Supplies, drugs & other prices at Memorialcare Orange Coast Medical Center
Fountain Valley, CA · every code in this section with a posted price and a Medicare benchmark.
161 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) | $6,635 | $6,635 | 6.6× |
| 2d tte w or w/o fol w/con,co (C8923) | $4,170 | $4,170 | 4.1× |
| 2d tte w or w/o fol w/con,fu (C8924) | $3,300 | $3,300 | 7.4× |
| Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T) | $14,936 | $14,936 | 3.0× |
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) | $8,265 | $8,265 | 3.3× |
| Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) | $8,265 | $8,265 | 3.3× |
| Adm of soc dtr assess 5-15 m (G0136) | $76 | $76 | 1.6× |
| Adm tocilizu covid-19 1st (M0249) | $1,460 | $1,460 | 2.6× |
| Adm tocilizu covid-19 2nd (M0250) | $1,460 | $1,460 | 2.6× |
| Admin hepatitis b vaccine (G0010) range across 3 matching MRF lines |
$111–$184 | $111–$184 | varies |
| Admin influenza virus vac (G0008) range across 2 matching MRF lines |
$117–$184 | $117–$184 | varies |
| Admin pneumococcal vaccine (G0009) range across 2 matching MRF lines |
$117–$184 | $117–$184 | varies |
| Alcohol/sub misuse assess (G2011) | $107 | $107 | 2.9× |
| Alcohol/subs interv 15-30mn (G0396) | $127 | $127 | 2.6× |
| Alcohol/subs interv >30 min (G0397) | $625 | $625 | 2.7× |
| Annual alcohol screen 15 min (G0442) | $76 | $76 | 1.6× |
| Blind interatrial shunt ide (C9758) | $44,195 | $44,195 | 2.0× |
| Brief alcohol misuse counsel (G0443) range across 2 matching MRF lines |
$235–$325 | $235–$325 | varies |
| Ca screen;flexi sigmoidscope (G0104) | $3,568 | $3,568 | 3.0× |
| Ca screen;pelvic/breast exam (G0101) range across 6 matching MRF lines |
$338–$416 | $338–$416 | varies |
| Chemo extend iv infus w/pump (G0498) | $2,499 | $2,499 | 5.9× |
| Colon ca scrn not hi rsk ind (G0121) | $5,125 | $5,125 | 4.3× |
| Colorectal scrn; hi risk ind (G0105) | $5,118 | $5,118 | 4.3× |
| Comm hlth intg svs sdoh 60mn (G0019) | $290 | $290 | 2.2× |
| CT breast w/3d rendering bi with contrast (0637T) | $6,381 | $6,381 | 14.2× |
| CT breast w/3d rendering bi without contrast (0636T) | $6,007 | $6,007 | 19.6× |
| CT breast w/3d rendering uni with contrast (0634T) | $4,168 | $4,168 | 18.5× |
| CT breast w/3d rendering uni without contrast (0633T) | $3,919 | $3,919 | 29.1× |
| CT brst w/3d rendering bi wo cntrst flwd cntrst (0638T) | $6,840 | $6,840 | 15.2× |
| CT brst w/3d rendering uni wo cntrst flwd cntrst (0635T) | $4,880 | $4,880 | 21.6× |
| Depression screen annual (G0444) | $76 | $76 | 1.6× |
| Diab manage trn per indiv (G0108) range across 2 matching MRF lines |
$135–$321 | $135–$321 | varies |
| Diab manage trn ind/group (G0109) range across 2 matching MRF lines |
$38–$218 | $38–$218 | varies |
| Direct refer hospital observ (G0379) | $922 | $922 | 1.2× |
| Drug test def 1-7 classes (G0480) | $172 | $172 | 1.5× |
| Drug test def 15-21 classes (G0482) | $1,575 | $1,575 | 7.9× |
| Drug test def 22+ classes (G0483) | $370 | $370 | 1.5× |
| Drug test def 8-14 classes (G0481) | $1,318 | $1,318 | 8.4× |
