Supplies, drugs & other prices at Mount Sinai West

New York, NY · every code in this section with a posted price and a Medicare benchmark.

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

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
2019-ncov diagnostic p (U0001) $171 $190 4.8×
2d cephalometric image (D0340) $180 $200 1.7×
2d tee w or w/o fol w/con,in (C8925) $3,150 $3,500 3.2×
2d tte w or w/o fol w/con,co (C8923) $2,610 $2,900 2.7×
2d tte w or w/o fol w/con,fu (C8924) $1,944 $2,160 4.5×
Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T) $4,500 $5,000 0.9×
Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv (0442T) $13,050 $14,500 1.2×
Adm tocilizu covid-19 1st (M0249) $1,890 $2,100 3.4×
Adm tocilizu covid-19 2nd (M0250) $1,890 $2,100 3.4×
Admin hepatitis b vaccine (G0010)
range across 3 matching MRF lines		 $22.59–$157.50 $25.10–$175 varies
Admin influenza virus vac (G0008)
range across 3 matching MRF lines		 $22.59–$157.50 $25.10–$175 varies
Admin pneumococcal vaccine (G0009)
range across 3 matching MRF lines		 $22.59–$157.50 $25.10–$175 varies
Alcohol/subs interv 15-30mn (G0396) $225 $250 4.8×
Alcohol/subs interv >30 min (G0397) $225 $250 1.0×
Alveoloplasty not w/extracts (D7321) $450 $500 0.2×
Alveoloplasty w/extract 1-3 (D7311) $1,800 $2,000 0.9×
Alveolus clsd reduc stblz te (D7771) $3,510 $3,900 0.8×
Alveoplasty w/ extraction (D7310) $1,710 $1,900 0.9×
Alveoplasty w/o extraction (D7320) $450 $500 0.2×
Amalgam 4 or > surfaces perm (D2161) $540 $600 0.7×
Amalgam one surface permanen (D2140) $225 $250 0.3×
Amalgam three surfaces perma (D2160) $360 $400 0.4×
Amalgam two surfaces permane (D2150) $315 $350 0.4×
Ant resin-based cmpst crown (D2390) $288 $320 0.4×
Apexification/recalc final (D3353) $315 $350 0.4×
Apexification/recalc initial (D3351) $216 $240 0.3×
Apexification/recalc interim (D3352) $234 $260 0.3×
Apically positioned flap (D4245) $1,890 $2,100 1.0×
Apicoectomy - anterior (D3410) $1,440 $1,600 1.8×
Ascvd rsk mng clin stf pr mo (G0538) $216 $240 1.7×
Behavior counsel obesity 15m (G0447) $144 $160 1.1×
Bia whole body composition assessment w/i&r (0358T) $225 $250 6.2×
Bitewings four images (D0274) $288 $320 1.0×
Blind cor sinus reducer impl (C9783) $28,800 $32,000 2.0×
Bone replce graft first site (D4263) $1,710 $1,900 2.1×
Brief alcohol misuse counsel (G0443) $144 $160 1.1×
Ca screen;pelvic/breast exam (G0101) $261 $290 2.1×
Canal prep/fitting of dowel (D3950) $202.50 $225 0.3×
Catheterize for urine spec (P9612) $112.50 $125 12.0×
Chemo extend iv infus w/pump (G0498) $1,800 $2,000 4.4×
Closd rductn splint alveolus (D7670) $3,420 $3,800 0.8×
Comp periodontal evaluation (D0180) $198 $220 1.2×
Complete occlusal adjustment (D9952) $337.50 $375 0.4×
Compre ful bdy cptr mrkrls 3d knmtc&kin mtn alys (0693T) $1,215 $1,350 2.8×
Comprehensve oral evaluation (D0150) $292.50 $325 1.8×
Cone beam ct interp both jaw (D0367) $720 $800 5.5×
Core build-up incl any pins (D2950) $450 $500 0.6×
