Supplies, drugs & other prices at Memorial Hospital of South Bend
South Bend, IN · every code in this section with a posted price and a Medicare benchmark.
64 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) | $1,768 | $2,720 | 2.1× |
| 2d tte w or w/o fol w/con,co (C8923) | $1,768 | $2,720 | 2.1× |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,768 | $2,720 | 4.8× |
| Adm tocilizu covid-19 1st (M0249) | $813.80 | $1,252 | 1.7× |
| Adm tocilizu covid-19 2nd (M0250) | $813.80 | $1,252 | 1.7× |
| Admin hepatitis b vaccine (G0010) | $76.70 | $118 | 1.5× |
| Admin influenza virus vac (G0008) | $78.65 | $121 | 1.6× |
| Admin pneumococcal vaccine (G0009) | $82.55 | $127 | 1.7× |
| Alcohol/subs interv 15-30mn (G0396) | $30.55 | $47 | 0.8× |
| Alcohol/subs interv >30 min (G0397) | $154.70 | $238 | 0.8× |
| Antibody treponema pallidum total & rpr ia qual (0064U) | $357.50 | $550 | 11.4× |
| Autolog prp not diab ulcer (G0460) | $3,270.15 | $5,031 | 1.5× |
| Catheterize for urine spec (P9612) | $56.55 | $87 | 6.1× |
| Chemo extend iv infus w/pump (G0498) | $620.75 | $955 | 1.8× |
| Direct refer hospital observ (G0379) | $406.90 | $626 | 0.6× |
| Drug test def 1-7 classes (G0480) | $1,084.85 | $1,669 | 9.5× |
| Drug test def 15-21 classes (G0482) | $1,675.70 | $2,578 | 8.4× |
| Drug test def 22+ classes (G0483) | $2,192.45 | $3,373 | 8.9× |
| Drug test def 8-14 classes (G0481) | $1,320.15 | $2,031 | 8.4× |
| Elec stim other than wound (G0283) | $29.25 | $45 | 2.3× |
| Elec stim unattend for press (G0281) | $55.90 | $86 | 4.8× |
| Esd endoscopy or colonoscopy (C9779) | $2,502.50 | $3,850 | 0.6× |
| Ev Catheter Dir Chem Abltj Incmptnt Xtr Vein (0524T) | $6,125.60 | $9,424 | 1.8× |
| Hbot, full body chamber, 30m (G0277) | $557.70 | $858 | 3.8× |
| Hospital outpt clinic visit (G0463) | $204.10 | $314 | 1.4× |
| Intens cardiac rehab no exer (G0423) | $141.05 | $217 | 1.0× |
| Intens cardiac rehab w/exerc (G0422) | $141.05 | $217 | 1.0× |
| Mra w/cont, lwr ext (C8912) | $1,573 | $2,420 | 4.3× |
| Mra w/o cont, abd (C8901) | $1,257.75 | $1,935 | 5.0× |
| Mra w/o cont, chest (C8910) | $1,257.75 | $1,935 | 5.0× |
| Mra w/o cont, lwr ext (C8913) | $1,257.75 | $1,935 | 5.0× |
| Mra w/o fol w/cont, chest (C8911) | $1,651.65 | $2,541 | 4.5× |
| Mri w/o fol w/cont, breast, (C8908) | $1,746.55 | $2,687 | 4.7× |
| Oth resp proc, group (G0239) | $72.15 | $111 | 1.8× |
| Oth resp proc, indiv (G0238) | $57.85 | $89 | 1.9× |
| Perc d-e cor revasc chro sin (C9607) | $14,140.75 | $21,755 | 0.7× |
| Perc d-e cor revasc t cabg s (C9604) | $12,823.20 | $19,728 | 1.0× |
| Perc d-e cor stent ather s (C9602) | $14,140.75 | $21,755 | 0.7× |
| Perc drug-el cor stent sing (C9600) | $12,823.20 | $19,728 | 1.0× |
| Perq Sacral Augmt Bilat Inj (0201T) | $6,011.85 | $9,249 | 0.8× |
| Perq Sacral Augmt Unilat Inj (0200T) | $4,167.15 | $6,411 | 0.5× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) unusually low: confirm this is the full procedure |
$5,558.80 | $8,552 | 0.5× |
| Prolonged iv inf, req pump (C8957) | $620.75 | $955 | 2.8× |
| Prostate biopsy, any mthd (G0416) | $2,163.20 | $3,328 | 5.7× |
| Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) | $3,534.05 | $5,437 | 3.6× |
| Quan mr alys tiss compj w/o MRI same sess 1orgn (0648T) | $491.40 | $756 | 0.5× |
| Quan mr alys tiss composition w/MRI 1orgn (0649T) | $1,767.35 | $2,719 | 1.8× |
| Revasc intra lithotrip-ather (C9766) | $20,435.35 | $31,439 | 1.1× |
| Revasc intra lithotrip-stent (C9765) | $20,280 | $31,200 | 1.0× |
| Revasc intravasc lithotripsy (C9764) | $10,086.70 | $15,518 | 0.8× |
| Revasc lith-sten-ath tib/per (C9775) | $32,686.55 | $50,287 | 1.7× |
| Revasc lithotr-ather tib/per (C9774) | $32,686.55 | $50,287 | 1.7× |
| Revasc lithotr-stent tib/per (C9773) | $32,686.55 | $50,287 | 1.7× |
| Revasc lithotrip tibi/perone (C9772) | $20,435.35 | $31,439 | 1.7× |
| Revasc lithotrip-stent-ather (C9767) | $32,686.55 | $50,287 | 1.7× |
| Syphilis tst non-treponemal antibody ia qual rpr (0065U) | $165.10 | $254 | 9.1× |
| Therapeutic procd strg endur (G0237) | $77.35 | $119 | 2.5× |
| Tomosynthesis, mammo (G0279) | $41.60 | $64 | 3.3× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $5,558.80 | $8,552 | 0.9× |
| Transcatheter renal sympath denervation unilat (0338T) | $5,558.80 | $8,552 | 0.9× |
| Trauma respons w/hosp criti (G0390) range across 2 matching MRF lines |
$4,932.20–$7,421.05 | $7,588–$11,417 | varies |
| Trluml Perip Athrc Iliac Art (0238T) | $19,713.20 | $30,328 | 1.0× |
| Tte w or w/o fol w/con,stres (C8928) | $1,768 | $2,720 | 2.1× |
| Unsched dialysis esrd pt hos (G0257) | $2,732.60 | $4,204 | 3.8× |
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.