Supplies, drugs & other prices at Mammoth Hospital
Mammoth Lakes, CA · every code in this section with a posted price and a Medicare benchmark.
82 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) | $227.50 | $325 | 0.1× |
| Admin hepatitis b vaccine (G0010) range across 3 matching MRF lines |
$16.10–$18.90 | $23–$27 | varies |
| Admin influenza virus vac (G0008) range across 2 matching MRF lines |
$16.10–$20.30 | $23–$29 | varies |
| Admin pneumococcal vaccine (G0009) range across 4 matching MRF lines |
$16.10–$18.20 | $23–$26 | varies |
| Alcohol/subs interv 15-30mn (G0396) | $58.10 | $83 | 1.2× |
| Alcohol/subs interv >30 min (G0397) | $140.70 | $201 | 0.6× |
| Amalgam 4 or > surfaces perm (D2161) | $138.60 | $198 | 0.2× |
| Amalgam one surface permanen (D2140) | $84 | $120 | 0.1× |
| Amalgam three surfaces perma (D2160) | $114.10 | $163 | 0.1× |
| Amalgam two surfaces permane (D2150) | $92.40 | $132 | 0.1× |
| Annual alcohol screen 15 min (G0442) | $20.30 | $29 | 0.4× |
| Ant resin-based cmpst crown (D2390) | $198.80 | $284 | 0.2× |
| Behavior counsel obesity 15m (G0447) | $49.70 | $71 | 0.4× |
| Bitewings four images (D0274) | $42 | $60 | 0.1× |
| Brief alcohol misuse counsel (G0443) | $49.70 | $71 | 0.4× |
| Ca screen;pelvic/breast exam (G0101) | $25.20 | $36 | 0.2× |
| Comprehensve oral evaluation (D0150) | $42 | $60 | 0.2× |
| Core build-up incl any pins (D2950) | $168 | $240 | 0.2× |
| Covid-19 lab test non-cdc (U0002) | $79.55 | $113.64 | 1.6× |
| Crown full cast high noble m (D2790) | $747.60 | $1,068 | 0.9× |
| Crown porcelain fused base m (D2751) | $855.40 | $1,222 | 1.0× |
| Crown porcelain w/ h noble m (D2750) | $924 | $1,320 | 1.1× |
| Crown porcelain/ceramic (D2740) | $840 | $1,200 | 1.0× |
| Dental bitewings two images (D0272) | $29.40 | $42 | 0.3× |
| Dental onlay porc 4/more sur (D2644) | $786.10 | $1,123 | 0.9× |
| Dental onlay porcelin 2 surf (D2642) | $667.80 | $954 | 0.8× |
| Dental onlay porcelin 3 surf (D2643) | $756 | $1,080 | 0.9× |
| Dental prophylaxis adult (D1110) | $66.50 | $95 | 0.4× |
| Depression screen annual (G0444) | $18.90 | $27 | 0.4× |
| Diab manage trn per indiv (G0108) | $77 | $110 | 1.4× |
| Diab manage trn ind/group (G0109) | $21 | $30 | 1.3× |
| Drug test def 1-7 classes (G0480) range across 7 matching MRF lines |
$16.10–$375.90 | $23–$537 | varies |
| Ekg tracing for initial prev (G0404) | $38.50 | $55 | 1.0× |
| End thxpy, anterior tooth (D3310) | $435.40 | $622 | 0.5× |
| End thxpy, molar tooth (D3330) | $725.90 | $1,037 | 0.9× |
| End thxpy, premolar tooth (D3320) | $519.40 | $742 | 0.6× |
| Extraction coronal remnants (D7111) | $74.90 | $107 | 0.1× |
| Extraction erupted tooth/exr (D7140) | $92.40 | $132 | 0.1× |
| Fecal blood scrn immunoassay (G0328) | $67.20 | $96 | 3.7× |
| Full mouth debridement (D4355) | $105 | $150 | 0.1× |
