Supplies, drugs & other prices at Mount St. Mary's Hospital and Health Center

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

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

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ProcedurePosted cashPosted gross× Medicare
Admin hepatitis b vaccine (G0010) $82 $82 1.4×
Admin influenza virus vac (G0008) $82 $82 1.4×
Admin pneumococcal vaccine (G0009) $82 $82 1.4×
Alcohol/subs interv 15-30mn (G0396) $82 $82 1.8×
Alcohol/subs interv >30 min (G0397)
range across 8 matching MRF lines
$163.39–$274 $274 varies
Ca screen;pelvic/breast exam (G0101) $153 $153 1.2×
Catheterize for urine spec (P9612) $5 $5 0.5×
Covid-19 lab test non-cdc (U0002) $103 $103 2.0×
Depression screen annual (G0444) $82 $82 1.8×
Diab manage trn per indiv (G0108) $99 $99 1.8×
Diab manage trn ind/group (G0109) $27 $27 1.7×
Direct refer hospital observ (G0379) $1,500 $1,500 2.0×
Elec stim other than wound (G0283) $50 $50 3.9×
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) $32,886 $32,886 0.6×
Fecal microbiota prep instil (G0455) $1,086 $1,086 0.9×
Group mnt 2 or more 30 mins (G0271) $19 $19 1.1×
Hbot, full body chamber, 30m (G0277) $294 $294 1.7×
Initial preventive exam (G0402) $243 $243 1.5×
Insertion/Replacement Complete Iims (0525T) $21,291 $21,291 0.9×
Insertion/Replacement Iims Electrode Only (0526T) $16,706 $16,706 1.6×
Insertion/Replacement Iims Implantable Mntr Only (0527T) $16,706 $16,706 1.6×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $24,700 $24,700 0.6×
Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) $8,739 $8,739 0.8×
Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) $8,739 $8,739 0.8×
Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) $24,700 $24,700 0.9×
Interro Device Evaluation Cardiac Modulj System (0418T) $72 $72 1.5×
Interrog dev eval iims ip (0529T) $76 $76 1.6×
Mnt subs tx for change dx (G0270) $35 $35 1.1×
Obtaining screen pap smear (Q0091) $51 $51 1.4×
Oth resp proc, group (G0239) $69 $69 1.5×
Oth resp proc, indiv (G0238) $51 $51 1.4×
Pathogen test for platelets (P9100) $114 $114 1.5×
Prgrmg dev eval iims ip (0528T) $76 $76 1.6×
Prgrmg Device Evaluation Cardiac Modulj System (0417T) $72 $72 1.5×
Psa screening (G0103) $30 $30 1.6×
Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) $3,331 $3,331 1.3×
Removal complete iims (0530T) $7,051 $7,051 1.5×
Removal iims electrode only (0531T) $7,051 $7,051 1.5×
Removal iims implt mntr only (0532T) $7,051 $7,051 1.5×
Repos Cardiac Modulj Transvenous Electrode (0415T) $1,112 $1,112 1.4×
Revasc intra lithotrip-ather (C9766) $32,886 $32,886 1.4×
Revasc intra lithotrip-stent (C9765) $32,886 $32,886 1.4×
Revasc intravasc lithotripsy (C9764) $20,568 $20,568 1.4×
Revasc lith-sten-ath tib/per (C9775) $32,886 $32,886 1.4×
Revasc lithotr-ather tib/per (C9774) $32,886 $32,886 1.4×
Revasc lithotr-stent tib/per (C9773) $32,886 $32,886 1.4×
Revasc lithotrip tibi/perone (C9772) $20,568 $20,568 1.4×
Revasc lithotrip-stent-ather (C9767) $32,886 $32,886 1.4×
Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) $24,700 $24,700 0.9×
Rmvl Car Modulj Tranvns Elt (0413T) $6,681 $6,681 1.4×
Rmvl Cardiac Modulj Pls Gen (0412T) $6,681 $6,681 1.4×
Trluml Perip Athrc Iliac Art (0238T) $32,886 $32,886 1.4×

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.