Supplies, drugs & other prices at MetroHealth System
Cleveland, OH · every code in this section with a posted price and a Medicare benchmark.
314 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2019-ncov diagnostic p (U0001) | $26.95 | $77 | 0.8× |
| 2d cephalometric image (D0340) | $44.45 | $127 | 0.5× |
| 3D contour simulaj trgt lvr les&mrgn micrwv ablt (0944T) range across 2 matching MRF lines |
$234.15–$324.80 | $669–$928 | varies |
| Ablation, irreversible electroporation; 1 or more tumors, including fluoroscopic and ultrasound guidance, when… (0601T) likely a partial charge, not the full procedure |
$780 | $2,228.58 | 0.1× |
| Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T) range across 4 matching MRF lines |
$5,275.55 | $326–$15,073 | 1.4× |
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) range across 2 matching MRF lines |
$2,783.40 | $253.60–$7,952.56 | 1.5× |
| Adm of soc dtr assess 5-15 m (G0136) | $12.25 | $35 | 0.3× |
| Admin hepatitis b vaccine (G0010) | $59.50 | $170 | 1.3× |
| Alcohol/subs interv 15-30mn (G0396) range across 3 matching MRF lines |
$8.77–$35 | $25.05–$100 | varies |
| Alcohol/subs interv >30 min (G0397) range across 2 matching MRF lines |
$16.69–$20.65 | $47.68–$59 | varies |
| Alveoloplasty not w/extracts (D7321) | $54.60 | $156 | 0.0× |
| Alveoloplasty w/extract 1-3 (D7311) | $50.05 | $143 | 0.0× |
| Alveolus open reduction (D7671) likely a partial charge, not the full procedure |
$245.70 | $702 | 0.0× |
| Alveoplasty w/ extraction (D7310) | $127.75 | $365 | 0.1× |
| Alveoplasty w/o extraction (D7320) | $177.10 | $506 | 0.1× |
| Amalgam 4 or > surfaces perm (D2161) range across 2 matching MRF lines |
$101.50–$458.85 | $290–$1,311 | varies |
| Amalgam one surface permanen (D2140) range across 2 matching MRF lines |
$59.50–$458.85 | $170–$1,311 | varies |
| Amalgam three surfaces perma (D2160) range across 2 matching MRF lines |
$87.50–$458.85 | $250–$1,311 | varies |
| Amalgam two surfaces permane (D2150) range across 2 matching MRF lines |
$75.25–$458.85 | $215–$1,311 | varies |
| Ant resin-based cmpst crown (D2390) range across 2 matching MRF lines |
$189–$458.85 | $540–$1,311 | varies |
| Apexification/recalc final (D3353) range across 2 matching MRF lines |
$193.55–$458.85 | $553–$1,311 | varies |
| Apexification/recalc initial (D3351) range across 2 matching MRF lines |
$129.50–$458.85 | $370–$1,311 | varies |
| Apexification/recalc interim (D3352) range across 2 matching MRF lines |
$129.50–$458.85 | $370–$1,311 | varies |
| Apically positioned flap (D4245) | $208.60 | $596 | 0.1× |
| Apicoectomy - anterior (D3410) | $301.70 | $862 | 0.5× |
| Assessment of a patient (D0191) | $20.65 | $59 | 0.2× |
| Auto tissue graft 1st tooth (D4273) | $415.80 | $1,188 | 0.3× |
| Bio mtrls to aid soft/os reg (D4265) | $34.30 | $98 | 0.1× |
| Bitewings - three images (D0273) | $22.75 | $65 | 0.1× |
| Bitewings four images (D0274) | $26.25 | $75 | 0.1× |
| Bone replce graft first site (D4263) | $232.05 | $663 | 0.4× |
| Ca screen;flexi sigmoidscope (G0104) range across 2 matching MRF lines |
$174.65–$346.85 | $499–$991 | varies |
| Ca screen;pelvic/breast exam (G0101) range across 2 matching MRF lines |