Covid-19 lab test non-cdc (U0002) $171 $190 3.3×
Crown 3/4 cast base metal (D2781) $675 $750 0.8×
Crown 3/4 cast hi noble met (D2780) $720 $800 0.9×
Crown 3/4 cast noble metal (D2782) $720 $800 0.9×
Crown full cast base metal (D2791) $900 $1,000 1.1×
Crown full cast high noble m (D2790) $1,170 $1,300 1.4×
Crown full cast noble metal (D2792) $1,170 $1,300 1.4×
Crown lengthen hard tissue (D4249) $1,170 $1,300 1.4×
Crown porc fused to titanium (D2753) $1,080 $1,200 1.3×
Crown porcelain fused base m (D2751) $900 $1,000 1.1×
Crown porcelain w/ h noble m (D2750) $1,215 $1,350 1.5×
Crown porcelain w/ noble met (D2752) $1,170 $1,300 1.4×
Crown porcelain/ceramic (D2740)
range across 2 matching MRF lines		 $855–$1,080 $950–$1,200 varies
Crown repair (D2980) $360 $400 0.4×
Crown resin w/ base metal (D2721) $810 $900 1.0×
Crown resin w/ high noble me (D2720) $900 $1,000 1.1×
Crown resin w/ noble metal (D2722) $1,170 $1,300 1.4×
Crown resin-based indirect (D2710) $675 $750 0.8×
Crtj Subq Insj Impltbl Glucose Sensor Sys Train (0446T) $3,150 $3,500 0.6×
Demonstrate use home inr mon (G0248) $459 $510 2.8×
Dental bitewing single image (D0270) $126 $140 1.2×
Dental bitewings two images (D0272) $144 $160 1.3×
Dental inlay metalic 1 surf (D2510) $585 $650 0.7×
Dental inlay metallic 2 surf (D2520) $675 $750 0.8×
Dental inlay metl 3/more sur (D2530) $765 $850 0.9×
Dental inlay resin 3/mre sur (D2652) $585 $650 0.7×
Dental onlay metallic 2 surf (D2542) $675 $750 0.8×
Dental onlay metallic 3 surf (D2543) $765 $850 0.9×
Dental onlay metl 4/more sur (D2544) $900 $1,000 1.1×
Dental onlay porc 3/more sur (D2630) $652.50 $725 0.8×
Dental onlay porc 4/more sur (D2644) $742.50 $825 0.9×
Dental onlay porcelin 2 surf (D2642) $652.50 $725 0.8×
Dental onlay porcelin 3 surf (D2643) $697.50 $775 0.9×
Dental onlay resin 2 surface (D2662) $540 $600 0.7×
Dental onlay resin 3 surface (D2663) $607.50 $675 0.8×
Dental onlay resin 4/mre sur (D2664) $675 $750 0.8×
Dental prophylaxis adult (D1110) $225 $250 1.4×
Dental unspec restorative pr (D2999) $1,080 $1,200 1.3×
Devlopment test interpt&rep (G0451) $315 $350 2.5×
Diab manage trn per indiv (G0108) $270 $300 4.8×
Diab manage trn ind/group (G0109) $135 $150 8.4×
Direct refer hospital observ (G0379) $675 $750 0.9×
Drug test def 1-7 classes (G0480)
range across 167 matching MRF lines		 $21.60–$261 $24–$290 varies
Drug test def 22+ classes (G0483) $222.23 $246.92 0.9×
Drug test def 8-14 classes (G0481)
range across 10 matching MRF lines		 $36–$188.10 $40–$209 varies
Ekg tracing for initial prev (G0404) $355.50 $395 9.8×
Elec stim other than wound (G0283) $112.50 $125 8.9×
End thxpy, anterior tooth (D3310) $1,080 $1,200 1.3×
End thxpy, molar tooth (D3330) $1,080 $1,200 1.3×
End thxpy, premolar tooth (D3320) $1,080 $1,200 1.3×
Endodontic endosseous implan (D3460) $810 $900 1.0×
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) $41,400 $46,000 0.8×
Ev Catheter Dir Chem Abltj Incmptnt Xtr Vein (0524T) $6,300 $7,000 1.6×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $16,200 $18,000 1.1×
