Supplies, drugs & other prices at Montefiore Medical Center (Bronx, NY)

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

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Procedure	Posted cash	Posted gross	× Medicare
3D contour simulaj trgt lvr les&mrgn micrwv ablt (0944T) range across 2 matching MRF lines	$1,863.90–$9,135.75	$2,850–$14,055	varies
Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T)	—	$13,910	—
Adm of soc dtr assess 5-15 m (G0136)	—	$60	—
Adm tocilizu covid-19 1st (M0249) range across 2 matching MRF lines	$1,040–$1,046.40	$1,600	varies
Adm tocilizu covid-19 2nd (M0250) range across 2 matching MRF lines	$1,040–$1,046.40	$1,600	varies
Admin hepatitis b vaccine (G0010)	$118.95	$183	2.0×
Admin influenza virus vac (G0008)	—	$213	—
Admin pneumococcal vaccine (G0009)	$118.95	$183	2.0×
Adv prim care mgmt lvl 1 (G0556) range across 2 matching MRF lines	$32.70–$42.25	$50–$65	varies
Adv prim care mgmt lvl 2 (G0557) range across 2 matching MRF lines	$94.83–$130	$145–$200	varies
Adv prim care mgmt lvl 3 (G0558) range across 2 matching MRF lines	$209.28–$282.75	$320–$435	varies
Alcohol/subs interv 15-30mn (G0396)	—	$132	—
Alcohol/subs interv >30 min (G0397)	—	$419	—
Anatomic guide 3d printed 1st anatomic guide (0561T) range across 2 matching MRF lines	$353.16–$1,262.95	$540–$1,943	varies
Anatomic Model 3D Printed 1St Compnt Antmc Strux (0559T) range across 2 matching MRF lines	$353.16–$1,262.95	$540–$1,943	varies
Annual alcohol screen 15 min (G0442)	$21.55	$32.95	0.5×
Ascvd rsk mng clin stf pr mo (G0538) range across 2 matching MRF lines	$22.89–$42.25	$35–$65	varies
Asstv alg ECG rsk asmt cncrt (0764T)	$780	$1,200	4.7×
Asstv alg ECG rsk asmt prev (0765T)	$780	$1,200	4.7×
Behavior counsel obesity 15m (G0447) range across 2 matching MRF lines	$160.23–$172.25	$245–$265	varies
Bone Strength & Fracture Risk Assessment (0556T)	$209.28	$320	0.7×
Bone strength & fracture rsk cncrnt vrt fx assmt (0743T) range across 2 matching MRF lines	$140.61–$357.50	$215–$550	varies
Bone strength and fracture risk using finite element analysis of functional data and bone-mineral density utilizing… (0555T)	$209.28	$320	5.8×
Brief alcohol misuse counsel (G0443)	$160.23	$245	1.3×
Brief chkin by md/qhp, 11-20 (G2252) range across 2 matching MRF lines	$65.40–$68.25	$100–$105	varies
Brief chkin, 5-10, non-e/m (G2251) range across 2 matching MRF lines	$35.97–$39	$55–$60	varies
Ca screen;flexi sigmoidscope (G0104)	$634.38	$970	0.5×
Ca screen;pelvic/breast exam (G0101)	—	$309	—
Cardiokymography (Q0035) range across 2 matching MRF lines	$49.51	$30.57–$75.70	1.1×
Care manage beh svs 20mins (G0323) range across 2 matching MRF lines	$679.25–$683.43	$1,045	varies
Catheterize for urine spec (P9612) range across 2 matching MRF lines	$8.42–$81.17	$12.87–$124.87	varies
Chemo extend iv infus w/pump (G0498)	—	$3,080	—
Colon ca scrn not hi rsk ind (G0121) range across 2 matching MRF lines	$1,690.59–$3,311.75	$2,585–$5,095	varies
Colorectal scrn; hi risk ind (G0105)	$1,690.59	$2,585	1.5×
Comm hlth intg svs sdoh 60mn (G0019)	—	$185	—
Computed tomography scan taken for the purpose of biomechanical computed tomography analysis Non-Facility Physician (0558T)	$716.13	$1,095	6.6×
Coms therapy wnd assmt&dr 1st appl <=50 sq cm (0906T) range across 2 matching MRF lines	$88.29–$260	$135–$400	varies