$44.45–$109.90 | $127–$314 | varies |
| Canal prep/fitting of dowel (D3950) | $71.40 | $204 | 0.1× |
| Closd rductn splint alveolus (D7670) | $179.20 | $512 | 0.1× |
| Colon ca scrn not hi rsk ind (G0121) | $1,071 | $3,060 | 1.2× |
| Colorectal scrn; hi risk ind (G0105) range across 2 matching MRF lines |
$507.85–$1,071 | $1,451–$3,060 | varies |
| Comp periodontal evaluation (D0180) | $38.15 | $109 | 0.3× |
| Complete occlusal adjustment (D9952) | $262.50 | $750 | 0.4× |
| Comprehensve oral evaluation (D0150) range across 2 matching MRF lines |
$34.65–$458.85 | $99–$1,311 | varies |
| Cone beam ct capt & interp (D0364) | $84 | $240 | 0.8× |
| Cone beam ct interp both jaw (D0367) | $76.30 | $218 | 0.8× |
| Core build-up incl any pins (D2950) | $113.75 | $325 | 0.2× |
| Coronectomy (D7251) | $151.20 | $432 | 0.1× |
| Covid-19 lab test non-cdc (U0002) | $38.50 | $110 | 0.8× |
| Crown 3/4 cast base metal (D2781) | $307.30 | $878 | 0.5× |
| Crown 3/4 cast noble metal (D2782) | $307.30 | $878 | 0.5× |
| Crown 3/4 porcelain/ceramic (D2783) | $448.70 | $1,282 | 0.7× |
| Crown full cast base metal (D2791) | $285.60 | $816 | 0.5× |
| Crown full cast high noble m (D2790) | $490 | $1,400 | 0.8× |
| Crown full cast noble metal (D2792) | $324.45 | $927 | 0.5× |
| Crown lengthen hard tissue (D4249) | $309.75 | $885 | 0.5× |
| Crown porc fused to titanium (D2753) | $420.35 | $1,201 | 0.7× |
| Crown porcelain fused base m (D2751) range across 2 matching MRF lines |
$441–$458.85 | $1,260–$1,311 | varies |
| Crown porcelain w/ noble met (D2752) | $441 | $1,260 | 0.7× |
| Crown porcelain/ceramic (D2740) range across 2 matching MRF lines |
$455–$458.85 | $1,300–$1,311 | varies |
| Crown repair (D2980) | $113.40 | $324 | 0.2× |
| Crown resin w/ base metal (D2721) | $307.65 | $879 | 0.5× |
| Crown resin w/ noble metal (D2722) | $307.65 | $879 | 0.5× |
| Crown resin-based indirect (D2710) | $375.90 | $1,074 | 0.6× |
| Dental bitewing single image (D0270) | $9.10 | $26 | 0.1× |
| Dental bitewings two images (D0272) | $19.25 | $55 | 0.2× |
| Dental connector bar (D6920) | $44.10 | $126 | 0.1× |
| Dental gold foil one surface (D2410) | $140 | $400 | 0.2× |
| Dental gold foil three surfa (D2430) | $154 | $440 | 0.3× |
| Dental gold foil two surface (D2420) | $147 | $420 | 0.2× |
| Dental inlay metalic 1 surf (D2510) | $211.05 | $603 | 0.3× |
| Dental inlay metallic 2 surf (D2520) | $388.15 | $1,109 | 0.6× |
| Dental inlay metl 3/more sur (D2530) | $266.35 | $761 | 0.4× |
| Dental inlay resin 3/mre sur (D2652) | $258.30 | $738 | 0.4× |
| Dental onlay metallic 2 surf (D2542) | $258.65 | $739 | 0.4× |
| Dental onlay metallic 3 surf (D2543) | $420.70 | $1,202 | 0.7× |
| Dental onlay metl 4/more sur (D2544) | $310.80 | $888 | 0.5× |
| Dental onlay porc 3/more sur (D2630) | $310.45 | $887 | 0.5× |
| Dental onlay porc 4/more sur (D2644) | $462.70 | $1,322 | 0.8× |
| Dental onlay porcelin 2 surf (D2642) | $430.50 | $1,230 | 0.7× |
| Dental onlay porcelin 3 surf (D2643) | $449.40 | $1,284 | 0.7× |
| Dental onlay resin 2 surface (D2662) | $346.50 | $990 | 0.6× |
| Dental onlay resin 3 surface (D2663) | $362.95 | $1,037 | 0.6× |
| Dental onlay resin 4/mre sur (D2664) | $434 | $1,240 | 0.7× |