Evacuation meibomian glands using heat bilateral (0563T) $189 $210 2.6×
Exposure of unerupted tooth (D7280) $495 $550 0.6×
Extensv oral eval prob focus (D0160) $171 $190 1.0×
Extraction coronal remnants (D7111) $157.50 $175 0.2×
Extraction erupted tooth/exr (D7140)
range across 2 matching MRF lines		 $163.80–$315 $182–$350 varies
Extraoral 2d project image (D0250) $126 $140 1.2×
Facial moulage complete (D5912) $1,350 $1,500 1.7×
Facial moulage sectional (D5911) $1,170 $1,300 1.4×
Fecal blood scrn immunoassay (G0328) $40.50 $45 2.2×
Fern test (Q0114)
range across 3 matching MRF lines		 $54–$63 $60–$70 varies
Followup eval of foot pt lop (G0246) $202.50 $225 1.2×
Full mouth debridement (D4355) $990 $1,100 1.2×
Gingival flap proc w/ planin (D4240) $3,690 $4,100 0.9×
Gingivectomy/plasty 1 to 3 (D4211) $3,330 $3,700 0.8×
Gingivectomy/plasty 4 or mor (D4210) $3,780 $4,200 0.9×
Glaucoma scrn hgh risk direc (G0118) $121.50 $135 2.6×
Glaucoma scrn hgh risk direc (G0117) $108 $120 3.0×
Gngvl flap w rootplan 1-3 th (D4241) $1,800 $2,000 0.9×
Gross pulpal debridement (D3221) $171 $190 0.2×
Group mnt 2 or more 30 mins (G0271) $72 $80 4.2×
Guided tiss regen nonresorb (D4267) $1,665 $1,850 0.9×
Guided tiss regen resorble (D4266) $1,710 $1,900 0.9×
Heart Symp Image Plnr (0331T) $2,070 $2,300 1.3×
High inten beh couns std 30m (G0445) $144 $160 1.1×
Hiv prep counsel, clin staff (G0013) $180 $200 3.8×
Home sleep test/type 2 porta (G0398) $1,350 $1,500 5.0×
Hospital outpt clinic visit (G0463)
range across 22 matching MRF lines		 $270–$585 $300–$650 varies
I&d absc intraoral soft tiss (D7510) $855 $950 1.0×
I&d abscess extraoral (D7520) $855 $950 1.0×
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) $153 $170 3.5×
Impact tooth rem bony w/comp (D7241) $585 $650 0.7×
Impact tooth remov comp bony (D7240) $810 $900 1.0×
Impact tooth remov part bony (D7230) $720 $800 0.9×
Impact tooth remov soft tiss (D7220) $630 $700 0.8×
Initial foot exam pt lops (G0245) $270 $300 1.6×
Initial preventive exam (G0402) $315 $350 1.9×
Inj for sacroiliac jt anesth (G0260) $2,065.50 $2,295 2.3×
Injection of hiv prep drug (G0012) $270 $300 3.0×
Inlay composite/resin one su (D2650) $450 $500 0.6×
Inlay composite/resin two su (D2651) $517.50 $575 0.6×
Inlay porcelain/ceramic 1 su (D2610) $517.50 $575 0.6×
Inlay porcelain/ceramic 2 su (D2620) $585 $650 0.7×
Insertion perm ccm-d system pulse generator only (0916T)
likely a partial charge, not the full procedure		 $2,700 $3,000 0.1×
Insj perm ccm-d sys 1 transvns lead only (0917T) $12,600 $14,000 1.2×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) $16,200 $18,000 1.6×
Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) $37,800 $42,000 1.0×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $37,777.50 $41,975 1.0×
Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) $12,600 $14,000 1.2×
Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) $12,600 $14,000 1.2×
Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) $27,000 $30,000 1.0×
Intens behave ther cardio dx (G0446) $99 $110 2.1×
Interim crown (D2799) $360 $400 0.4×
Interro Device Evaluation Cardiac Modulj System (0418T) $450 $500 9.7×
Intraor comprehensive series (D0210) $315 $350 1.1×
Intraoral occlusal film (D0240) $126 $140 1.2×
Intraoral periapical first (D0220) $117 $130 1.1×
Ire Abltj 1+Tum Organ Perq (0600T) $13,806 $15,340 1.0×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U)
range across 2 matching MRF lines		 $427.50–$576 $475–$640 varies
Labial veneer porc indirect (D2962) $1,350 $1,500 1.7×
Labial veneer resin direct (D2960) $1,170 $1,300 1.4×
Lev 1 hosp type b ed visit (G0380) $900 $1,000 9.7×
Lev 2 hosp type b ed visit (G0381) $1,080 $1,200 9.3×
Lev 3 hosp type b ed visit (G0382) $1,260 $1,400 5.9×
Lev 4 hosp type b ed visit (G0383) $1,440 $1,600 4.4×
Lev 5 hosp type b ed visit (G0384) $1,620 $1,800 3.2×
Limit oral eval problm focus (D0140) $153 $170 0.9×
Limited occlusal adjustment (D9951) $225 $250 0.3×
Mnt subs tx for change dx (G0270) $139.50 $155 4.4×
Mra w/cont, abd (C8900) $3,600 $4,000 8.3×
Mra w/cont, chest (C8909) $3,573 $3,970 8.2×
Mra w/cont, lwr ext (C8912) $4,081.50 $4,535 9.4×
Mra w/cont, pelvis (C8918) $3,600 $4,000 8.3×
Mra w/o cont, abd (C8901) $2,583 $2,870 8.7×
Mra w/o cont, chest (C8910) $3,060 $3,400 10.3×
Mra w/o cont, lwr ext (C8913) $3,316.50 $3,685 11.1×
Mra w/o cont, pelvis (C8919) $2,790 $3,100 9.4×
Mra w/o fol w/cont, abd (C8902) $4,500 $5,000 10.3×
Mra w/o fol w/cont, chest (C8911) $4,081.50 $4,535 9.4×
Mra w/o fol w/cont, lwr ext (C8914) $4,846.50 $5,385 11.1×
Mra w/o fol w/cont, pelvis (C8920) $4,846.50 $5,385 11.1×
Mra, w/dye, spinal canal (C8931) $3,600 $4,000 8.3×
Mra, w/dye, upper extremity (C8934) $3,267 $3,630 7.5×
Mra, w/o dye, spinal canal (C8932) $2,610 $2,900 8.8×
Mra, w/o dye, upper extr (C8935) $3,060 $3,400 10.3×
Mra, w/o&w/dye, spinal canal (C8933) $4,500 $5,000 10.3×
Mra, w/o&w/dye, upper extr (C8936) $4,500 $5,000 10.3×
Mri w/cont, breast, bi (C8906) $3,865.50 $4,295 8.9×
Mri w/cont, breast, uni (C8903) $3,600 $4,000 16.4×
Mri w/o fol w/cont, breast, (C8908) $7,650 $8,500 17.6×
Mri w/o fol w/cont, brst, un (C8905) $4,293 $4,770 9.9×
Myocrd Symp Innervaj Img Plnr Qual&Quant W/Spect (0332T) $2,520 $2,800 1.6×
Njx platelet plasma (0232T) $1,080 $1,200 1.9×
No pt prsnt train initial 30 (G0541) $180 $200 5.0×
Obtaining screen pap smear (Q0091) $135 $150 3.7×
Occ guard, hard, full arch (D9944) $2,070 $2,300 2.6×
Occ guard, hard, part arch (D9946) $1,890 $2,100 2.3×
Occ guard, soft, full arch (D9945) $2,025 $2,250 2.5×
Occlusion analysis (D9950) $450 $500 0.6×
Open reduc compd alveolus fx (D7770) $6,300 $7,000 0.9×
Opto-acoustic img breast uni augmnt alys&reprt (0857T) $427.50 $475 3.3×
Oral antral fistula closure (D7260) $630 $700 0.8×
Oral hiv-1/hiv-2 screen (G0435) $63 $70 5.3×
Oral/facial photo images (D0350) $144 $160 1.3×
Osseous surg 1 to 3 teeth (D4261) $3,600 $4,000 0.9×