| Egd flexible transnasal dx w/collj spec br/wa (0652T) | $4,821 | $4,821 | 2.0× |
| Egd flexible transnasal w/biopsy single/multiple (0653T) | $4,821 | $4,821 | 2.0× |
| Egd flexible transnasal w/insj intral tube/cath (0654T) | $8,668 | $8,668 | 1.7× |
| Elec stim other than wound (G0283) | $553 | $553 | 43.6× |
| Elec stim unattend for press (G0281) | $552 | $552 | 47.2× |
| Electrophysiologic eval ccm-d leads at 1st impl (0930T) | $4,665 | $4,665 | 3.0× |
| Electrophysiologic eval ccm-d leads separate (0931T) | $4,665 | $4,665 | 3.0× |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $35,000 | $35,000 | 2.4× |
| Extrnl counterpulse, per tx (G0166) | $2,412 | $2,412 | 14.1× |
| Fecal blood scrn immunoassay (G0328) | $81 | $81 | 4.5× |
| Fecal microbiota prep instil (G0455) range across 2 matching MRF lines |
$1,829–$4,960 | $1,829–$4,960 | varies |
| Followup eval of foot pt lop (G0246) | $352 | $352 | 2.1× |
| Group mnt 2 or more 30 mins (G0271) range across 2 matching MRF lines |
$56–$146 | $56–$146 | varies |
| Hbot, full body chamber, 30m (G0277) range across 3 matching MRF lines |
$2,160–$2,985 | $2,160–$2,985 | varies |
| Hdr electronic brachytherapy ntrstl/intrcav (0395T) | $4,553 | $4,553 | 5.1× |
| Heart Symp Image Plnr (0331T) | $2,848 | $2,848 | 1.7× |
| Home sleep test/type 2 porta (G0398) | $1,813 | $1,813 | 6.5× |
| Home sleep test/type 3 porta (G0399) | $1,469 | $1,469 | 5.3× |
| Home sleep test/type 4 porta (G0400) | $1,252 | $1,252 | 4.5× |
| Hopd mntl hlt, grp (C7903) | $113 | $113 | 2.3× |
| Hospital outpt clinic visit (G0463) | $1,098 | $1,098 | 6.4× |
| Initial care training 30 m (G0539) | $284 | $284 | 5.3× |
| Initial foot exam pt lops (G0245) | $379 | $379 | 2.2× |
| Initial preventive exam (G0402) | $287 | $287 | 1.7× |
| Inj for sacroiliac jt anesth (G0260) range across 3 matching MRF lines |
$6,845–$12,559 | $6,845–$12,559 | varies |
| Insertion perm ccm-d system pulse generator only (0916T) | $28,459 | $28,459 | 1.0× |
| Insj perm ccm-d sys 1 transvns lead only (0917T) | $13,310 | $13,310 | 1.3× |
| Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) | $13,310 | $13,310 | 1.3× |
| Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) | $42,350 | $42,350 | 1.0× |
| Mnt subs tx for change dx (G0270) range across 2 matching MRF lines |
$92–$189 | $92–$189 | varies |
| Mra w/cont, abd (C8900) | $6,405 | $6,405 | 14.3× |
| Mra w/cont, chest (C8909) | $6,571 | $6,571 | 14.6× |
| Mra w/cont, lwr ext (C8912) range across 3 matching MRF lines |
$5,476–$10,946 | $5,476–$10,946 | varies |
| Mra w/cont, pelvis (C8918) | $5,840 | $5,840 | 13.0× |
| Mra w/o cont, abd (C8901) | $5,608 | $5,608 | 18.3× |
| Mra w/o cont, chest (C8910) | $5,990 | $5,990 | 19.5× |
| Mra w/o cont, lwr ext (C8913) range across 3 matching MRF lines |
$6,064–$9,776 | $6,064–$9,776 | varies |
| Mra w/o cont, pelvis (C8919) | $5,434 | $5,434 | 17.7× |
| Mra w/o fol w/cont, abd (C8902) | $7,614 | $7,614 | 17.0× |
| Mra w/o fol w/cont, chest (C8911) | $8,372 | $8,372 | 18.7× |
| Mra w/o fol w/cont, lwr ext (C8914) range across 3 matching MRF lines |
