Supplies, drugs & other prices at Memorial Hermann Memorial City Medical Center
Houston, TX · every code in this section with a posted price and a Medicare benchmark.
93 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) | $5,670.40 | $17,720 | 2.9× |
| Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T) | $5,670.40 | $17,720 | 0.6× |
| Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) | $6,520.96 | $20,378 | 3.3× |
| Adm tocilizu covid-19 1st (M0249) | $144 | $450 | 0.3× |
| Adm tocilizu covid-19 2nd (M0250) | $144 | $450 | 0.3× |
| Admin hepatitis b vaccine (G0010) | $46.96 | $146.75 | 1.0× |
| Admin influenza virus vac (G0008) | $40.88 | $127.75 | 0.9× |
| Admin pneumococcal vaccine (G0009) | $40.48 | $126.50 | 0.9× |
| Ca screen;flexi sigmoidscope (G0104) | $604.32 | $1,888.50 | 0.6× |
| Colon ca scrn not hi rsk ind (G0121) | $644.24 | $2,013.25 | 0.7× |
| Colorectal scrn; hi risk ind (G0105) | $564.88 | $1,765.25 | 0.6× |
| Comt gene (0032U) | $119.28 | $372.75 | 0.7× |
| Covid-19 lab test non-cdc (U0002) | $62.08 | $194 | 1.2× |
| Diab manage trn per indiv (G0108) | $98.24 | $307 | 1.8× |
| Diab manage trn ind/group (G0109) | $80.96 | $253 | 5.1× |
| Direct refer hospital observ (G0379) | $148.56 | $464.25 | 0.2× |
| Drug test def 1-7 classes (G0480) | $148.88 | $465.25 | 1.3× |
| Drug test def 15-21 classes (G0482) | $227.92 | $712.25 | 1.1× |
| Drug test def 22+ classes (G0483) | $283.36 | $885.50 | 1.1× |
| Drug test def 8-14 classes (G0481) | $203.68 | $636.50 | 1.3× |
| Elec stim other than wound (G0283) | $152.16 | $475.50 | 12.0× |
| Elec stim unattend for press (G0281) | $153.44 | $479.50 | 13.1× |
| Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) likely a partial charge, not the full procedure |
$10,640.80 | $33,252.50 | 0.2× |
| Esd endoscopy or colonoscopy (C9779) | $859.84 | $2,687 | 0.2× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $6,691.36 | $20,910.50 | 0.6× |
| Group train w/o patient (G0543) | $29.44 | $92 | 1.0× |
| Hbot, full body chamber, 30m (G0277) | $557.68 | $1,742.75 | 4.0× |
| Home sleep test/type 3 porta (G0399) | $172 | $537.50 | 0.8× |
| Initial care training 30 m (G0539) | $147.36 | $460.50 | 2.8× |
| Inj for sacroiliac jt anesth (G0260) | $2,360.48 | $7,376.50 | 3.3× |
| Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation… (0647T) | $1,565.44 | $4,892 | 0.8× |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) unusually low: confirm this is the full procedure |
$14,076.64 | $43,989.50 | 0.4× |
| Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) | $4,692.64 | $14,664.50 | 0.6× |
| Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) | $4,692.64 | $14,664.50 | 0.6× |
| Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) | $14,076.48 | $43,989 | 0.6× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) | $21,667.20 | $67,710 | 0.7× |
| Instill pharm renal pelvis (C9789) | $71.60 | $223.75 | 0.1× |
| Mra w/cont, abd (C8900) | $1,436.80 | $4,490 | 4.1× |
| Mra w/cont, chest (C8909) | $1,336.64 | $4,177 | 3.8× |
| Mra w/cont, lwr ext (C8912) | $2,159.12 | $6,747.25 | 6.2× |
| Mra w/o cont, abd (C8901) | $1,336.96 | $4,178 | 5.6× |
| Mra w/o cont, chest (C8910) | $1,164.56 | $3,639.25 | 4.9× |
| Mra w/o cont, lwr ext (C8913) | $1,807.44 | $5,648.25 | 7.5× |
| Mra w/o cont, pelvis (C8919) | $1,130.32 | $3,532.25 | 4.7× |
| Mra w/o fol w/cont, abd (C8902) | $1,580.56 | $4,939.25 | 4.5× |
| Mra w/o fol w/cont, chest (C8911) | $1,596.64 | $4,989.50 | 4.6× |
| Mra w/o fol w/cont, lwr ext (C8914) | $2,190.40 | $6,845 | 6.3× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,578.16 | $4,931.75 | 4.5× |
| Mra, w/o&w/dye, upper extr (C8936) | $1,241.52 | $3,879.75 | 3.5× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $519.36 | $1,623 | 1.0× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $230 | $718.75 | 0.5× |
