Supplies, drugs & other prices at Memorial Hospital
Belleville, IL · every code in this section with a posted price and a Medicare benchmark.
69 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $3,175.80 | $5,293 | 3.8× |
| 2d tte w or w/o fol w/con,co (C8923) | $1,631.40 | $2,719 | 1.9× |
| 2d tte w or w/o fol w/con,fu (C8924) | $466.20 | $777 | 1.2× |
| Admin hepatitis b vaccine (G0010) | $82.20 | $137 | 1.6× |
| Admin influenza virus vac (G0008) | $82.20 | $137 | 1.6× |
| Admin pneumococcal vaccine (G0009) | $82.20 | $137 | 1.6× |
| Adrnl cortcl tum bchm asy 25 (0015M) | $1,958.40 | $3,264 | 1.5× |
| Antibody treponema pallidum total & rpr ia qual (0064U) | $61.20 | $102 | 2.0× |
| Direct refer hospital observ (G0379) | $570 | $950 | 0.9× |
| Drug test def 1-7 classes (G0480) range across 4 matching MRF lines |
$96–$159 | $160–$265 | varies |
| Drug test def 15-21 classes (G0482) | $298.80 | $498 | 1.5× |
| Drug test def 22+ classes (G0483) | $370.80 | $618 | 1.5× |
| Drug test def 8-14 classes (G0481) | $235.20 | $392 | 1.5× |
| Eia hiv-1/hiv-2 screen (G0432) | $69.60 | $116 | 3.6× |
| Elec stim other than wound (G0283) | $136.20 | $227 | 10.7× |
| Fecal blood scrn immunoassay (G0328) | $56.40 | $94 | 3.1× |
| Hep c screen high risk/other (G0472) | $79.80 | $133 | 1.7× |
| Hiv combination assay (G0475) | $101.40 | $169 | 4.2× |
| Home sleep test/type 3 porta (G0399) | $870 | $1,450 | 3.8× |
| Hospital outpt clinic visit (G0463) range across 4 matching MRF lines |
$302.40–$1,531.80 | $504–$2,553 | varies |
| Hpv combo assay ca screen (G0476) | $58.20 | $97 | 1.7× |
| Inj for sacroiliac jt anesth (G0260) range across 2 matching MRF lines |
$24,348.18–$47,477.26 | $40,580.30–$79,128.77 | varies |
| Insertion perm ccm-d system pulse generator only (0916T) unusually low: confirm this is the full procedure |
$11,089.20 | $18,482 | 0.5× |
| Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) | $6,502.80 | $10,838 | 0.7× |
| Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) unusually low: confirm this is the full procedure |
$10,901.40 | $18,169 | 0.3× |
| Interrog dev eval impl ccm-d system in person (0927T) | $53.40 | $89 | 1.3× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) | $498.60 | $831 | 4.1× |
| Mra w/cont, abd (C8900) | $1,897.80 | $3,163 | 5.1× |
| Mra w/cont, chest (C8909) | $1,519.80 | $2,533 | 4.1× |
| Mra w/o fol w/cont, abd (C8902) | $2,157 | $3,595 | 5.8× |
| Mri w/o fol w/cont, breast, (C8908) | $3,357 | $5,595 | 9.0× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,554.60 | $2,591 | 4.2× |
| Oth resp proc, group (G0239) | $173.40 | $289 | 4.3× |
| Pathogen test for platelets (P9100) | $1,287.60 | $2,146 | 20.4× |
| Perc d-e cor revasc chro sin (C9607) | $15,614.40 | $26,024 | 0.8× |
| Perc d-e cor revasc t cabg s (C9604) range across 3 matching MRF lines |
$21,154.10–$26,712.86 | $35,256.83–$44,521.44 | varies |
| Perc d-e cor stent ather s (C9602) range across 4 matching MRF lines |
$33,197.97–$53,558.79 | $55,329.95–$89,264.65 | varies |
| Perc drug-el cor stent sing (C9600) range across 4 matching MRF lines |
$26,360.60–$29,963.50 | $43,934.33–$49,939.16 | varies |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) | $7,480.20 | $12,467 | 0.6× |
| Programming device eval impl ccm-d sys in person (0926T) | $53.40 | $89 | 1.3× |
| Prostate biopsy, any mthd (G0416) | $742.80 | $1,238 | 1.9× |
| Psa screening (G0103) | $166.80 | $278 | 8.6× |
| Qmrcp W/Diagnostic MRI Same Anatomy (0724T) | $1,095.60 | $1,826 | 1.1× |
| Quan CT tiss charac i&r w/cncrnt CT exam (0722T) | $750 | $1,250 | 1.1× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $789.60 | $1,316 | 1.1× |
| Relocation skin pocket implanted ccm-d pg (0925T) | $2,097 | $3,495 | 0.9× |
| Removal perm ccm-d system pulse generator only (0919T) | $7,263 | $12,105 | 1.8× |
| Repositioning prev impl ccm-d transvns eltrd/ld (0924T) | $2,875.80 | $4,793 | 4.3× |
| Revasc intra lithotrip-ather (C9766) | $59,504.33 | $99,173.89 | 3.0× |
| Revasc intra lithotrip-stent (C9765) range across 4 matching MRF lines |
$40,126.03–$86,033.19 | $66,876.72–$143,388.65 | varies |
| Revasc intravasc lithotripsy (C9764) range across 3 matching MRF lines |
$43,543.01–$59,554.35 | $72,571.69–$99,257.25 | varies |
| Revasc lith-sten-ath tib/per (C9775) | $59,912.57 | $99,854.29 | 3.0× |
| Revasc lithotr-ather tib/per (C9774) | $36,117.17 | $60,195.28 | 1.8× |
| Revasc lithotr-stent tib/per (C9773) range across 2 matching MRF lines |
$47,408.57–$60,262.34 | $79,014.28–$100,437.24 | varies |
| Revasc lithotrip tibi/perone (C9772) range across 2 matching MRF lines |
$32,920.86–$37,910.37 | $54,868.10–$63,183.95 | varies |
| Revasc lithotrip-stent-ather (C9767) range across 2 matching MRF lines |
$58,596.58–$77,171.24 | $97,660.96–$128,618.74 | varies |
| Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T) | $3,313.20 | $5,522 | 0.8× |
| Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) | $3,313.20 | $5,522 | 0.8× |
| Rmvl perm ccm-d sys dual transvns leads only (0922T) | $3,313.20 | $5,522 | 0.8× |
| Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) unusually low: confirm this is the full procedure |
$10,018.80 | $16,698 | 0.4× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $127.20 | $212 | 4.8× |
| Screen cerv/vag thin layer (G0123) | $72.60 | $121 | 3.6× |
| Syphilis tst non-treponemal antibody ia qual rpr (0065U) | $34.80 | $58 | 1.9× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) unusually low: confirm this is the full procedure |
$9,108.60 | $15,181 | 0.4× |
| Tomosynthesis, mammo (G0279) range across 6 matching MRF lines |
$30–$60 | $50–$100 | varies |
| Tpmt and Nudt15 Genotype (0034U) | $640.80 | $1,068 | 1.4× |
| Tte w or w/o fol w/con,stres (C8928) | $4,407 | $7,345 | 5.2× |
| Tte w or wo fol wcon,doppler (C8929) | $5,880.60 | $9,801 | 7.0× |
| Unsched dialysis esrd pt hos (G0257) | $875.40 | $1,459 | 1.2× |
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.