$7,495–$12,929 | $7,495–$12,929 | varies |
| Mra w/o fol w/cont, pelvis (C8920) | $7,326 | $7,326 | 16.3× |
| Mra, w/dye, spinal canal (C8931) | $8,696 | $8,696 | 19.4× |
| Mra, w/dye, upper extremity (C8934) | $5,064 | $5,064 | 11.3× |
| Mra, w/o dye, spinal canal (C8932) | $6,943 | $6,943 | 22.6× |
| Mra, w/o dye, upper extr (C8935) | $4,668 | $4,668 | 15.2× |
| Mra, w/o&w/dye, spinal canal (C8933) | $9,629 | $9,629 | 21.5× |
| Mra, w/o&w/dye, upper extr (C8936) | $5,534 | $5,534 | 12.3× |
| Mri w/o fol w/cont, breast, (C8908) range across 2 matching MRF lines |
$4,343–$8,468 | $4,343–$8,468 | varies |
| Mri w/o fol w/cont, brst, un (C8905) range across 4 matching MRF lines |
$2,855–$6,606 | $2,855–$6,606 | varies |
| N-invas assmt car rsk augmnt sw alys fat w/CT (0993T) | $975 | $975 | 3.2× |
| N-invas assmt car rsk augmnt sw alys fat w/o CT (0992T) | $975 | $975 | 3.2× |
| N-Invas Detcj Heart Failure Drv Augmnt Alys Echo (0932T) | $962 | $962 | 2.4× |
| Nav srv peer sup 60 min pr m (G0140) | $290 | $290 | 2.2× |
| No pt prsnt train initial 30 (G0541) | $284 | $284 | 7.6× |
| Obtaining screen pap smear (Q0091) | $62 | $62 | 1.7× |
| Opps service,sched team conf (G0175) range across 14 matching MRF lines |
$355–$980 | $355–$980 | varies |
| Oth resp proc, group (G0239) range across 4 matching MRF lines |
$168–$616 | $168–$616 | varies |
| Oth resp proc, indiv (G0238) | $459 | $459 | 12.3× |
| Pathogen test for platelets (P9100) | $84 | $84 | 1.1× |
| Perq Sacral Augmt Bilat Inj (0201T) | $18,829 | $18,829 | 2.0× |
| Perq Sacral Augmt Unilat Inj (0200T) | $18,829 | $18,829 | 2.0× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) | $21,913 | $21,913 | 1.5× |
| Pet not otherwise specified (G0235) | $12,613 | $12,613 | 24.5× |
| Pin service 60m per month (G0023) | $290 | $290 | 2.2× |
| Place device/marker, non pro (C9728) | $9,945 | $9,945 | 5.6× |
| Post d/c phone follow up (G0544) | $244 | $244 | 1.9× |
| Ppps, initial visit (G0438) | $395 | $395 | 2.3× |
| Ppps, subseq visit (G0439) | $322 | $322 | 2.3× |
| Prgrmg dev eval ldls pm single car chamber ip (0826T) | $130 | $130 | 2.7× |
| Prolonged iv inf, req pump (C8957) | $3,276 | $3,276 | 12.0× |
| Prostate biopsy, any mthd (G0416) | $4,020 | $4,020 | 8.7× |
| Psa screening (G0103) | $93 | $93 | 4.8× |
| Relocation skin pocket implanted ccm-d pg (0925T) | $10,890 | $10,890 | 4.1× |
| Rem auton alg nsln cal setup (0740T) | $270 | $270 | 3.6× |
| Rem auton alg nsln data coll (0741T) | $184 | $184 | 3.8× |
| Removal perm ccm-d system pulse generator only (0919T) | $12,100 | $12,100 | 2.5× |
| Repositioning prev impl ccm-d transvns eltrd/ld (0924T) | $2,375 | $2,375 | 2.9× |
| Revasc intra lithotrip-ather (C9766) | $30,604 | $30,604 | 1.3× |
| Revasc intra lithotrip-stent (C9765) | $29,617 | $29,617 | 1.3× |
| Revasc intravasc lithotripsy (C9764) | $24,680 | $24,680 | 1.7× |
| Revasc lith-sten-ath tib/per (C9775) | $25,175 | $25,175 | 1.1× |
| Revasc lithotr-ather tib/per (C9774) | $24,186 | $24,186 | 1.0× |
| Revasc lithotr-stent tib/per (C9773) | $23,693 | $23,693 | 1.0× |
