Supplies, drugs & other prices at Monadnock Community Hospital

Peterborough, NH · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Admin hepatitis b vaccine (G0010) $40.80 $68 0.8×
Admin influenza virus vac (G0008) $40.80 $68 0.8×
Admin pneumococcal vaccine (G0009) $40.80 $68 0.8×
Ca screen;flexi sigmoidscope (G0104) $57.60 $96 0.1×
Ca screen;pelvic/breast exam (G0101) $28.80 $48 0.3×
Colon ca scrn not hi rsk ind (G0121) $685.20 $1,142 0.7×
Colorectal scrn; hi risk ind (G0105) $685.20 $1,142 0.7×
Demonstrate use home inr mon (G0248) $40.20 $67 0.3×
Diab manage trn per indiv (G0108) $106.20 $177 1.9×
Diab manage trn ind/group (G0109) $49.20 $82 3.1×
Direct refer hospital observ (G0379) $367.86 $613.10 0.6×
Ekg tracing for initial prev (G0404) $143.40 $239 4.6×
Fecal blood scrn immunoassay (G0328) $54.60 $91 3.0×
Hospital outpt clinic visit (G0463) $205.20 $342 1.4×
Initial preventive exam (G0402) $101.70 $169.50 0.7×
Mnt subs tx for change dx (G0270) $32.40 $54 1.0×
Mra w/cont, abd (C8900) $2,093.78 $3,489.64 5.6×
Mra w/cont, chest (C8909) $2,093.78 $3,489.64 5.6×
Mra w/cont, lwr ext (C8912) $2,093.78 $3,489.64 5.6×
Mra w/cont, pelvis (C8918) $1,901.59 $3,169.31 5.1×
Mra w/o cont, abd (C8901) $1,756.36 $2,927.26 6.9×
Mra w/o cont, chest (C8910) $1,756.36 $2,927.26 6.9×
Mra w/o cont, lwr ext (C8913) $1,932.49 $3,220.81 7.6×
Mra w/o cont, pelvis (C8919) $1,756.36 $2,927.26 6.9×
Mra w/o fol w/cont, abd (C8902) $2,501.66 $4,169.44 6.7×
Mra w/o fol w/cont, chest (C8911) $2,098.11 $3,496.85 5.6×
Mra w/o fol w/cont, lwr ext (C8914) $2,779.76 $4,632.94 7.5×
Mra w/o fol w/cont, pelvis (C8920) $2,070.92 $3,451.53 5.6×
Obtaining screen pap smear (Q0091) $24.60 $41 0.8×
Oth resp proc, group (G0239) $97.20 $162 2.4×
Oth resp proc, indiv (G0238) $49.20 $82 1.6×
Pne flu hepb cov home admin (M0201) $33 $55 0.9×
Potassium hydroxide preps (Q0112) $33.60 $56 5.8×
Ppps, initial visit (G0438) $169.20 $282 1.0×
Ppps, subseq visit (G0439) $128.40 $214 0.9×
Psa screening (G0103) $87.76 $146.26 4.5×
Therapeutic procd strg endur (G0237) $54.60 $91 1.8×