Osseous surgery 4 or more (D4260) $6,750 $7,500 0.9×
Panoramic image (D0330) $360 $400 1.2×
Pattern erg w/i&r (0509T) $765 $850 2.8×
Pemivibart infusion (M0224) $1,890 $2,100 3.4×
Perc d-e cor revasc chro sin (C9607) $20,700 $23,000 0.9×
Perc d-e cor revasc t cabg s (C9604) $16,650 $18,500 1.2×
Perc d-e cor stent ather s (C9602) $19,800 $22,000 0.9×
Perc drug-el cor stent sing (C9600) $13,500 $15,000 0.9×
Periodic oral evaluation (D0120) $198 $220 1.2×
Periodontal maint procedures (D4910) $360 $400 0.4×
Periodontal scaling & root (D4341) $1,080 $1,200 1.3×
Periodontal scaling 1-3teeth (D4342) $1,260 $1,400 1.6×
Perq njx algc cell &/prdct uni/bi fluor lmbr 1st (0627T) $18,900 $21,000 1.2×
Perq njx algc cell&/prdct uni/bi CT lmbr 1st (0629T) $20,700 $23,000 1.3×
Perq Sacral Augmt Bilat Inj (0201T) $11,700 $13,000 1.3×
Perq Sacral Augmt Unilat Inj (0200T) $9,900 $11,000 1.1×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T)
unusually low: confirm this is the full procedure		 $6,300 $7,000 0.4×
Pet not otherwise specified (G0235) $3,600 $4,000 7.2×
Pin service 60m per month (G0023) $315 $350 2.5×
Place device/marker, non pro (C9728) $2,700 $3,000 1.6×
Place direct restoration (D2940) $225 $250 0.3×
Place intra-socket bio dress (D7922) $315 $350 0.4×
Post 1 srfc resinbased cmpst (D2391) $225 $250 0.3×
Post 2 srfc resinbased cmpst (D2392) $315 $350 0.4×
Post 3 srfc resinbased cmpst (D2393) $360 $400 0.4×
Post >=4srfc resinbase cmpst (D2394) $540 $600 0.7×
Post and core cast + crown (D2952) $630 $700 0.8×
Ppps, initial visit (G0438) $315 $350 1.8×
Ppps, subseq visit (G0439) $270 $300 2.0×
Pre 3d mdl w/ccta and/or mri (C9793) $2,160 $2,400 2.0×
Prefab post/core + crown (D2954) $540 $600 0.7×
Prefab stainless steel crown (D2933) $270 $300 0.3×
Prefab stnlss steel crown pe (D2931) $540 $600 0.7×
Prefab stnlss steel crwn pri (D2930) $405 $450 0.5×
Prefabricated resin crown (D2932) $216 $240 0.3×
Prgrmg dev eval ldls pm single car chamber ip (0826T) $270 $300 5.8×
Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) $270 $300 5.8×
Prgrmg Device Evaluation Cardiac Modulj System (0417T) $450 $500 9.7×
Primary closure sinus perf (D7261) $630 $700 0.8×
Prolonged iv inf, req pump (C8957) $900 $1,000 3.4×
Prostate biopsy, any mthd (G0416) $1,350 $1,500 3.0×
Provide inr test mater/equip (G0249) $472.50 $525 2.8×
Psa screening (G0103) $166.50 $185 8.6×
Pulm tiss vntj alys prev CT (0807T) $630 $700 2.3×
Pulm tiss vntj alys w/CT (0808T) $1,093.50 $1,215 4.1×
Pulp cap direct (D3110) $180 $200 0.2×
Pulp cap indirect (D3120) $180 $200 0.2×
Pulp vitality test (D0460) $990 $1,100 1.2×
Pulpal therapy anterior prim (D3230) $1,080 $1,200 1.3×
Pulpal therapy posterior pri (D3240) $1,080 $1,200 1.3×
Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) $1,143 $1,270 1.0×
Quan mr alys tiss composition w/MRI mlt organs (0698T) $1,530 $1,700 1.3×
Quan MRI alys brain w/o diagnostic MRI same sess (0865T) $850.50 $945 2.9×
Quan MRI alys brain with diagnostic MRI (0866T) $850.50 $945 2.9×
