Supplies, drugs & other prices at Memorial Hospital

Abilene, KS · every code in this section with a posted price and a Medicare benchmark.

67 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) $3,210.50 $3,210.50 4.5×
2d tte w or w/o fol w/con,fu (C8924) $972.50 $972.50 3.0×
Adm of soc dtr assess 5-15 m (G0136) $30 $30 0.9×
Admin influenza virus vac (G0008) $82.60 $82.60 1.9×
Admin pneumococcal vaccine (G0009) $82.60 $82.60 1.9×
Ascvd rsk mng clin stf pr mo (G0538) $38 $38 0.4×
Behavior counsel obesity 15m (G0447) $40 $40 0.4×
Ca screen;flexi sigmoidscope (G0104) $541.70 $541.70 0.6×
Ca screen;pelvic/breast exam (G0101) $85 $85 0.9×
Colon ca scrn not hi rsk ind (G0121) $935.40 $935.40 1.1×
Colorectal scrn; hi risk ind (G0105) $990.40 $990.40 1.2×
Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation… (0446T) $256.80 $256.80 0.1×
Diab manage trn per indiv (G0108) $70 $70 1.3×
Diab manage trn ind/group (G0109) $45.80 $45.80 2.9×
Direct refer hospital observ (G0379) $136.90 $136.90 0.2×
Drug test def 1-7 classes (G0480) $268.10 $268.10 2.3×
Drug test def 15-21 classes (G0482) $700 $700 3.5×
Drug test def 8-14 classes (G0481) $700 $700 4.5×
Ekg tracing for initial prev (G0404) $122.30 $122.30 4.6×
Elec stim other than wound (G0283) $135.10 $135.10 10.6×
Elec stim unattend for press (G0281) $157.40 $157.40 13.5×
Extracorporeal shock wave muscskel sys nos (0101T) $150 $150 0.7×
Extrnl counterpulse, per tx (G0166) $775.80 $775.80 6.3×
Group mnt 2 or more 30 mins (G0271) $93.80 $93.80 5.5×
Hep c screen high risk/other (G0472) $127.40 $127.40 2.7×
Hepb screen high risk indiv (G0499) $316 $316 11.2×
Hiv combination assay (G0475) $67.75 $67.75 2.8×
Home sleep test/type 3 porta (G0399) $726.40 $726.40 3.7×
Hopd mntl hlt, 15-29 min (C7900) $652.70 $652.70 18.9×
Hopd mntl hlt, 30-60 min (C7901) $807.90 $807.90 8.6×
Hopd mntl hlt, grp (C7903) $786.50 $786.50 22.8×
Hospital outpt clinic visit (G0463) $169.30 $169.30 1.4×
Hpv combo assay ca screen (G0476) $97 $97 2.8×
Initial preventive exam (G0402) $139.10 $139.10 1.1×
Inj for sacroiliac jt anesth (G0260) $3,007.05 $3,007.05 4.6×
Intens behave ther cardio dx (G0446) $40 $40 1.2×
Liver dis 10 assays w/nash (0003M) $1,221.30 $1,221.30 2.4×
Mnt subs tx for change dx (G0270) $93.80 $93.80 3.0×
Mra w/o cont, pelvis (C8919) $4,269.60 $4,269.60 19.5×
Mra w/o fol w/cont, pelvis (C8920) $5,657.70 $5,657.70 17.6×
Njx pltlt plasma w/img harvest/preparation (0232T) $380 $380 0.9×
Obtaining screen pap smear (Q0091) $28 $28 1.1×
Open tx iliac spine uni/bil (G0412)
likely a partial charge, not the full procedure
$1,945.30 $1,945.30 0.3×
Open tx post pelvic fxcture (G0415) $2,846.40 $2,846.40 0.9×
Oth resp proc, group (G0239) $92.40 $92.40 2.7×
Oth resp proc, indiv (G0238) $75.30 $75.30 2.8×
Pelvic ring fracture uni/bil (G0413)
likely a partial charge, not the full procedure
$1,681.95 $1,681.95 0.3×
Pemivibart infusion (M0224) $900 $900 2.2×
Perc d-e cor revasc chro sin (C9607) $20,007.70 $20,007.70 1.2×
Perc d-e cor revasc t cabg s (C9604) $20,007.70 $20,007.70 1.9×
Perc d-e cor stent ather s (C9602) $49,822.60 $49,822.60 3.0×
Perc drug-el cor stent sing (C9600) $32,536.40 $32,536.40 3.1×
Perq Sacral Augmt Bilat Inj (0201T) $10,380.10 $10,380.10 1.6×
Perq Sacral Augmt Unilat Inj (0200T) $10,380.10 $10,380.10 1.6×
Ppps, initial visit (G0438) $270.30 $270.30 1.6×
Ppps, subseq visit (G0439) $180.90 $180.90 1.3×
Prostate biopsy, any mthd (G0416) $337.10 $337.10 1.0×
Psa screening (G0103) $180.30 $180.30 9.3×
Risk ascvd tst once pr 12 mo (G0537) $30 $30 0.9×
Therapeutic procd strg endur (G0237) $75.30 $75.30 2.8×
Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) $3,850 $3,850 1.1×
Trim nail(s) (G0127) $144.80 $144.80 2.7×
Trluml peripheral atherectomy iliac artery ea (0238T) $21,362.10 $21,362.10 1.3×
Tte w or w/o fol w/con,stres (C8928) $2,023.70 $2,023.70 2.8×
Tte w or wo fol wcon,doppler (C8929) $4,368 $4,368 6.1×
Visit to determ ldct elig (G0296) $79.10 $79.10 0.8×
Wet mounts/ w preparations (Q0111) $40.20 $40.20 2.2×