Supplies, drugs & other prices at Midwest Surgical Hospital LLC
Omaha, NE · every code in this section with a posted price and a Medicare benchmark.
5 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin pneumococcal vaccine (G0009) | $85.50 | $114 | 1.8× |
| Hospital outpt clinic visit (G0463) | $178.50 | $238 | 1.3× |
| Inj for sacroiliac jt anesth (G0260) | $1,523.25 | $2,031 | 2.1× |
| Injection(s), bone substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion,… (0707T) | $7,599 | $10,132 | 2.2× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $2,387.25 | $3,183 | 5.1× |