| No pt prsnt train initial 30 (G0541) | $128.16 | $400.50 | 4.4× |
| Oth resp proc, group (G0239) | $48.56 | $151.75 | 1.3× |
| Oth resp proc, indiv (G0238) | $45.60 | $142.50 | 1.6× |
| Pathogen test for platelets (P9100) | $35.28 | $110.25 | 0.6× |
| Perc d-e cor revasc chro sin (C9607) likely a partial charge, not the full procedure |
$5,351.52 | $16,723.50 | 0.3× |
| Perc d-e cor revasc t cabg s (C9604) unusually low: confirm this is the full procedure |
$5,481.68 | $17,130.25 | 0.5× |
| Perc d-e cor stent ather s (C9602) likely a partial charge, not the full procedure |
$5,138.24 | $16,057 | 0.3× |
| Perc drug-el cor stent sing (C9600) | $6,307.68 | $19,711.50 | 0.5× |
| Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) unusually low: confirm this is the full procedure |
$4,535.36 | $14,173 | 0.4× |
| Place endorectal app (C9725) | $1,504 | $4,700 | 1.6× |
| Prgrmg dev eval wcs ip (0522T) | $170.88 | $534 | 4.6× |
| Prostate biopsy, any mthd (G0416) | $450.88 | $1,409 | 1.3× |
| Quan us tiss charac i&r w/o dx us same anat (0689T) | $129.44 | $404.50 | 1.5× |
| Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) | $1,910.24 | $5,969.50 | 0.9× |
| Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s)… (0519T) likely a partial charge, not the full procedure |
$2,814.08 | $8,794 | 0.3× |
| Removal Cardiac Modulj Sys Pls Generator Only (0412T) | $3,492.96 | $10,915.50 | 0.9× |
| Removal Cardiac Modulj Sys Transvenous Electrode (0413T) | $3,492.96 | $10,915.50 | 0.9× |
| Repos Cardiac Modulj Transvenous Electrode (0415T) | $746.08 | $2,331.50 | 1.2× |
| Revasc intra lithotrip-ather (C9766) unusually low: confirm this is the full procedure |
$8,046.08 | $25,144 | 0.4× |
| Revasc intra lithotrip-stent (C9765) unusually low: confirm this is the full procedure |
$8,046.08 | $25,144 | 0.4× |
| Revasc intravasc lithotripsy (C9764) unusually low: confirm this is the full procedure |
$4,543.68 | $14,199 | 0.4× |
| Revasc lith-sten-ath tib/per (C9775) | $10,786.64 | $33,708.25 | 0.6× |
| Revasc lithotr-ather tib/per (C9774) | $10,724.88 | $33,515.25 | 0.6× |
| Revasc lithotr-stent tib/per (C9773) | $10,724.88 | $33,515.25 | 0.6× |
| Revasc lithotrip tibi/perone (C9772) | $9,205.68 | $28,767.75 | 0.8× |
| Revasc lithotrip-stent-ather (C9767) | $10,786.64 | $33,708.25 | 0.6× |
| Screen cerv/vag thin layer (G0123) | $197.68 | $617.75 | 9.8× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) likely a partial charge, not the full procedure |
$1,566.64 | $4,895.75 | 0.1× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $9,775.28 | $30,547.75 | 0.5× |
| Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) | $1,870.40 | $5,845 | 0.6× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $3,536.56 | $11,051.75 | 0.6× |
| Therapeutic procd strg endur (G0237) | $230.56 | $720.50 | 7.9× |
| Tomosynthesis, mammo (G0279) | $32 | $100 | 2.5× |
| Tpmt Nudt15 Gene Analysis Common Variants (0034U) | $447.52 | $1,398.50 | 1.0× |
| Train for caregiver add 15 (G0540) | $79.60 | $248.75 | 3.1× |
| Transcatheter implantation of coronary sinus reduction device including vascular access and closure, right heart… (0645T) unusually low: confirm this is the full procedure |
$7,251.12 | $22,659.75 | 0.4× |
| Trluml Perip Athrc Renal Art (0234T) likely a partial charge, not the full procedure |
$2,570.48 | $8,032.75 | 0.2× |
| Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) likely a partial charge, not the full procedure |
$2,896.96 | $9,053 | 0.2× |
| Trluml peripheral atherectomy iliac artery ea (0238T) likely a partial charge, not the full procedure |
$3,038.72 | $9,496 | 0.2× |
| Tte w or w/o contr, cont ecg (C8930) | $3,143.84 | $9,824.50 | 4.0× |
| Unsched dialysis esrd pt hos (G0257) | $2,258.16 | $7,056.75 | 3.3× |
| Warfarin response genotype (0030U) | $270.64 | $845.75 | 2.0× |