| Glyca nuc mr spectroscopy quantitative (0024U) | $11.76 | $16.80 | 0.3× |
| Gross pulpal debridement (D3221) | $168 | $240 | 0.2× |
| Group mnt 2 or more 30 mins (G0271) range across 2 matching MRF lines |
$21.70–$29.40 | $31–$42 | varies |
| High inten beh couns std 30m (G0445) | $49.70 | $71 | 0.4× |
| Hospital outpt clinic visit (G0463) | $147.70 | $211 | 0.9× |
| Impact tooth remov soft tiss (D7220) | $193.20 | $276 | 0.2× |
| Initial preventive exam (G0402) | $250.60 | $358 | 1.5× |
| Intens behave ther cardio dx (G0446) | $49.70 | $71 | 1.0× |
| Intraor comprehensive series (D0210) | $84 | $120 | 0.3× |
| Intraoral periapical first (D0220) | $21 | $30 | 0.2× |
| Limit oral eval problm focus (D0140) | $42 | $60 | 0.2× |
| Mnt subs tx for change dx (G0270) range across 2 matching MRF lines |
$21–$28.70 | $30–$41 | varies |
| Osseous surg 1 to 3 teeth (D4261) | $449.40 | $642 | 0.1× |
| Panoramic image (D0330) | $70 | $100 | 0.2× |
| Periodic oral evaluation (D0120) | $29.40 | $42 | 0.2× |
| Periodontal maint procedures (D4910) | $87.50 | $125 | 0.1× |
| Periodontal scaling & root (D4341) | $210 | $300 | 0.3× |
| Periodontal scaling 1-3teeth (D4342) | $113.40 | $162 | 0.1× |
| Post 1 srfc resinbased cmpst (D2391) | $91 | $130 | 0.1× |
| Post 2 srfc resinbased cmpst (D2392) | $168 | $240 | 0.2× |
| Post 3 srfc resinbased cmpst (D2393) | $226.80 | $324 | 0.3× |
| Post >=4srfc resinbase cmpst (D2394) | $239.40 | $342 | 0.3× |
| Post and core cast + crown (D2952) | $245 | $350 | 0.3× |
| Ppps, initial visit (G0438) | $276.50 | $395 | 1.6× |
| Ppps, subseq visit (G0439) | $276.50 | $395 | 2.0× |
| Prefab post/core + crown (D2954) | $210 | $300 | 0.3× |
| Prefab stnlss steel crown pe (D2931) | $138.60 | $198 | 0.2× |
| Prefab stnlss steel crwn pri (D2930) | $168 | $240 | 0.2× |
| Psa screening (G0103) range across 2 matching MRF lines |
$160.30–$471.80 | $229–$674 | varies |
| Pulp cap direct (D3110) | $52.50 | $75 | 0.1× |
| Re-cement or re-bond crown (D2920) | $63 | $90 | 0.1× |
| Recement inlay onlay or part (D2910) | $105 | $150 | 0.1× |
| Rem imp tooth w mucoper flp (D7210) | $142.10 | $203 | 0.1× |
| Resin 4/> surf or w incis an (D2335) | $168 | $240 | 0.2× |
| Resin one surface-anterior (D2330) | $84 | $120 | 0.1× |
| Resin three surfaces-anterio (D2332) | $147 | $210 | 0.2× |
| Resin two surfaces-anterior (D2331) | $126 | $180 | 0.2× |
| Scr c/v cyto,thinlayer,rescr (G0145) range across 14 matching MRF lines |
$13.52–$79.62 | $19.32–$113.75 | varies |
| Space maintainer fxd unilat (D1510) | $245.70 | $351 | 0.3× |
| Therapeutic pulpotomy (D3220) | $126 | $180 | 0.2× |
| Tomosynthesis, mammo (G0279) range across 9 matching MRF lines |
$75.60–$79.10 | $108–$113 | varies |
| Tooth root removal (D7250) | $172.20 | $246 | 0.2× |
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.