Supplies, drugs & other prices at Missouri Baptist Sullivan Hospital

Sullivan, MO · every code in this section with a posted price and a Medicare benchmark.

34 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $54 $90 1.5×
2d tee w or w/o fol w/con,in (C8925) $2,994 $4,990 3.8×
2d tte w or w/o fol w/con,fu (C8924) $558.60 $931 1.6×
Admin hepatitis b vaccine (G0010) $93.60 $156 2.0×
Admin influenza virus vac (G0008) $93.60 $156 2.0×
Admin pneumococcal vaccine (G0009) $93.60 $156 2.0×
Covid-19 lab test non-cdc (U0002) $77.40 $129 1.5×
Direct refer hospital observ (G0379) $570 $950 1.0×
Drug test def 1-7 classes (G0480) $94.20 $157 0.8×
Drug test def 15-21 classes (G0482) $298.80 $498 1.5×
Drug test def 22+ classes (G0483) $370.80 $618 1.5×
Drug test def 8-14 classes (G0481) $235.20 $392 1.5×
Eia hiv-1/hiv-2 screen (G0432) $61.80 $103 3.2×
Elec stim other than wound (G0283) $83.40 $139 6.6×
Hbot, full body chamber, 30m (G0277) $598.20 $997 4.3×
Hep c screen high risk/other (G0472) $151.80 $253 3.3×
Hiv combination assay (G0475) $61.20 $102 2.5×
Home sleep test/type 3 porta (G0399) $870 $1,450 4.0×
Hospital outpt clinic visit (G0463) $3,343.86 $5,573.10 25.1×
Hpv combo assay ca screen (G0476) $114 $190 3.2×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) $218.40 $364 1.8×
Mra w/o fol w/cont, abd (C8902) $3,068.40 $5,114 8.8×
Mra w/o fol w/cont, chest (C8911) $2,238 $3,730 6.4×
Mri w/o fol w/cont, breast, (C8908) $2,539.20 $4,232 7.3×
Oth resp proc, group (G0239) $193.20 $322 5.2×
Pathogen test for platelets (P9100) $1,287.60 $2,146 21.8×
Prostate biopsy, any mthd (G0416) $673.80 $1,123 1.9×
Psa screening (G0103) $139.20 $232 7.2×
Qmrcp w/dx MRI same anatomy (0724T) $1,095.60 $1,826 1.2×
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) $1,087.80 $1,813 1.5×
Scr c/v cyto,thinlayer,rescr (G0145) $68.40 $114 2.6×
Screen cerv/vag thin layer (G0123) $49.80 $83 2.5×
Tomosynthesis, mammo (G0279) $30 $50 2.4×
Tte w or wo fol wcon,doppler (C8929) $4,392.60 $7,321 5.6×