CT breast w/3d rendering bi with contrast (0637T) range across 4 matching MRF lines	$1,056.25–$1,062.75	$345–$1,625	varies
CT breast w/3d rendering bi without contrast (0636T) range across 4 matching MRF lines	$1,433.25–$1,442.07	$370–$2,205	varies
CT breast w/3d rendering uni with contrast (0634T) range across 4 matching MRF lines	$1,056.25–$1,062.75	$345–$1,625	varies
CT breast w/3d rendering uni without contrast (0633T) range across 4 matching MRF lines	$1,433.25–$1,442.07	$370–$2,205	varies
CT brst w/3d rendering bi wo cntrst flwd cntrst (0638T) range across 4 matching MRF lines	$1,729–$1,739.64	$405–$2,660	varies
CT brst w/3d rendering uni wo cntrst flwd cntrst (0635T) range across 4 matching MRF lines	$1,729–$1,739.64	$405–$2,660	varies
Cysto impl 4 or more (C9740)	$7,689.50	$11,830	0.7×
Cystoscopy prostatic imp 1-3 (C9739) unusually low: confirm this is the full procedure	$3,250	$5,000	0.5×
Demonstrate use home inr mon (G0248)	$267.72	$409.36	1.6×
Depression screen annual (G0444)	—	$84	—
Dermal filler injection(s) (G0429)	—	$3,608	—
Devlopment test interpt&rep (G0451) range across 2 matching MRF lines	$23.64–$94.99	$36.14–$146.14	varies
Diab manage trn per indiv (G0108)	—	$269	—
Diab manage trn ind/group (G0109) range across 2 matching MRF lines	$191.75–$192.93	$295	varies
Ed svc ckd grp per session (G0421)	$55.06	$84.19	2.0×
Ed svc ckd ind per session (G0420)	—	$472	—
Egd Flx Trnsorl Vol Adjmt Ntrgstr Bariatric Balo (0813T) range across 2 matching MRF lines	$1,298.19–$1,579.50	$1,985–$2,430	varies
Eia hiv-1/hiv-2 screen (G0432)	$22.89	$35	1.2×
Ekg tracing for initial prev (G0404)	—	$677	—
Elec alys cplx prgrmg iins ptn 4+ parameters (0590T) range across 2 matching MRF lines	$52.32–$252.85	$80–$389	varies
Elec Alys Cplx Prgrmg Iins Sp/Sac Nrv 4+Param (0789T) range across 2 matching MRF lines	$162.50–$163.50	$250	varies
Elec alys int nstimj sys vagus nrv w/o prgrmg (0911T) range across 2 matching MRF lines	$48.75–$49.05	$75	varies
Elec alys int nstimj sys vagus nrv w/smpl prgrmg (0912T) range across 2 matching MRF lines	$98.10–$123.50	$150–$190	varies
Elec alys smpl prgrmg iins ptn 1-3 parameters (0589T) range across 2 matching MRF lines	$52.32–$234.65	$80–$361	varies
Elec Alys Smpl Prgrmg Iins Sp/Sac Nrv 1-3 Param (0788T) range across 2 matching MRF lines	$139.75–$140.61	$215	varies
Elec stim other than wound (G0283)	$170.04	$260	13.4×
Elec stim unattend for press (G0281)	$31.73	$48.51	2.7×
Electromagntic tx for ulcers (G0329)	$23.77	$36.34	2.2×
Electrophysiologic eval ccm-d leads at 1st impl (0930T) range across 2 matching MRF lines	$1,404–$1,412.64	$2,160	varies
Electrophysiologic eval ccm-d leads separate (0931T) range across 2 matching MRF lines	$867.75–$873.09	$1,335	varies
Electrophysiologic Eval Icds W/Ss Electrode (0577T)	—	$460	—
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) range across 2 matching MRF lines	$3,976.32–$40,657.50	$6,080–$62,550	varies
Esw integumentary wound healing initial wound (0512T)	$1,589.22	$2,430	6.3×
Ev Catheter Dir Chem Abltj Incmptnt Xtr Vein (0524T)	$519.93	$795	0.1×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) likely a partial charge, not the full procedure	$1,543.44	$2,360	0.1×
Evac Meibomian Glnds Auto Ht& Intmt Press Uni (0207T) range across 2 matching MRF lines	$111.18–$130	$170–$200	varies
Extrnl counterpulse, per tx (G0166)	$330.24	$504.96	2.0×
Fecal blood scrn immunoassay (G0328)	$71.94	$110	4.0×