| Dental prophylaxis adult (D1110) range across 2 matching MRF lines |
$36.75–$458.85 | $105–$1,311 | varies |
| Dental saliography (D0310) | $39.55 | $113 | 0.2× |
| Dental tomographic survey (D0322) | $35 | $100 | 0.4× |
| Depression screen annual (G0444) range across 3 matching MRF lines |
$5.60–$37.80 | $16–$108 | varies |
| Devlopment test interpt&rep (G0451) | $14 | $40 | 0.1× |
| Diab manage trn per indiv (G0108) | $56.70 | $162 | 1.0× |
| Diab manage trn ind/group (G0109) | $49 | $140 | 3.1× |
| Each addtnl prefab post (D2957) | $20.30 | $58 | 0.0× |
| Ed svc ckd grp per session (G0421) | $20.65 | $59 | 0.8× |
| Ed svc ckd ind per session (G0420) | $87.15 | $249 | 0.8× |
| Ekg tracing for initial prev (G0404) range across 2 matching MRF lines |
$13.65–$81.20 | $39–$232 | varies |
| Elec alys cplx prgrmg iins ptn 4+ parameters (0590T) range across 2 matching MRF lines |
$133.88–$206.32 | $382.50–$589.50 | varies |
| Elec alys smpl prgrmg iins ptn 1-3 parameters (0589T) range across 2 matching MRF lines |
$67.72–$206.32 | $193.50–$589.50 | varies |
| Elec stim other than wound (G0283) | $47.27 | $135.06 | 3.7× |
| End thxpy, anterior tooth (D3310) | $309.75 | $885 | 0.5× |
| End thxpy, molar tooth (D3330) range across 2 matching MRF lines |
$423.50–$458.85 | $1,210–$1,311 | varies |
| End thxpy, premolar tooth (D3320) | $350 | $1,000 | 0.6× |
| Endodontic endosseous implan (D3460) | $336.35 | $961 | 0.5× |
| Excision benign lesion compl (D7412) | $156.80 | $448 | 0.1× |
| Excision benign lesion>1.25c (D7411) | $138.95 | $397 | 0.1× |
| Exposure of unerupted tooth (D7280) | $178.15 | $509 | 0.3× |
| Extensv oral eval prob focus (D0160) | $60.20 | $172 | 0.5× |
| Extraction coronal remnants (D7111) | $56 | $160 | 0.1× |
| Extraction erupted tooth/exr (D7140) range across 2 matching MRF lines |
$72.10–$458.85 | $206–$1,311 | varies |
| Extraoral 2d project image (D0250) | $13.65 | $39 | 0.2× |
| Extraoral posterior image (D0251) | $15.05 | $43 | 0.2× |
| Fecal microbiota prep instil (G0455) | $117.60 | $336 | 0.1× |
| Fern test (Q0114) range across 2 matching MRF lines |
$37.80–$39.55 | $108–$113 | varies |
| Fixed bilat space maint, man (D1517) range across 2 matching MRF lines |
$179.55–$458.85 | $513–$1,311 | varies |
| Fixed bilat space maint, max (D1516) range across 2 matching MRF lines |
$173.25–$458.85 | $495–$1,311 | varies |
| Fractional abl lsr fenestration first 100 sqcm (0479T) range across 2 matching MRF lines |
$330.90–$909.48 | $945.42–$2,598.51 | varies |
| Full mouth debridement (D4355) | $72.45 | $207 | 0.1× |
| Gingival flap proc w/ planin (D4240) | $309.75 | $885 | 0.1× |
| Gingivectomy/plasty 1 to 3 (D4211) | $131.25 | $375 | 0.0× |
| Gingivectomy/plasty 4 or mor (D4210) | $259 | $740 | 0.1× |
| Gingivectomy/plasty rest (D4212) | $101.50 | $290 | 0.0× |
| Gngvl flap w rootplan 1-3 th (D4241) | $249.55 | $713 | 0.2× |
| Gross pulpal debridement (D3221) | $94.50 | $270 | 0.2× |
| Group mnt 2 or more 30 mins (G0271) | $26.95 | $77 | 1.6× |
| Guided tiss regen nonresorb (D4267) | $282.45 | $807 | 0.2× |
| Guided tiss regen resorble (D4266) | $114.45 | $327 | 0.1× |
| Hbot, full body chamber, 30m (G0277) range across 2 matching MRF lines |
