17 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
| Adm tocilizu covid-19 1st (M0249) |
$465.40 |
$716 |
1.1× |
| Adm tocilizu covid-19 2nd (M0250) |
$465.40 |
$716 |
1.1× |
| Admin influenza virus vac (G0008) |
$36.40 |
$56 |
0.8× |
| Admin pneumococcal vaccine (G0009) |
$36.40 |
$56 |
0.8× |
| Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative Other Outpatient (0064U) |
$55.25 |
$85 |
1.8× |
| Catheterize for urine spec (P9612) |
$52.65 |
$81 |
5.6× |
| CYP1A2 (cytochrome P450 family 1, subfamily A, member 2) (eg, drug metabolism) gene analysis, common variants (ie, *1F,… (0031U) |
$473.85 |
$729 |
2.7× |
| Cyp2d6 gen com&slct rar vrnt (0070U) |
$722.15 |
$1,111 |
1.1× |
| Diab manage trn per indiv (G0108) |
$79.95 |
$123 |
1.4× |
| Direct refer hospital observ (G0379) |
$434.20 |
$668 |
0.8× |
| Ig paraprotein qual bld/ur (0077U) |
$206.70 |
$318 |
4.8× |
| Inj for sacroiliac jt anesth (G0260) |
$1,927.90 |
$2,966 |
3.0× |
| Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) |
$289.25 |
$445 |
2.4× |
| Liver dis 10 assays w/nash (0003M) |
$418.60 |
$644 |
0.8× |
| Pathogen test for platelets (P9100) |
$50.70 |
$78 |
0.9× |
| Psa screening (G0103) |
$119.60 |
$184 |
6.2× |
| Tpmt Nudt15 Gene Analysis Common Variants (0034U) |
$334.75 |
$515 |
0.7× |