| Revasc lithotrip tibi/perone (C9772) | $22,705 | $22,705 | 1.5× |
| Revasc lithotrip-stent-ather (C9767) | $37,513 | $37,513 | 1.6× |
| Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T) | $12,100 | $12,100 | 2.5× |
| Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) | $12,100 | $12,100 | 2.5× |
| Rmvl perm ccm-d sys dual transvns leads only (0922T) | $12,100 | $12,100 | 2.5× |
| Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) | $28,459 | $28,459 | 1.0× |
| Routine footcare pt w lops (G0247) | $505 | $505 | 2.0× |
| Scr c/v cyto,thinlayer,rescr (G0143) | $64 | $64 | 2.4× |
| Screen pap by tech w md supv (P3000) | $158 | $158 | 8.5× |
| Tc Auricular Nstimj Setup Calibration &Pt Educaj (0783T) | $398 | $398 | 2.4× |
| Tcat implt wrls l atr prs snr l-t l atr prs mntr (0933T) | $12,361 | $12,361 | 3.0× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $23,662 | $23,662 | 1.0× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) | $18,150 | $18,150 | 0.7× |
| Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) | $18,150 | $18,150 | 0.7× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $22,990 | $22,990 | 0.9× |
| Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) | $12,605 | $12,605 | 3.1× |
| Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) | $25,961 | $25,961 | 1.0× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $22,385 | $22,385 | 3.1× |
| Tee w or w/o fol w/cont, mon (C8927) | $5,693 | $5,693 | 5.6× |
| Tee w or w/o fol w/cont,cong (C8926) | $5,506 | $5,506 | 5.5× |
| Therapeutic procd strg endur (G0237) | $419 | $419 | 11.3× |
| Therapeutic ultrafiltration (0692T) | $1,633 | $1,633 | 0.8× |
| Train for caregiver add 15 (G0540) | $121 | $121 | 4.6× |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $26,600 | $26,600 | 3.6× |
| Transcatheter renal sympath denervation unilat (0338T) | $18,241 | $18,241 | 2.5× |
| Trauma respons w/hosp criti (G0390) range across 3 matching MRF lines |
$20,217–$49,520 | $20,217–$49,520 | varies |
| Trim nail(s) (G0127) | $216 | $216 | 2.8× |
| Trluml perip athrc abd aorta (0236T) | $35,470 | $35,470 | 2.4× |
| Trluml Perip Athrc Brchiocph (0237T) range across 3 matching MRF lines |
$36,166–$66,951 | $36,166–$66,951 | varies |
| Trluml Perip Athrc Iliac Art (0238T) range across 3 matching MRF lines |
$42,251–$76,960 | $42,251–$76,960 | varies |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) range across 3 matching MRF lines |
$35,873–$66,266 | $35,873–$66,266 | varies |
| Tte w or w/o contr, cont ecg (C8930) | $6,601 | $6,601 | 6.5× |
| Tte w or w/o fol w/con,stres (C8928) | $5,614 | $5,614 | 5.6× |
| Tte w or w/o fol w/cont, com (C8921) | $4,995 | $4,995 | 5.0× |
| Tte w or w/o fol w/cont, f/u (C8922) | $3,620 | $3,620 | 3.6× |
| Tte w or wo fol wcon,doppler (C8929) | $6,563 | $6,563 | 6.5× |
| Unsched dialysis esrd pt hos (G0257) range across 2 matching MRF lines |
$3,703–$9,073 | $3,703–$9,073 | varies |
| Visit to determ ldct elig (G0296) | $261 | $261 | 2.0× |
| Wet mounts/ w preparations (Q0111) | $36 | $36 | 1.9× |
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.