$49.62–$183.61 | $141.76–$524.61 | varies |
| High inten beh couns std 30m (G0445) range across 2 matching MRF lines |
$14–$116.55 | $40–$333 | varies |
| Home sleep test/type 3 porta (G0399) | $1,072.58 | $3,064.50 | 5.3× |
| Hopd mntl hlt, 15-29 min (C7900) | $38.15 | $109 | 1.1× |
| Hopd mntl hlt, 30-60 min (C7901) | $96.95 | $277 | 1.0× |
| Hopd mntl hlt, grp (C7903) | $136.15 | $389 | 3.8× |
| Hospital outpt clinic visit (G0463) | $70 | $200 | 0.6× |
| I&d absc intraoral soft tiss (D7510) | $56 | $160 | 0.1× |
| I&d abscess extraoral (D7520) | $120.75 | $345 | 0.2× |
| Impact tooth rem bony w/comp (D7241) | $149.10 | $426 | 0.2× |
| Impact tooth remov comp bony (D7240) | $162.40 | $464 | 0.3× |
| Impact tooth remov part bony (D7230) | $133.70 | $382 | 0.2× |
| Impact tooth remov soft tiss (D7220) | $123.20 | $352 | 0.2× |
| Incision/drain abscess extra (D7521) | $134.75 | $385 | 0.2× |
| Incision/drain abscess intra (D7511) | $62.65 | $179 | 0.1× |
| Initial preventive exam (G0402) range across 2 matching MRF lines |
$63.35–$95.20 | $181–$272 | varies |
| Inj for sacroiliac jt anesth (G0260) range across 3 matching MRF lines |
$173.85–$888.77 | $496.71–$2,539.35 | varies |
| Inlay composite/resin one su (D2650) | $207.90 | $594 | 0.3× |
| Inlay composite/resin two su (D2651) | $20.65 | $59 | 0.0× |
| Inlay porcelain/ceramic 1 su (D2610) | $304.85 | $871 | 0.5× |
| Inlay porcelain/ceramic 2 su (D2620) | $396.90 | $1,134 | 0.6× |
| Inlay repair (D2981) | $99.40 | $284 | 0.2× |
| Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space;… (0449T) unusually low: confirm this is the full procedure |
$1,515.48 | $4,329.95 | 0.3× |
| Insertion of substernal implantable defibrillator electrode (0572T) range across 2 matching MRF lines |
$11,747.05 | $833–$33,563 | 1.5× |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) likely a partial charge, not the full procedure |
$6,729.45 | $19,227 | 0.2× |
| Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) | $6,729.45 | $19,227 | 0.9× |
| Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) | $6,729.45 | $19,227 | 0.9× |
| Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) | $22,037.40 | $62,964 | 1.0× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) | $45,507.70 | $130,022 | 1.5× |
| Intens behave ther cardio dx (G0446) range across 2 matching MRF lines |
$14–$37.80 | $40–$108 | varies |
| Intentional replantation (D3470) | $195.65 | $559 | 0.3× |
| Interim crown (D2799) | $166.25 | $475 | 0.3× |
| Internal root repair (D3333) | $239.05 | $683 | 0.4× |
| Interrogation Dev Eval Icds W/Ss Eltrd In Person (0576T) range across 2 matching MRF lines |
$35–$53.20 | $100–$152 | varies |
| Intraor comprehensive series (D0210) | $55.30 | $158 | 0.2× |
| Intraoral occlusal film (D0240) | $16.10 | $46 | 0.2× |
| Intraoral periapical first (D0220) | $12.25 | $35 | 0.1× |
| Ire Abltj 1+Tum Organ Perq (0600T) likely a partial charge, not the full procedure |
$780 | $2,228.58 | 0.1× |
| Isolation- tooth w rubb dam (D3910) | $51.10 | $146 | 0.1× |
| Labial veneer porc indirect (D2962) | $471.45 | $1,347 | 0.8× |
| Labial veneer resin direct (D2960) | $270.20 | $772 | 0.4× |
