 srfc resinbased cmpst (D2393) | $539 | $539 | 0.7× |
| Post >=4srfc resinbase cmpst (D2394) | $583 | $583 | 0.7× |
| Post and core cast + crown (D2952) | $875 | $875 | 1.1× |
| Posterior vertebral joint(s) arthroplasty (e.g., facet joint(s) replacement) including facetectomy, laminectomy,… (0202T) | $19,102 | $19,102 | 1.2× |
| Ppps, initial visit (G0438) range across 2 matching MRF lines |
$413–$465 | $413–$465 | varies |
| Ppps, subseq visit (G0439) | $413 | $413 | 3.0× |
| Prefab post/core + crown (D2954) | $660 | $660 | 0.8× |
| Prefab stainless steel crown (D2933) | $693 | $693 | 0.9× |
| Prefab steel crown primary (D2934) | $693 | $693 | 0.9× |
| Prefab stnlss steel crown pe (D2931) | $798 | $798 | 1.0× |
| Prefab stnlss steel crwn pri (D2930) | $638 | $638 | 0.8× |
| Prefabricated resin crown (D2932) | $638 | $638 | 0.8× |
| Primary closure sinus perf (D7261) | $1,073 | $1,073 | 1.3× |
| Prostate biopsy, any mthd (G0416) | $1,084 | $1,084 | 2.4× |
| Pulp cap direct (D3110) | $81 | $81 | 0.1× |
| Pulp cap indirect (D3120) | $69 | $69 | 0.1× |
| Pulpal therapy anterior prim (D3230) | $913 | $913 | 1.1× |
| Pulpal therapy posterior pri (D3240) | $792 | $792 | 1.0× |
| Rad exc lesion up to 1.25 cm (D7410) | $605 | $605 | 0.3× |
| Re-cement or re-bond crown (D2920) | $220 | $220 | 0.3× |
| Re-eval,est pt,problem focus (D0170) | $187 | $187 | 1.1× |
| Rem exostosis any site (D7471) | $1,524 | $1,524 | 0.4× |
| Rem imp tooth w mucoper flp (D7210) | $715 | $715 | 0.4× |
| Rem nonodonto cyst > 1.25 cm (D7461) | $1,067 | $1,067 | 1.3× |
| Rem nonodonto cyst to 1.25cm (D7460) | $693 | $693 | 0.9× |
| Rem odontogen cyst > 1.25 cm (D7451) | $999 | $999 | 0.2× |
| Rem odontogen cyst to 1.25cm (D7450) | $666 | $666 | 0.2× |
| Removal of sloughed off bone (D7550) range across 2 matching MRF lines |
$370–$850 | $370–$850 | varies |
| Removal of torus palatinus (D7472) range across 2 matching MRF lines |
$1,155–$2,900 | $1,155–$2,900 | varies |
| Remove torus mandibularis (D7473) | $1,155 | $1,155 | 1.4× |
| Remove unilat space maintain (D1520) | $627 | $627 | 0.8× |
| Resin 4/> surf or w incis an (D2335) | $594 | $594 | 0.7× |
| Resin one surface-anterior (D2330) | $363 | $363 | 0.4× |
| Resin three surfaces-anterio (D2332) | $520 | $520 | 0.6× |
| Resin two surfaces-anterior (D2331) | $462 | $462 | 0.6× |
| Retreat root canal anterior (D3346) | $1,898 | $1,898 | 2.4× |
| Retreat root canal molar (D3348) | $2,750 | $2,750 | 3.4× |
| Retreat root canal premolar (D3347) | $2,228 | $2,228 | 2.8× |
| Revasc intra lithotrip-ather (C9766) | $52,000 | $52,000 | 2.3× |
| Revasc intra lithotrip-stent (C9765) | $60,500 | $60,500 | 2.6× |
| Revasc intravasc lithotripsy (C9764) | $51,700 | $51,700 | 3.6× |
| Revasc lith-sten-ath tib/per (C9775) | $67,000 | $67,000 | 2.9× |
| Revasc lithotr-ather tib/per (C9774) | $52,000 | $52,000 | 2.3× |
| Revasc lithotr-stent tib/per (C9773) | $60,500 | $60,500 | 2.6× |
| Revasc lithotrip tibi/perone (C9772) | $51,700 | $51,700 | 3.6× |
| Revasc lithotrip-stent-ather (C9767) | $67,000 | $67,000 | 2.9× |
| Root surgery molar (D3425) | $1,925 | $1,925 | 2.4× |
| Root surgery premolar (D3421) | $1,916 | $1,916 | 2.4× |
| Space maintainer fxd unilat (D1510) | $726 | $726 | 0.9× |
| Surg reduct osseoustuberosit (D7485) likely a partial charge, not the full procedure |
$990 | $990 | 0.1× |
| Surgical splint (D5988) | $585 | $585 | 0.7× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $50,000 | $50,000 | 2.1× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) | $60,000 | $60,000 | 2.5× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $30,000 | $30,000 | 4.2× |
| Tee w or w/o fol w/cont, mon (C8927) | $3,788 | $3,788 | 3.9× |
| Tee w or w/o fol w/cont,cong (C8926) | $3,788 | $3,788 | 3.9× |
| Therapeutic pulpotomy (D3220) | $440 | $440 | 0.5× |
| Tomosynthesis, mammo (G0279) range across 3 matching MRF lines |
$273–$333 | $273–$333 | varies |
| Tooth reimplantation (D7270) | $952 | $952 | 1.2× |
| Tooth root removal (D7250) | $660 | $660 | 0.8× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $20,900 | $20,900 | 2.9× |
| Transcatheter renal sympath denervation unilat (0338T) | $20,900 | $20,900 | 2.9× |
| Trauma respons w/hosp criti (G0390) range across 2 matching MRF lines |
$5,000–$12,000 | $5,000–$12,000 | varies |
| Treatment of complications (D9930) | $471 | $471 | 0.6× |
| Trim nail(s) (G0127) | $295 | $295 | 4.0× |
| Trluml perip athrc abd aorta (0236T) | $47,850 | $47,850 | 3.3× |
| Trluml Perip Athrc Brchiocph (0237T) | $47,850 | $47,850 | 3.3× |
| Trluml Perip Athrc Iliac Art (0238T) range across 2 matching MRF lines |
$71,500–$88,967 | $71,500–$88,967 | varies |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) range across 3 matching MRF lines |
$44,000–$58,369 | $44,000–$58,369 | varies |
| Tte w or w/o contr, cont ecg (C8930) | $3,788 | $3,788 | 3.9× |
| Tte w or w/o fol w/con,stres (C8928) | $3,788 | $3,788 | 3.9× |
| Tte w or w/o fol w/cont, com (C8921) | $3,788 | $3,788 | 3.9× |
| Tte w or w/o fol w/cont, f/u (C8922) | $3,788 | $3,788 | 3.9× |
| Tte w or wo fol wcon,doppler (C8929) | $3,788 | $3,788 | 3.9× |
| U/s trtmt, not leiomyomata (C9734) | $38,500 | $38,500 | 2.4× |
| Unsched dialysis esrd pt hos (G0257) | $3,164 | $3,164 | 3.7× |
| Vasc emb/occ w/prs cath (C9797) | $12,100 | $12,100 | 0.5× |
| Visit to determ ldct elig (G0296) range across 2 matching MRF lines |
$70–$396 | $70–$396 | varies |
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.