Supplies, drugs & other prices at Mount Carmel St. Ann's
Westerville, OH · every code in this section with a posted price and a Medicare benchmark.
123 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $2,652.65 | $4,081 | 3.5× |
| 2d tte w or w/o fol w/con,co (C8923) | $1,728.35 | $2,659 | 2.3× |
| 2d tte w or w/o fol w/con,fu (C8924) | $815.10 | $1,254 | 2.4× |
| Adm tocilizu covid-19 1st (M0249) | $587.60 | $904 | 1.4× |
| Admin hepatitis b vaccine (G0010) range across 2 matching MRF lines |
$13.81–$54.60 | $21.25–$84 | varies |
| Admin influenza virus vac (G0008) range across 2 matching MRF lines |
$13.81–$54.60 | $21.25–$84 | varies |
| Admin pneumococcal vaccine (G0009) range across 2 matching MRF lines |
$13.81–$54.60 | $21.25–$84 | varies |
| Bdy surf activation mapg pm/cvdfb leads tm f/up (0696T) | $56.55 | $87 | 1.6× |
| Ca screen;pelvic/breast exam (G0101) | $91 | $140 | 0.9× |
| Catheterize for urine spec (P9612) | $9.75 | $15 | 1.0× |
| Colon ca scrn not hi rsk ind (G0121) range across 3 matching MRF lines |
$2,792.33–$2,911.02 | — | varies |
| Colorectal scrn; hi risk ind (G0105) range across 3 matching MRF lines |
$2,708.87–$2,838.22 | — | varies |
| Covid-19 lab test non-cdc (U0002) | $96.20 | $148 | 1.9× |
| Cysto impl 4 or more (C9740) | $32,469.90 | — | 3.6× |
| Cysto, litho, vacuum kidney (C9761) | $38,894.56 | — | 4.3× |
| Cystoscopy prostatic imp 1-3 (C9739) | $24,578.77 | — | 4.8× |
| Diab manage trn per indiv (G0108) | $222.30 | — | 4.0× |
| Diab manage trn ind/group (G0109) | $257.40 | — | 16.1× |
| Direct refer hospital observ (G0379) | $9,852.05 | — | 17.2× |
| Ekg tracing for initial prev (G0404) | $185.25 | $285 | 6.6× |
| Elec stim other than wound (G0283) | $74.10 | $114 | 5.8× |
| Electrophysiologic eval ccm-d leads at 1st impl (0930T) | $1,010.10 | $1,554 | 0.9× |
| Electrophysiologic eval ccm-d leads separate (0931T) | $1,758.90 | $2,706 | 1.5× |
| Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) range across 3 matching MRF lines |
$22,659.65–$33,989.80 | $34,861–$52,292 | varies |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) | $15,648.10 | $24,074 | 1.4× |
| Fecal blood scrn immunoassay (G0328) | $33.80 | $52 | 1.9× |
| Fecal microbiota prep instil (G0455) | $1,049.75 | $1,615 | 1.2× |
| Fern test (Q0114) | $31.85 | $49 | 3.3× |
| Hbot, full body chamber, 30m (G0277) | $34,834.80 | — | 262.5× |
| Hep c screen high risk/other (G0472) | $89.70 | $138 | 1.9× |
| Histotripsy mal hepatocellular tiss w/img gdn (0686T) | $18,423.60 | $28,344 | 1.1× |
| Hiv combination assay (G0475) | $7,304.83 | — | 303.4× |
| Home sleep test/type 3 porta (G0399) | $730.60 | $1,124 | 3.5× |
| Hospital outpt clinic visit (G0463) | $138.45 | — | 1.1× |
| Inj for sacroiliac jt anesth (G0260) range across 3 matching MRF lines |
$2,393.95–$3,591.25 | $3,683–$5,525 | varies |
| Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system… (0680T) likely a partial charge, not the full procedure |
$3,735.55 | $5,747 | 0.2× |
| Insertion perm ccm-d system pulse generator only (0916T) likely a partial charge, not the full procedure |
$6,428.50 | $9,890 | 0.3× |
| Insertion wrls car stimulator lv pacg compl sys (0515T) | $35,141.60 | $54,064 | 1.6× |
| Insertion/Replacement Complete Iims (0525T) | $15,355.60 | $23,624 | 0.8× |
| Insertion/Replacement Iims Electrode Only (0526T) | $11,508.90 | $17,706 | 1.4× |