| Labial veneer resin indirect (D2961) | $397.60 | $1,136 | 0.7× |
| Limit oral eval problm focus (D0140) range across 2 matching MRF lines |
$31.15–$458.85 | $89–$1,311 | varies |
| Limited occlusal adjustment (D9951) | $71.75 | $205 | 0.1× |
| Localized delivery antimicro (D4381) | $20.65 | $59 | 0.0× |
| Malig tumor exc to 1.25 cm (D7440) | $280.70 | $802 | 0.1× |
| Mandible graft (D7950) unusually low: confirm this is the full procedure |
$1,745.10 | $4,986 | 0.3× |
| Mesial/distal wedge proc (D4274) | $185.15 | $529 | 0.3× |
| Mnt subs tx for change dx (G0270) | $33.25 | $95 | 1.0× |
| Mra, w/dye, upper extremity (C8934) | $961.80 | $2,748 | 2.9× |
| Nav srv peer sup 60 min pr m (G0140) range across 2 matching MRF lines |
$33.25–$136.15 | $95–$389 | varies |
| Neuro csf prion prtn qual (0035U) | $430.50 | $1,230 | 0.8× |
| Njx platelet plasma (0232T) range across 3 matching MRF lines |
$94.93–$527.40 | $271.24–$1,506.87 | varies |
| Non-surg tx root canal obs (D3331) | $177.45 | $507 | 0.3× |
| Obtaining screen pap smear (Q0091) range across 2 matching MRF lines |
$13.67–$38.29 | $39.07–$109.39 | varies |
| Occ guard, hard, full arch (D9944) | $224 | $640 | 0.4× |
| Occ guard, hard, part arch (D9946) | $187.25 | $535 | 0.3× |
| Occ guard, soft, full arch (D9945) | $169.75 | $485 | 0.3× |
| Occlusion analysis (D9950) | $141.75 | $405 | 0.2× |
| Onlay repair (D2982) | $98.35 | $281 | 0.2× |
| Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg,… (0817T) | $36,411.06 | $104,031.60 | 2.0× |
| Open tx iliac spine uni/bil (G0412) likely a partial charge, not the full procedure |
$1,436.50 | $4,104.28 | 0.2× |
| Open tx post pelvic fxcture (G0415) | $2,333.73 | $6,667.80 | 0.8× |
| Oral antral fistula closure (D7260) | $738.50 | $2,110 | 1.2× |
| Oral/facial photo images (D0350) | $29.05 | $83 | 0.4× |
| Osseous surg 1 to 3 teeth (D4261) | $351.40 | $1,004 | 0.1× |
| Osseous surgery 4 or more (D4260) likely a partial charge, not the full procedure |
$435.40 | $1,244 | 0.1× |
| Oth resp proc, group (G0239) range across 2 matching MRF lines |
$66.41–$100.79 | $189.75–$287.98 | varies |
| Oth resp proc, indiv (G0238) | $142.99 | $408.53 | 5.2× |
| Panoramic image (D0330) | $49 | $140 | 0.2× |
| Pedicle soft tissue graft pr (D4270) | $210.35 | $601 | 0.1× |
| Pelvic ring fracture uni/bil (G0413) likely a partial charge, not the full procedure |
$1,413.05 | $4,037.29 | 0.2× |
| Pelvic ring fx treat int fix (G0414) likely a partial charge, not the full procedure |
$1,909.61 | $5,456.02 | 0.3× |
| Periodic oral evaluation (D0120) range across 2 matching MRF lines |
$21–$458.85 | $60–$1,311 | varies |
| Periodontal maint procedures (D4910) range across 2 matching MRF lines |
$57.05–$458.85 | $163–$1,311 | varies |
| Periodontal scaling & root (D4341) range across 2 matching MRF lines |
$104.30–$458.85 | $298–$1,311 | varies |
| Periodontal scaling 1-3teeth (D4342) range across 2 matching MRF lines |
$74.90–$458.85 | $214–$1,311 | varies |
| Perq njx algc cell &/prdct uni/bi fluor lmbr 1st (0627T) likely a partial charge, not the full procedure |
$70.34 | $200.97 | 0.0× |
| Perq njx algc cell&/prdct uni/bi CT lmbr 1st (0629T) likely a partial charge, not the full procedure |
