Supplies, drugs & other prices at Memorial Medical Center
Port Lavaca, TX · every code in this section with a posted price and a Medicare benchmark.
42 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin hepatitis b vaccine (G0010) | $42 | $60 | 0.9× |
| Admin influenza virus vac (G0008) | $69.30 | $99 | 1.5× |
| Admin pneumococcal vaccine (G0009) | $69.30 | $99 | 1.5× |
| Alcohol/subs interv 15-30mn (G0396) | $24.93 | $35.61 | 0.7× |
| Alcohol/subs interv >30 min (G0397) | $48.02 | $68.60 | 0.3× |
| Ca screen;flexi sigmoidscope (G0104) | $90.36 | $129.08 | 0.1× |
| Ca screen;pelvic/breast exam (G0101) | $50.41 | $72.02 | 0.5× |
| Cardiokymography (Q0035) | $13.63 | $19.47 | 0.4× |
| Colon ca scrn not hi rsk ind (G0121) | $599.20 | $856 | 0.6× |
| Colorectal scrn; hi risk ind (G0105) | $259.72 | $371.03 | 0.3× |
| Demonstrate use home inr mon (G0248) | $70.95 | $101.36 | 0.5× |
| Diab manage trn per indiv (G0108) | $35.99 | $51.42 | 0.6× |
| Diab manage trn ind/group (G0109) | $9.92 | $14.17 | 0.6× |
| Elec stim other than wound (G0283) | $46.66 | $66.65 | 3.7× |
| Elec stim unattend for press (G0281) | $9.31 | $13.30 | 0.8× |
| Electromagntic tx for ulcers (G0329) | $6.53 | $9.33 | 0.6× |
| Extrnl counterpulse, per tx (G0166) | $87.82 | $125.45 | 0.7× |
| Followup eval of foot pt lop (G0246) | $25.45 | $36.36 | 0.2× |
| Glaucoma scrn hgh risk direc (G0118) | $29.27 | $41.82 | 0.8× |
| Glaucoma scrn hgh risk direc (G0117) | $36.71 | $52.44 | 1.3× |
| Group mnt 2 or more 30 mins (G0271) | $10.84 | $15.48 | 0.6× |
| Hopd mntl hlt, 15-29 min (C7900) | $122.50 | $175 | 3.3× |
| Hopd mntl hlt, 30-60 min (C7901) | $140 | $200 | 1.4× |
| Hopd mntl hlt, grp (C7903) | $122.50 | $175 | 3.3× |
| Hospital outpt clinic visit (G0463) | $147.70 | $211 | 1.1× |
| Initial foot exam pt lops (G0245) | $44.22 | $63.17 | 0.3× |
| Initial preventive exam (G0402) | $211.70 | $302.43 | 1.6× |
| Mnt subs tx for change dx (G0270) | $20.63 | $29.47 | 0.7× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $839.30 | $1,199 | 1.9× |
| Obtaining screen pap smear (Q0091) | $36.40 | $52.01 | 1.3× |
| Oth resp proc, group (G0239) | $48.92 | $69.89 | 1.3× |
| Oth resp proc, indiv (G0238) | $6.87 | $9.81 | 0.2× |
| Ppps, initial visit (G0438) | $240.58 | $343.69 | 1.4× |
| Ppps, subseq visit (G0439) | $168.16 | $240.24 | 1.2× |
| Provide inr test mater/equip (G0249) | $71.18 | $101.69 | 0.5× |
| Psa screening (G0103) | $109.90 | $157 | 5.7× |
| Routine footcare pt w lops (G0247) | $47.81 | $68.30 | 0.2× |
| Single energy x-ray study (G0130) | $22.46 | $32.09 | 0.2× |
| Therapeutic procd strg endur (G0237) | $55.36 | $79.08 | 1.9× |
| Tomosynthesis, mammo (G0279) | $65.80 | $94 | 5.2× |
| Trauma respons w/hosp criti (G0390) | $940.80 | $1,344 | 0.7× |
| Trim nail(s) (G0127) | $19.18 | $27.40 | 0.3× |