| Insertion/Replacement Iims Implantable Mntr Only (0527T) | $11,508.90 | $17,706 | 1.4× |
| Insj perm ccm-d sys 1 transvns lead only (0917T) unusually low: confirm this is the full procedure |
$2,418.65 | $3,721 | 0.3× |
| Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) unusually low: confirm this is the full procedure |
$2,660.45 | $4,093 | 0.3× |
| Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) likely a partial charge, not the full procedure |
$8,386.30 | $12,902 | 0.3× |
| Insj Wcs Lv Eltrd Only (0516T) | $6,905.60 | $10,624 | 0.7× |
| Insj Wcs Lv Pg Compnt (0517T) | $6,905.60 | $10,624 | 0.7× |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) | $36,803.65 | $56,621 | 1.2× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) likely a partial charge, not the full procedure |
$9,012.90 | $13,866 | 0.3× |
| Interrogation device evaluation in person isdss (0685T) | $57.85 | $89 | 1.6× |
| Liver Dis 10 Assays Serum Algorithm W/Nash (0003M) | $434.85 | $669 | 0.9× |
| Mra w/o cont, abd (C8901) | $2,064.40 | $3,176 | 9.0× |
| Mra w/o cont, chest (C8910) | $1,415.05 | $2,177 | 6.2× |
| Mra w/o cont, lwr ext (C8913) range across 3 matching MRF lines |
$1,411.15–$2,117.05 | $2,171–$3,257 | varies |
| Mra w/o cont, pelvis (C8919) | $1,288.95 | $1,983 | 5.6× |
| Mra w/o fol w/cont, abd (C8902) | $2,781.35 | $4,279 | 8.3× |
| Mra w/o fol w/cont, chest (C8911) | $1,619.15 | $2,491 | 4.8× |
| Mra w/o fol w/cont, lwr ext (C8914) range across 3 matching MRF lines |
$2,025.40–$3,038.10 | $3,116–$4,674 | varies |
| Mra w/o fol w/cont, pelvis (C8920) | $1,885.65 | $2,901 | 5.6× |
| Mri w/cont, breast, bi (C8906) | $1,837.55 | $2,827 | 5.5× |
| Mri w/o fol w/cont, breast, (C8908) | $1,882.40 | $2,896 | 5.6× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,476.15 | $2,271 | 4.4× |
| Neuro csf prion prtn qual (0035U) | $440.05 | $677 | 0.8× |
| Oth resp proc, group (G0239) | $50.05 | $77 | 1.4× |
| Oth resp proc, indiv (G0238) | $48.10 | $74 | 1.7× |
| Pathogen test for platelets (P9100) | $104.65 | $161 | 1.8× |
| Perc d-e cor revasc chro sin (C9607) | $19,989.45 | $30,753 | 1.1× |
| Perc d-e cor revasc t cabg s (C9604) | $17,109.30 | $26,322 | 1.5× |
| Perc d-e cor stent ather s (C9602) | $21,908.25 | $33,705 | 1.2× |
| Perc drug-el cor stent sing (C9600) | $22,115.60 | $34,024 | 2.0× |
| Perq Sacral Augmt Bilat Inj (0201T) | $13,992.55 | $21,527 | 2.0× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) unusually low: confirm this is the full procedure |
$3,595.80 | $5,532 | 0.3× |
| Place device/marker, non pro (C9728) | $1,220.70 | $1,878 | 0.9× |
| Ppps, initial visit (G0438) | $130 | $200 | 0.7× |
| Ppps, subseq visit (G0439) | $131.30 | $202 | 1.0× |
| Prgrmg dev eval ldls pm single car chamber ip (0826T) | $45.50 | $70 | 1.3× |
| Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of… (0683T) | $56.55 | $87 | 1.6× |
| Psa screening (G0103) | $46.80 | $72 | 2.4× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $2,300.35 | $3,539 | 3.2× |
| Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for… (0681T) | $2,144.35 | $3,299 | 0.6× |
| Relocation pg wcs lv pacg battery component only (0862T) | $2,152.15 | $3,311 | 1.1× |
| Relocation pg wcs lv pacg transmittr compnt only (0863T) | $2,152.15 | $3,311 | 1.1× |
| Relocation skin pocket implanted ccm-d pg (0925T) | $1,612.65 | $2,481 | 0.8× |