$70.34 | $200.97 | 0.0× |
| Pin service 60m per month (G0023) range across 2 matching MRF lines |
$33.25–$303.80 | $95–$868 | varies |
| Place device/marker, non pro (C9728) range across 2 matching MRF lines |
$1,537.68 | $110–$4,393.36 | 1.2× |
| Place direct restoration (D2940) | $52.50 | $150 | 0.1× |
| Place intra-socket bio dress (D7922) | $7.70 | $22 | 0.0× |
| Pne flu hepb cov home admin (M0201) | $26.25 | $75 | 0.8× |
| Post 1 srfc resinbased cmpst (D2391) range across 2 matching MRF lines |
$73.50–$458.85 | $210–$1,311 | varies |
| Post 2 srfc resinbased cmpst (D2392) range across 2 matching MRF lines |
$93.80–$458.85 | $268–$1,311 | varies |
| Post 3 srfc resinbased cmpst (D2393) range across 2 matching MRF lines |
$111.30–$458.85 | $318–$1,311 | varies |
| Post >=4srfc resinbase cmpst (D2394) range across 2 matching MRF lines |
$131.25–$458.85 | $375–$1,311 | varies |
| Post and core cast + crown (D2952) range across 2 matching MRF lines |
$164.50–$458.85 | $470–$1,311 | varies |
| Post-coital mucous exam (Q0115) | $9.45 | $27 | 0.4× |
| Posterior vertebral joint(s) arthroplasty (e.g., facet joint(s) replacement) including facetectomy, laminectomy,… (0202T) likely a partial charge, not the full procedure |
$2,057.82 | $5,879.49 | 0.2× |
| Ppps, initial visit (G0438) range across 2 matching MRF lines |
$87.50–$156.45 | $250–$447 | varies |
| Ppps, subseq visit (G0439) range across 2 matching MRF lines |
$70–$119.35 | $200–$341 | varies |
| Prefab porc/cer crown perm (D2928) | $96.25 | $275 | 0.2× |
| Prefab porc/ceram crown pri (D2929) | $96.25 | $275 | 0.2× |
| Prefab post/core + crown (D2954) range across 2 matching MRF lines |
$140.35–$458.85 | $401–$1,311 | varies |
| Prefab stainless steel crown (D2933) range across 2 matching MRF lines |
$112.70–$458.85 | $322–$1,311 | varies |
| Prefab stnlss steel crown pe (D2931) range across 2 matching MRF lines |
$127.75–$458.85 | $365–$1,311 | varies |
| Prefab stnlss steel crwn pri (D2930) range across 2 matching MRF lines |
$111.65–$458.85 | $319–$1,311 | varies |
| Prefabricated resin crown (D2932) | $92.75 | $265 | 0.2× |
| Prgrmg Device Evaluation Cardiac Modulj System (0417T) range across 2 matching MRF lines |
$33.60–$45.50 | $96–$130 | varies |
| Primary closure sinus perf (D7261) | $266 | $760 | 0.4× |
| Prostate biopsy, any mthd (G0416) range across 2 matching MRF lines |
$87.15–$253.40 | $249–$724 | varies |
| Psa screening (G0103) | $57.75 | $165 | 3.0× |
| Pulp cap direct (D3110) | $34.30 | $98 | 0.1× |
| Pulp cap indirect (D3120) | $32.90 | $94 | 0.1× |
| Pulp vitality test (D0460) | $17.85 | $51 | 0.0× |
| Pulpal therapy anterior prim (D3230) | $105 | $300 | 0.2× |
| Pulpal therapy posterior pri (D3240) | $110.60 | $316 | 0.2× |
| Rad exc lesion up to 1.25 cm (D7410) | $154 | $440 | 0.1× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) range across 2 matching MRF lines |
$142.10–$573.30 | $406–$1,638 | varies |
| Re-cement or re-bond crown (D2920) | $46.90 | $134 | 0.1× |
| Re-eval,est pt,problem focus (D0170) | $26.95 | $77 | 0.2× |
| Recement cast or prefab post (D2915) | $38.85 | $111 | 0.1× |
| Recement inlay onlay or part (D2910) | $27.30 | $78 | 0.0× |