Fecal microbiota prep instil (G0455)	$304.11	$465	0.3×
Flt3 gene int tandem dupl variants quantitative (0046U)	—	$1,313	—
Followup eval of foot pt lop (G0246) range across 2 matching MRF lines	$48.77–$158.32	$74.57–$243.57	varies
Gi myoelectrical activity study stmch-colon i&r (0779T) range across 3 matching MRF lines	$745.56–$887.25	$470–$1,365	varies
Glaucoma scrn hgh risk direc (G0118)	$106.47	$162.80	2.3×
Glaucoma scrn hgh risk direc (G0117)	$126.03	$192.70	3.5×
Group behave couns 2-10 (G0473)	$26.06	$39.85	0.6×
Group mnt 2 or more 30 mins (G0271) range across 2 matching MRF lines	$65.40–$71.50	$100–$110	varies
Group train w/o patient (G0543) range across 2 matching MRF lines	$29.43–$58.50	$45–$90	varies
Hbot, full body chamber, 30m (G0277)	—	$3,567	—
Hep c screen high risk/other (G0472) range across 2 matching MRF lines	$114.45–$143	$175–$220	varies
High inten beh couns std 30m (G0445) range across 2 matching MRF lines	$51.46–$85.60	$78.69–$131.69	varies
Hiv combination assay (G0475)	$35.97	$55	1.5×
Hiv prep counsel, clin staff (G0013) range across 2 matching MRF lines	$22.89–$61.75	$35–$95	varies
Home sleep test/type 2 porta (G0398)	$147.15	$225	0.5×
Hopd mntl hlt, grp (C7903)	$156	$240	3.3×
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U)	—	$275	—
Init/sub psych care m 1st 30 (G2214) range across 2 matching MRF lines	$225.63–$263.25	$345–$405	varies
Initial care training 30 m (G0539) range across 2 matching MRF lines	$114.45–$136.50	$175–$210	varies
Initial foot exam pt lops (G0245) range across 2 matching MRF lines	$96.22–$205.48	$147.12–$316.12	varies
Initial preventive exam (G0402)	—	$444	—
Injection of hiv prep drug (G0012) range across 2 matching MRF lines	$39–$39.24	$60	varies
Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) range across 2 matching MRF lines	$643.50–$647.46	$990	varies
Insert drug del implant, >=4 (G0516) range across 2 matching MRF lines	$304.11–$817.70	$465–$1,258	varies
Insertion of sinus tarsi implant (0335T) unusually low: confirm this is the full procedure	$2,933.19	$4,485	0.3×
Insertion of substernal implantable defibrillator electrode (0572T) likely a partial charge, not the full procedure	$1,386.48	$2,120	0.1×
Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging… (0786T) range across 2 matching MRF lines	$2,697.75–$7,306	$4,125–$11,240	varies
Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging… (0784T) range across 2 matching MRF lines	$8,307–$8,358.12	$12,780	varies
Insertion perm ccm-d system pulse generator only (0916T) range across 2 matching MRF lines	$1,345.50–$1,353.78	$2,070	varies
Insertion wrls car stimulator lv pacg compl sys (0515T) likely a partial charge, not the full procedure	$2,671.59	$4,085	0.1×
Insertion/Replacement Complete Iims (0525T) likely a partial charge, not the full procedure	$2,671.59	$4,085	0.1×
Insertion/Replacement Iims Electrode Only (0526T) likely a partial charge, not the full procedure	$2,671.59	$4,085	0.3×
Insertion/Replacement Iims Implantable Mntr Only (0527T) likely a partial charge, not the full procedure	$2,671.59	$4,085	0.3×
Insj bioprostc vlv fem vn (0744T) range across 2 matching MRF lines	$6,844.50–$6,886.62	$10,530	varies
Insj perm ccm-d sys 1 transvns lead only (0917T) range across 2 matching MRF lines	$1,345.50–$1,353.78	$2,070	varies
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) range across 2 matching MRF lines	$1,345.50–$1,353.78	$2,070	varies
Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) range across 2 matching MRF lines	$1,345.50–$1,353.78	$2,070	varies
Insj Wcs Lv Eltrd Only (0516T) likely a partial charge, not the full procedure	$2,671.59	$4,085	0.2×
Insj Wcs Lv Pg Compnt (0517T) likely a partial charge, not the full procedure	$2,671.59	$4,085	0.2×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) likely a partial charge, not the full procedure	$2,566.95	$3,925	0.1×
Instlj fecal microbiota ssp (0780T) range across 2 matching MRF lines	$693.24–$1,040	$1,060–$1,600	varies
Intens behave ther cardio dx (G0446)	$53.80	$82.26	1.2×
Intens cardiac rehab no exer (G0423)	$232.92	$356.14	1.4×
Intens cardiac rehab w/exerc (G0422)	$232.92	$356.14	1.4×
Interrog dev eval iims ip (0529T) range across 2 matching MRF lines	$104.64–$198.25	$160–$305	varies
Interrog dev eval impl ccm-d system in person (0927T) range across 2 matching MRF lines	$146.25–$147.15	$225	varies
Interrog Dev Eval Wrls Car Stimulator in Person (0521T) range across 2 matching MRF lines	$104.64–$198.25	$160–$305	varies
Interrogation Dev Eval Icds W/Ss Eltrd In Person (0576T) range across 2 matching MRF lines	$179.85–$237.25	$275–$365	varies
Lev 2 hosp type b ed visit (G0381)	$91.56	$140	0.8×
Lev 3 hosp type b ed visit (G0382)	$127.53	$195	0.6×
Low intensity eswt corpus cavernosum low energy (0864T) range across 2 matching MRF lines	$1,868.75–$1,880.25	$2,875	varies
Macular pigment optical density measurement by heterochromatic flicker photometry, unilateral or bilateral, with… (0506T) range across 3 matching MRF lines	$130.80–$252.85	$190–$389	varies
Mnt subs tx for change dx (G0270) range across 2 matching MRF lines	$133.25–$134.07	$205	varies
Monthly tx for dmht 20mins (G0553) range across 2 matching MRF lines	$78.48–$139.75	$120–$215	varies
Mra w/o fol w/cont, lwr ext (C8914)	$893.75	$1,375	2.1×
Mra, w/dye, upper extremity (C8934) range across 2 matching MRF lines	$159.58–$1,425.45	$244–$2,193	varies
Mra, w/o dye, spinal canal (C8932) range across 2 matching MRF lines	$165.46–$860.60	$253–$1,324	varies
Mra, w/o dye, upper extr (C8935) range across 2 matching MRF lines	$159.58–$1,260.35	$244–$1,939	varies
Myocardial img by mcg detcj cardiac ischemia (0541T)	$2,583.30	$3,950	5.5×
N-Invas Detcj Heart Failure Drv Augmnt Alys Echo (0932T) range across 2 matching MRF lines	$802.75–$807.69	$1,235	varies
Nav srv peer sup 60 min pr m (G0140) range across 2 matching MRF lines	$130.80–$211.25	$200–$325	varies
Near infrared dual imaging (ie, simultaneous reflective and transilluminated light) of meibomian glands, unilateral or… (0507T) range across 3 matching MRF lines	$130.80–$252.85	$190–$389	varies
Neuro csf prion prtn qual (0035U)	—	$1,742	—
Njx bone sub matrl into subchondral bone defect (0707T) range across 2 matching MRF lines	$4,712.50–$4,741.50	$7,250	varies
Njx platelet plasma (0232T)	—	$1,658	—
No pt prsnt train initial 30 (G0541) range across 2 matching MRF lines	$114.45–$136.50	$175–$210	varies
Obtaining screen pap smear (Q0091)	—	$138	—
Onc Thyr Dna&Mrna 112 Genes Fna Ndul Alg Alys (0026U)	—	$15,392	—
Open impltj int neurostimulation sys vagus nerve (0908T) range across 2 matching MRF lines	$1,631.50–$1,641.54	$2,510	varies
Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg,… (0817T) range across 2 matching MRF lines	$5,245.50–$5,277.78	$8,070	varies