| Rem interrog dev eval ss ld icds < 90d tech (0579T) | $35.10 | $54 | 1.0× |
| Removal complete iims (0530T) | $4,865.90 | $7,486 | 1.4× |
| Removal iims electrode only (0531T) | $4,865.90 | $7,486 | 1.4× |
| Removal iims implt mntr only (0532T) | $4,865.90 | $7,486 | 1.4× |
| Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation… (0682T) | $2,542.15 | $3,911 | 0.8× |
| Removal perm ccm-d system pulse generator only (0919T) | $2,704.65 | $4,161 | 0.8× |
| Removal pg wcs lv pacing both components (0861T) | $3,610.75 | $5,555 | 1.0× |
| Repositioning prev impl ccm-d transvns eltrd/ld (0924T) | $1,916.20 | $2,948 | 3.2× |
| Revasc intra lithotrip-ather (C9766) | $17,209.40 | $26,476 | 1.0× |
| Revasc intra lithotrip-stent (C9765) | $17,209.40 | $26,476 | 1.0× |
| Revasc intravasc lithotripsy (C9764) | $10,635.30 | $16,362 | 1.0× |
| Revasc lith-sten-ath tib/per (C9775) | $19,735.30 | $30,362 | 1.1× |
| Revasc lithotr-ather tib/per (C9774) | $27,159.60 | $41,784 | 1.5× |
| Revasc lithotr-stent tib/per (C9773) | $18,106.40 | $27,856 | 1.0× |
| Revasc lithotrip tibi/perone (C9772) | $9,681.75 | $14,895 | 0.9× |
| Revasc lithotrip-stent-ather (C9767) | $19,093.75 | $29,375 | 1.1× |
| Rmvl & Rplcmt Pg Compnt Wcs (0519T) | $7,299.50 | $11,230 | 0.7× |
| Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T) | $2,704.65 | $4,161 | 0.8× |
| Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) | $2,704.65 | $4,161 | 0.8× |
| Rmvl perm ccm-d sys dual transvns leads only (0922T) | $2,975.05 | $4,577 | 0.8× |
| Rmvl Pg Compnt Wcs (0518T) | $7,299.50 | $11,230 | 2.0× |
| Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) likely a partial charge, not the full procedure |
$6,428.50 | $9,890 | 0.3× |
| Rmvl&Rplcmt Pg Wcs New Eltrd (0520T) | $34,190 | $52,600 | 3.4× |
| Tcat implt wrls l atr prs snr l-t l atr prs mntr (0933T) | $2,536.30 | $3,902 | 0.8× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) unusually low: confirm this is the full procedure |
$8,727.55 | $13,427 | 0.5× |
| Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) | $12,621.05 | $19,417 | 0.7× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) unusually low: confirm this is the full procedure |
$6,722.30 | $10,342 | 0.4× |
| Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) | $3,134.30 | $4,822 | 1.0× |
| Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) unusually low: confirm this is the full procedure |
$8,727.55 | $13,427 | 0.5× |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) | $3,595.80 | $5,532 | 0.7× |
| Tee w or w/o fol w/cont, mon (C8927) | $1,528.15 | $2,351 | 2.0× |
| Therapeutic procd strg endur (G0237) | $85.15 | $131 | 3.1× |
| Therapeutic ultrafiltration (0692T) | $1,464.45 | $2,253 | 1.0× |
| Tomosynthesis, mammo (G0279) range across 3 matching MRF lines |
$37.70–$56.55 | $58–$87 | varies |
| Transcatheter Renal Sympath Denervation Bilat (0339T) | $6,117.15 | $9,411 | 1.1× |
| Transcatheter renal sympath denervation unilat (0338T) | $4,077.45 | $6,273 | 0.7× |
| Trluml Perip Athrc Iliac Art (0238T) | $16,334.50 | $25,130 | 0.9× |
| Tte w or w/o contr, cont ecg (C8930) | $2,763.15 | $4,251 | 3.7× |
| Tte w or w/o fol w/con,stres (C8928) | $2,154.75 | $3,315 | 2.9× |
| Tte w or wo fol wcon,doppler (C8929) | $2,771.60 | $4,264 | 3.7× |
| Unsched dialysis esrd pt hos (G0257) | $48,137.60 | — | 72.7× |
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.