| Recement space maint - man (D1552) | $26.60 | $76 | 0.0× |
| Recement space maint - max (D1551) | $26.60 | $76 | 0.0× |
| Recement unilat space maint (D1553) | $26.60 | $76 | 0.0× |
| Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) | $1,915.20 | $5,472 | 1.0× |
| Rem exostosis any site (D7471) | $156.45 | $447 | 0.0× |
| Rem imp tooth w mucoper flp (D7210) | $117.95 | $337 | 0.1× |
| Rem interrog dev eval ss ld icds < 90d tech (0579T) | $52.85 | $151 | 1.5× |
| Rem nonodonto cyst > 1.25 cm (D7461) | $177.10 | $506 | 0.3× |
| Rem nonodonto cyst to 1.25cm (D7460) | $149.80 | $428 | 0.2× |
| Rem odontogen cyst > 1.25 cm (D7451) | $200.90 | $574 | 0.1× |
| Rem odontogen cyst to 1.25cm (D7450) | $192.50 | $550 | 0.1× |
| Remot img sub by pt, non e/m (G2250) | $5.25 | $15 | 0.4× |
| Removal fb skin/areolar tiss (D7530) | $90.65 | $259 | 0.1× |
| Removal of sloughed off bone (D7550) | $120.75 | $345 | 0.2× |
| Removal of torus palatinus (D7472) | $302.75 | $865 | 0.5× |
| Removal Ss Dfb Electrode (0573T) range across 2 matching MRF lines |
$260.75–$11,747.05 | $745–$33,563 | varies |
| Remove bilat space main, man (D1527) range across 2 matching MRF lines |
$109.90–$458.85 | $314–$1,311 | varies |
| Remove bilat space main, max (D1526) range across 2 matching MRF lines |
$109.90–$458.85 | $314–$1,311 | varies |
| Remove torus mandibularis (D7473) | $299.25 | $855 | 0.5× |
| Remove unilat space maintain (D1520) | $108.50 | $310 | 0.2× |
| Repos Cardiac Modulj Transvenous Electrode (0415T) | $891.45 | $2,547 | 1.5× |
| Repos prev impl ss impltbl dfb pacing eltrd (0574T) range across 2 matching MRF lines |
$235.55–$11,747.05 | $673–$33,563 | varies |
| Resin 4/> surf or w incis an (D2335) range across 2 matching MRF lines |
$120.75–$458.85 | $345–$1,311 | varies |
| Resin one surface-anterior (D2330) range across 2 matching MRF lines |
$66.50–$458.85 | $190–$1,311 | varies |
| Resin three surfaces-anterio (D2332) range across 2 matching MRF lines |
$98.35–$458.85 | $281–$1,311 | varies |
| Resin two surfaces-anterior (D2331) range across 2 matching MRF lines |
$82.25–$458.85 | $235–$1,311 | varies |
| Retreat root canal anterior (D3346) | $388.15 | $1,109 | 0.6× |
| Retreat root canal molar (D3348) | $472.50 | $1,350 | 0.8× |
| Retreat root canal premolar (D3347) | $399.70 | $1,142 | 0.7× |
| Retrograde filling (D3430) | $74.90 | $214 | 0.1× |
| Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and… (0819T) | $204.32 | $583.76 | 0.1× |
| Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) | $22,037.40 | $62,964 | 1.0× |
| Rmvl Car Modulj Tranvns Elt (0413T) | $2,502.15 | $7,149 | 0.7× |
| Rmvl Cardiac Modulj Pls Gen (0412T) | $2,502.15 | $7,149 | 0.7× |
| Root amputation (D3450) | $127.05 | $363 | 0.2× |
| Root surgery molar (D3425) | $326.90 | $934 | 0.5× |
| Root surgery premolar (D3421) | $296.45 | $847 | 0.5× |
| Scaling gingiv inflammation (D4346) | $44.80 | $128 | 0.1× |
| Soft tissue graft firsttooth (D4277) | $355.60 | $1,016 | 0.2× |
| Space maintainer fxd unilat (D1510) range across 2 matching MRF lines |
$128.45–$458.85 | $367–$1,311 | varies |
| Splint extra-coronal (D4323) | $158.55 | $453 | 0.3× |