Quan us tiss charac i&r w/o dx us same anat (0689T) $360 $400 3.3×
Rad exc lesion up to 1.25 cm (D7410) $1,710 $1,900 0.9×
Re-cement or re-bond crown (D2920) $108 $120 0.1×
Re-eval post-op visit (D0171) $162 $180 1.0×
Recement inlay onlay or part (D2910) $90 $100 0.1×
Recement space maint - man (D1552) $1,080 $1,200 1.3×
Recement space maint - max (D1551) $1,080 $1,200 1.3×
Recement unilat space maint (D1553) $450 $500 0.6×
Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) $3,780 $4,200 1.5×
Relocation skin pocket implanted ccm-d pg (0925T) $4,050 $4,500 1.6×
Rem exostosis any site (D7471) $405 $450 0.1×
Rem imp tooth w mucoper flp (D7210) $720 $800 0.4×
Rem nonodonto cyst > 1.25 cm (D7461) $450 $500 0.6×
Rem odontogen cyst to 1.25cm (D7450) $3,600 $4,000 0.9×
Removal fb skin/areolar tiss (D7530) $315 $350 0.4×
Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision (0447T) $990 $1,100 4.0×
Removal of sloughed off bone (D7550) $585 $650 0.7×
Removal of torus palatinus (D7472) $405 $450 0.5×
Removal perm ccm-d system pulse generator only (0919T) $9,000 $10,000 1.9×
Remove torus mandibularis (D7473) $405 $450 0.5×
Remove unilat space maintain (D1520) $1,080 $1,200 1.3×
Repos Cardiac Modulj Transvenous Electrode (0415T) $4,050 $4,500 5.2×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T) $1,800 $2,000 2.3×
Resin 4/> surf or w incis an (D2335) $540 $600 0.7×
Resin one surface-anterior (D2330) $225 $250 0.3×
Resin three surfaces-anterio (D2332) $360 $400 0.4×
Resin two surfaces-anterior (D2331) $315 $350 0.4×
Retreat root canal anterior (D3346) $1,260 $1,400 1.6×
Retreat root canal molar (D3348) $1,260 $1,400 1.6×
Retreat root canal premolar (D3347) $1,260 $1,400 1.6×
Retrograde filling (D3430) $720 $800 0.9×
Revasc intra lithotrip-ather (C9766) $21,600 $24,000 0.9×
Revasc intra lithotrip-stent (C9765) $21,150 $23,500 0.9×
Revasc intravasc lithotripsy (C9764) $13,500 $15,000 0.9×
Revasc lith-sten-ath tib/per (C9775) $30,600 $34,000 1.3×
Revasc lithotr-ather tib/per (C9774) $27,594 $30,660 1.2×
Revasc lithotr-stent tib/per (C9773) $27,594 $30,660 1.2×
Revasc lithotrip tibi/perone (C9772) $19,710 $21,900 1.4×
Revasc lithotrip-stent-ather (C9767) $25,200 $28,000 1.1×
Risk ascvd tst once pr 12 mo (G0537) $85.50 $95 1.8×
Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) $28,800 $32,000 1.0×
Rmvl Car Modulj Tranvns Elt (0413T) $7,200 $8,000 1.5×
Rmvl Cardiac Modulj Pls Gen (0412T) $7,200 $8,000 1.5×
Rmvl insj impltbl gluc sensor dif anatomic site (0448T) $2,700 $3,000 0.5×
Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T) $7,200 $8,000 1.5×
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) $6,300 $7,000 1.4×
Rmvl perm ccm-d sys dual transvns leads only (0922T) $8,100 $9,000 1.7×
Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) $29,700 $33,000 1.1×
Root surgery molar (D3425) $810 $900 1.0×
Root surgery premolar (D3421) $1,620 $1,800 2.0×
Routine footcare pt w lops (G0247) $387 $430 1.5×