Open insj/rplcmt integrated nstimj sys ptn subq (0816T) range across 2 matching MRF lines	$5,245.50–$5,277.78	$8,070	varies
Open tx iliac spine uni/bil (G0412)	$5,176.41	$7,915	0.6×
Open tx post pelvic fxcture (G0415)	$11,013.36	$16,840	2.7×
Opto-acoustic img breast uni augmnt alys&reprt (0857T) range across 4 matching MRF lines	$274.68–$685.75	$345–$1,055	varies
Oral hiv-1/hiv-2 screen (G0435) range across 2 matching MRF lines	$60.17–$75.40	$92–$116	varies
Ortho impl mvmt alys pair CT (0946T) range across 2 matching MRF lines	$204.75–$206.01	$315	varies
Oth resp proc, group (G0239)	—	$145	—
Oth resp proc, indiv (G0238)	—	$99	—
Pathogen test for platelets (P9100)	—	$204	—
Pattern erg w/i&r (0509T) range across 3 matching MRF lines	$402.21–$696.15	$380–$1,071	varies
Pelvic ring fracture uni/bil (G0413)	$8,544.51	$13,065	0.9×
Pelvic ring fx treat int fix (G0414)	$8,096.52	$12,380	0.9×
Percutaneous implantation or replacement of integrated single device neurostimulation system including electrode array… (0587T) range across 2 matching MRF lines	$990.81–$10,037.95	$1,515–$15,443	varies
Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart… (0632T) range across 2 matching MRF lines	$1,003.89–$11,947	$1,535–$18,380	varies
Perq njx algc cell &/prdct uni/bi fluor lmbr 1st (0627T) range across 2 matching MRF lines	$2,602.92–$36,689.25	$3,980–$56,445	varies
Perq njx algc cell&/prdct uni/bi CT lmbr 1st (0629T) range across 2 matching MRF lines	$2,602.92–$36,689.25	$3,980–$56,445	varies
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) range across 2 matching MRF lines	$159.25–$160.23	$245	varies
Pild/placebo control clin tr (G0276) likely a partial charge, not the full procedure	$971.11	$1,484.88	0.1×
Pin service 60m per month (G0023) range across 2 matching MRF lines	$130.80–$211.25	$200–$325	varies
Pne flu hepb cov home admin (M0201)	$282.75	$435	6.3×
Post d/c phone follow up (G0544) range across 2 matching MRF lines	$127.53–$162.50	$195–$250	varies
Ppps, initial visit (G0438) range across 2 matching MRF lines	$1,066–$1,072.56	$1,640	varies
Ppps, subseq visit (G0439) range across 2 matching MRF lines	$715–$719.40	$1,100	varies
Pre 3d mdl w/ccta and/or mri (C9793)	$2,986.75	$4,595	2.8×
Prgrmg dev eval iims ip (0528T) range across 3 matching MRF lines	$192.93–$237.25	$185–$365	varies
Prgrmg dev eval ldls pm single car chamber ip (0826T) range across 4 matching MRF lines	$150.42–$243.75	$205–$375	varies
Prgrmg device eval wrls car stimulator in person (0522T) range across 3 matching MRF lines	$192.93–$237.25	$185–$365	varies
Programming dev eval icds w/ss eltrd in person (0575T) range across 2 matching MRF lines	$252.85–$261.60	$389–$400	varies
Programming device eval impl ccm-d sys in person (0926T) range across 2 matching MRF lines	$172.25–$173.31	$265	varies
Prolonged iv inf, req pump (C8957)	—	$854	—
Prostate biopsy, any mthd (G0416) range across 2 matching MRF lines	$1,501.46	$925–$2,295.81	3.4×
Provide inr test mater/equip (G0249)	$266.16	$406.98	1.6×
Psa screening (G0103) range across 2 matching MRF lines	$85.02–$240.79	$130–$370.45	varies
Quan MRI alys brain w/o diagnostic MRI same sess (0865T) range across 4 matching MRF lines	$869.82–$3,441.75	$845–$5,295	varies
Quan MRI alys brain with diagnostic MRI (0866T) range across 4 matching MRF lines	$869.82–$3,441.75	$845–$5,295	varies