| Surg reduct osseoustuberosit (D7485) likely a partial charge, not the full procedure |
$375.90 | $1,074 | 0.1× |
| Surgical revision procedure (D4268) | $208.60 | $596 | 0.3× |
| Surgical splint (D5988) | $198.80 | $568 | 0.3× |
| Syphilis tst non-treponemal antibody ia qual rpr (0065U) | $19.25 | $55 | 1.1× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $25,855.20 | $73,872 | 1.4× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) | $25,855.20 | $73,872 | 1.4× |
| Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) | $25,855.20 | $73,872 | 1.4× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $25,855.20 | $73,872 | 1.4× |
| Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) range across 2 matching MRF lines |
$315–$25,855.20 | $900–$73,872 | varies |
| Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) range across 2 matching MRF lines |
$315–$4,229.75 | $900–$12,085 | varies |
| Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) range across 2 matching MRF lines |
$315–$4,229.75 | $900–$12,085 | varies |
| Tcat Rmvl Perm Dual Chamber Ldls Pm Compl Sys (0798T) range across 2 matching MRF lines |
$315–$4,229.75 | $900–$12,085 | varies |
| Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) | $25,855.20 | $73,872 | 1.4× |
| Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T) | $25,855.20 | $73,872 | 1.4× |
| Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) | $25,855.20 | $73,872 | 1.4× |
| Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) | $25,855.20 | $73,872 | 1.4× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) range across 2 matching MRF lines |
$7,154.70 | $532–$20,442 | 1.3× |
| Therapeutic procd strg endur (G0237) | $142.99 | $408.53 | 5.2× |
| Therapeutic pulpotomy (D3220) range across 2 matching MRF lines |
$82.25–$458.85 | $235–$1,311 | varies |
| Tomosynthesis, mammo (G0279) | $33.25 | $95 | 2.6× |
| Tooth pin retention (D2951) range across 2 matching MRF lines |
$458.85 | $54–$1,311 | 0.8× |
| Tooth reimplantation (D7270) | $96.95 | $277 | 0.2× |
| Tooth root removal (D7250) | $196.35 | $561 | 0.3× |
| Tooth splitting (D3920) | $126.70 | $362 | 0.2× |
| Tooth transplantation (D7272) | $96.95 | $277 | 0.2× |
| Transseptal fiberotomy (D7291) | $72.80 | $208 | 0.1× |
| Treatment of complications (D9930) | $48.65 | $139 | 0.1× |
| Trim nail(s) (G0127) range across 2 matching MRF lines |
$18.75–$81.65 | $53.58–$233.29 | varies |
| Trluml Perip Athrc Brchiocph (0237T) | $16,389.37 | $46,826.77 | 1.5× |
| Trluml Perip Athrc Iliac Art (0238T) | $13,657.81 | $39,022.31 | 0.8× |
| Unsched dialysis esrd pt hos (G0257) | $981.75 | $2,805.01 | 1.5× |
| Unscheduled dressing change (D4920) | $13.65 | $39 | 0.0× |
| Veneer repair (D2983) | $98.70 | $282 | 0.2× |
| Vert bitewings 7 to 8 images (D0277) | $38.85 | $111 | 0.2× |
| Vestibuloplasty exten graft (D7350) likely a partial charge, not the full procedure |
$156.45 | $447 | 0.0× |
| Vestibuloplasty ridge extens (D7340) likely a partial charge, not the full procedure |
$137.55 | $393 | 0.0× |
| Visual ep test for glaucoma (0464T) range across 2 matching MRF lines |
$47.95–$210 | $137–$600 | varies |
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.