Sbrt w/positron emission del (G0563) $8,010 $8,900 2.0×
Screen cerv/vag thin layer (G0123) $157.50 $175 7.8×
Space maintainer fxd unilat (D1510) $1,080 $1,200 1.3×
Surg reduct osseoustuberosit (D7485)
likely a partial charge, not the full procedure		 $360 $400 0.0×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $24,300 $27,000 1.0×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $21,600 $24,000 0.9×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $21,600 $24,000 0.9×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T)
range across 2 matching MRF lines		 $13,050–$26,100 $14,500–$29,000 varies
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $24,300 $27,000 6.2×
Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) $5,400 $6,000 1.4×
Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) $5,400 $6,000 1.4×
Tcat Rmvl Perm Dual Chamber Ldls Pm Compl Sys (0798T) $7,200 $8,000 1.8×
Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) $27,000 $30,000 1.1×
Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T) $27,000 $30,000 1.1×
Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) $22,500 $25,000 0.9×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) $22,500 $25,000 0.9×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $8,010 $8,900 1.1×
Tee w or w/o fol w/cont,cong (C8926) $3,150 $3,500 3.2×
Therapeutic procd strg endur (G0237) $229.50 $255 6.4×
Therapeutic pulpotomy (D3220) $315 $350 0.4×
Tooth pin retention (D2951) $108 $120 0.1×
Tooth reimplantation (D7270) $324 $360 0.4×
Tooth root removal (D7250) $450 $500 0.6×
Tooth transplantation (D7272) $405 $450 0.5×
Transcatheter Renal Sympath Denervation Bilat (0339T) $10,800 $12,000 1.5×
Transcatheter renal sympath denervation unilat (0338T) $9,000 $10,000 1.3×
Trauma respons w/hosp criti (G0390)
range across 2 matching MRF lines		 $4,725–$7,092 $5,250–$7,880 varies
Trim nail(s) (G0127) $130.50 $145 1.8×
Trluml perip athrc abd aorta (0236T) $16,200 $18,000 1.1×
Trluml Perip Athrc Brchiocph (0237T) $14,400 $16,000 1.0×
Trluml Perip Athrc Iliac Art (0238T) $21,600 $24,000 0.9×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $13,500 $15,000 0.9×
Tte w or w/o contr, cont ecg (C8930) $3,546 $3,940 3.6×
Tte w or w/o fol w/con,stres (C8928) $2,610 $2,900 2.7×
Tte w or w/o fol w/cont, com (C8921) $3,060 $3,400 3.1×
Tte w or w/o fol w/cont, f/u (C8922) $1,912.50 $2,125 2.0×
Tte w or wo fol wcon,doppler (C8929)
range across 2 matching MRF lines		 $3,060–$4,131 $3,400–$4,590 varies
Tympanostomy Automated Tube Delivery System (0583T) $2,880 $3,200 1.5×
Unsched dialysis esrd pt hos (G0257)
range across 5 matching MRF lines		 $1,890–$1,980 $2,100–$2,200 varies
Vasc emb/occ w/prs cath (C9797) $22,500 $25,000 1.0×
Vestibuloplasty exten graft (D7350) $6,300 $7,000 0.9×
Visit esketamine 56m or less (G2082) $3,600 $4,000 2.8×
Visit esketamine, > 56m (G2083) $4,500 $5,000 2.2×
Visit to determ ldct elig (G0296) $225 $250 1.8×

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.