Relocation pg wcs lv pacg battery component only (0862T) range across 2 matching MRF lines	$5,573.75–$5,608.05	$8,575	varies
Relocation pg wcs lv pacg transmittr compnt only (0863T) range across 2 matching MRF lines	$5,573.75–$5,608.05	$8,575	varies
Relocation skin pocket implanted ccm-d pg (0925T) range across 2 matching MRF lines	$913.25–$918.87	$1,405	varies
Rem auton alg nsln cal setup (0740T)	$117	$180	1.6×
Rem auton alg nsln data coll (0741T)	$234	$360	5.0×
Rem multi day cplx uroflowmetry dev sply w/reprt (0812T) range across 2 matching MRF lines	$241.98–$373.75	$370–$575	varies
Rem multi day cplx uroflowmetry setup&pt educaj (0811T) range across 2 matching MRF lines	$241.98–$373.75	$370–$575	varies
Remot img sub by pt, non e/m (G2250) range across 2 matching MRF lines	$26.16–$32.50	$40–$50	varies
Removal complete iims (0530T)	$1,504.20	$2,300	0.3×
Removal iims electrode only (0531T)	$1,504.20	$2,300	0.3×
Removal iims implt mntr only (0532T)	$1,504.20	$2,300	0.3×
Removal int neurostimulation sys vagus nerve (0910T) range across 2 matching MRF lines	$2,119–$2,132.04	$3,260	varies
Removal perm ccm-d system pulse generator only (0919T) range across 2 matching MRF lines	$900.25–$905.79	$1,385	varies
Removal pg wcs lv pacing both components (0861T) range across 2 matching MRF lines	$3,490.50–$3,511.98	$5,370	varies
Removal Ss Dfb Electrode (0573T)	$1,052.94	$1,610	0.2×
Remove drug implant (G0517) range across 2 matching MRF lines	$340.08–$853.45	$520–$1,313	varies
Remove w insert drug implant (G0518) range across 2 matching MRF lines	$555.90–$1,067.95	$850–$1,643	varies
Replacement int neurostimulation sys vagus nerve (0909T) range across 2 matching MRF lines	$2,177.50–$2,190.90	$3,350	varies
Repos prev impl ss impltbl dfb pacing eltrd (0574T)	$1,216.44	$1,860	0.3×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T) range across 2 matching MRF lines	$1,290.25–$1,298.19	$1,985	varies
Revasc lith-sten-ath tib/per (C9775) range across 2 matching MRF lines	$5,379.15–$101,357.75	$8,225–$155,935	varies
Revasc lithotr-ather tib/per (C9774) range across 2 matching MRF lines	$5,137.17–$80,297.75	$7,855–$123,535	varies
Revasc lithotr-stent tib/per (C9773) range across 2 matching MRF lines	$4,947.51–$62,968.75	$7,565–$96,875	varies
Revasc lithotrip tibi/perone (C9772) range across 2 matching MRF lines	$3,976.32–$40,657.50	$6,080–$62,550	varies
Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body… (0790T) range across 2 matching MRF lines	$3,642.78–$19,500	$5,570–$30,000	varies
Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and… (0819T) range across 2 matching MRF lines	$1,904.50–$1,916.22	$2,930	varies
Revision or removal of integrated single device neurostimulation system including electrode array and receiver or pulse… (0588T) range across 2 matching MRF lines	$415.29–$3,565.25	$635–$5,485	varies
Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator (0787T) range across 2 matching MRF lines	$1,904.50–$1,916.22	$2,930	varies
Revj/rmvl integrated nstimj sys ptn subcutaneous (0818T) range across 2 matching MRF lines	$1,904.50–$1,916.22	$2,930	varies
Revj/Rmvl Nstim Eltrd Ra Spi W/Integrated Nstim (0785T) range across 2 matching MRF lines	$2,374.02–$4,455.75	$3,630–$6,855	varies
Risk ascvd tst once pr 12 mo (G0537) range across 2 matching MRF lines	$22.89–$52	$35–$80	varies
Rmvl & Rplcmt Pg Compnt Wcs (0519T) likely a partial charge, not the full procedure	$2,573.49	$3,935	0.2×
Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T) range across 2 matching MRF lines	$900.25–$905.79	$1,385	varies
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) range across 2 matching MRF lines	$900.25–$905.79	$1,385	varies
Rmvl perm ccm-d sys dual transvns leads only (0922T) range across 2 matching MRF lines	$900.25–$905.79	$1,385	varies
Rmvl Pg Compnt Wcs (0518T)	$1,504.20	$2,300	0.3×
Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T)	$644.19	$985	0.1×
Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) range across 2 matching MRF lines	$984.75–$990.81	$1,515	varies
Rmvl&Rplcmt Pg Wcs New Eltrd (0520T) likely a partial charge, not the full procedure	$2,573.49	$3,935	0.2×
Routine footcare pt w lops (G0247) range across 2 matching MRF lines	$52.44–$140.52	$80.19–$216.19	varies
Rx Metab Advrs Trgt Seq Alys (0029U)	—	$4,268	—
Safety plan interven (G0560) range across 2 matching MRF lines	$104–$104.64	$160	varies
Scr c/v cyto,thinlayer,rescr (G0145)	$101.37	$155	3.8×
Single energy x-ray study (G0130) range across 2 matching MRF lines	$81.16	$38.78–$124.10	0.6×
Tc Auricular Nstimj Setup Calibration &Pt Educaj (0783T) range across 2 matching MRF lines	$2,583.75–$2,599.65	$3,975	varies
Tc mag stimj pn 1st tx 1nrv (0766T) range across 2 matching MRF lines	$153.69–$315.25	$235–$485	varies
Tcat implt wrls l atr prs snr l-t l atr prs mntr (0933T) range across 2 matching MRF lines	$880.75–$886.17	$1,355	varies
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) range across 2 matching MRF lines	$2,060.50–$2,073.18	$3,170	varies
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) range across 2 matching MRF lines	$1,495–$1,504.20	$2,300	varies
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) range across 2 matching MRF lines	$6,279–$6,317.64	$9,660	varies
Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) range across 2 matching MRF lines	$3,025.75–$3,044.37	$4,655	varies
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) range across 2 matching MRF lines	$5,892.54–$6,760	$9,010–$10,400	varies
Therapeutic procd strg endur (G0237)	—	$95	—
Tomosynthesis, mammo (G0279) range across 2 matching MRF lines	$202.74	$310–$330	16.0×
Trabeculostomy ab interno by laser (0621T) range across 2 matching MRF lines	$1,641.54–$1,976	$2,510–$3,040	varies
Train for caregiver add 15 (G0540) range across 2 matching MRF lines	$62.13–$65	$95–$100	varies
Transurethral ablation of malignant prostate tissue by high-energy water vapor thermotherapy, including intraoperative… (0582T) range across 2 matching MRF lines	$1,066.02–$6,352.32	$1,630–$9,772.80	varies
Trim nail(s) (G0127) range across 2 matching MRF lines	$234–$235.44	$360	varies
Trluml Perip Athrc Iliac Art (0238T) range across 2 matching MRF lines	$13,475.80–$13,558.73	$20,732	varies
Tympanostomy Automated Tube Delivery System (0583T) range across 2 matching MRF lines	$372.78–$982.15	$570–$1,511	varies
Unsched dialysis esrd pt hos (G0257)	—	$2,620	—
Urine specimen collect mult (P9615) range across 2 matching MRF lines	$9.03–$20.67	$13.80–$31.80	varies
Visit esketamine 56m or less (G2082)	—	$2,318	—
Visit esketamine, > 56m (G2083)	—	$3,200	—
Visit to determ ldct elig (G0296) range across 2 matching MRF lines	$150.42–$159.25	$230–$245	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.