Supplies, drugs & other prices at Munson Healthcare Charlevoix Hospital
Charlevoix, MI · every code in this section with a posted price and a Medicare benchmark.
64 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,964.35 | $2,311 | 2.5× |
| Adm of soc dtr assess 5-15 m (G0136) | $34 | $40 | 0.9× |
| Adm tocilizu covid-19 1st (M0249) range across 3 matching MRF lines |
$608.60–$663 | $716–$780 | varies |
| Adm tocilizu covid-19 2nd (M0250) | $608.60 | $716 | 1.4× |
| Admin hepatitis b vaccine (G0010) range across 17 matching MRF lines |
$19.55–$87.55 | $23–$103 | varies |
| Admin influenza virus vac (G0008) range across 16 matching MRF lines |
$19.55–$51 | $23–$60 | varies |
| Admin pneumococcal vaccine (G0009) range across 15 matching MRF lines |
$19.55–$56.95 | $23–$67 | varies |
| Behavior counsel obesity 15m (G0447) | $164.05 | $193 | 1.6× |
| Ca screen;flexi sigmoidscope (G0104) | $120.70 | $142 | 0.1× |
| Ca screen;pelvic/breast exam (G0101) | $85.85 | $101 | 0.8× |
| Catheterize for urine spec (P9612) range across 9 matching MRF lines |
$147.90–$184.45 | $174–$217 | varies |
| Covid-19 lab test non-cdc (U0002) range across 2 matching MRF lines |
$98.60–$175.10 | $116–$206 | varies |
| Demonstrate use home inr mon (G0248) | $329.80 | $388 | 2.5× |
| Depression screen annual (G0444) | $10.20 | $12 | 0.3× |
| Diab manage trn per indiv (G0108) | $92.65 | $109 | 1.7× |
| Diab manage trn ind/group (G0109) | $39.95 | $47 | 2.5× |
| Direct refer hospital observ (G0379) | $114.75 | $135 | 0.2× |
| Drug test def 1-7 classes (G0480) range across 84 matching MRF lines |
$7.65–$252.45 | $9–$297 | varies |
| Drug test def 15-21 classes (G0482) range across 2 matching MRF lines |
$42.70–$42.71 | $50.23–$50.24 | varies |
| Drug test def 22+ classes (G0483) | $189.49 | $222.92 | 0.8× |
| Drug test def 8-14 classes (G0481) | $44.63 | $52.50 | 0.3× |
| Ekg tracing for initial prev (G0404) | $54.40 | $64 | 1.9× |
| Elec stim other than wound (G0283) range across 5 matching MRF lines |
$65.45–$68.85 | $77–$81 | varies |
| Extrnl counterpulse, per tx (G0166) range across 2 matching MRF lines |
$453.90–$544 | $534–$640 | varies |
| Fern test (Q0114) | $39.95 | $47 | 4.1× |
| Group mnt 2 or more 30 mins (G0271) | $25.50 | $30 | 1.5× |
| Hepb screen high risk indiv (G0499) | $12.75 | $15 | 0.5× |
| Hiv combination assay (G0475) | $255 | $300 | 10.6× |
| Home sleep test/type 2 porta (G0398) | $535.50 | $630 | 2.5× |
| Home sleep test/type 3 porta (G0399) range across 3 matching MRF lines |
$141.95–$563.55 | $167–$663 | varies |
| Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) range across 3 matching MRF lines |
$38.82–$95.20 | $45.66–$112 | varies |
| Initial preventive exam (G0402) | $52.70 | $62 | 0.4× |
| Inj for sacroiliac jt anesth (G0260) | $1,520.65 | $1,789 | 2.2× |
| Mnt subs tx for change dx (G0270) | $51.85 | $61 | 1.6× |
| Mra w/cont, abd (C8900) | $2,527.05 | $2,973 | 7.3× |
| Mra w/cont, chest (C8909) | $2,527.05 | $2,973 | 7.3× |
| Mra w/o cont, abd (C8901) | $2,527.05 | $2,973 | 10.6× |
| Mra w/o cont, chest (C8910) | $2,527.05 | $2,973 | 10.6× |
| Mra w/o cont, lwr ext (C8913) | $4,503.30 | $5,298 | 18.9× |
| Mra w/o fol w/cont, abd (C8902) | $2,527.05 | $2,973 | 7.3× |
| Mra w/o fol w/cont, chest (C8911) | $2,527.05 | $2,973 | 7.3× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,926.10 | $2,266 | 5.5× |
| Mra, w/o&w/dye, upper extr (C8936) | $4,666.50 | $5,490 | 13.4× |
| Mri w/o fol w/cont, breast, (C8908) | $2,595.90 | $3,054 | 7.5× |
| Mri w/o fol w/cont, brst, un (C8905) | $886.55 | $1,043 | 2.6× |
| Non-ophthalmic fva (C9733) range across 2 matching MRF lines |
$1,168.12–$1,289.68 | $1,374.25–$1,517.27 | varies |
| Obtaining screen pap smear (Q0091) | $135.15 | $159 | 4.7× |
| Oth resp proc, group (G0239) | $147.05 | $173 | 4.0× |
| Oth resp proc, indiv (G0238) | $103.70 | $122 | 3.6× |
| Ppps, initial visit (G0438) | $61.20 | $72 | 0.4× |
| Ppps, subseq visit (G0439) | $57.80 | $68 | 0.4× |
| Prolonged iv inf, req pump (C8957) | $1,279.25 | $1,505 | 6.0× |
| Prostate biopsy, any mthd (G0416) | $797.30 | $938 | 2.2× |
| Psa screening (G0103) | $119.85 | $141 | 6.2× |
| Scr c/v cyto,thinlayer,rescr (G0144) | $61.20 | $72 | 1.4× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $116.45 | $137 | 4.4× |
| Screen cerv/vag thin layer (G0123) | $87.55 | $103 | 4.3× |
| Tomosynthesis, mammo (G0279) | $161.50 | $190 | 12.7× |
| Trauma respons w/hosp criti (G0390) range across 2 matching MRF lines |
$1,233.35–$3,208.75 | $1,451–$3,775 | varies |
| Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) | $3,064.25 | $3,605 | 0.9× |
| Trim nail(s) (G0127) | $310.25 | $365 | 5.3× |
| Tte w or w/o fol w/con,stres (C8928) | $1,456.90 | $1,714 | 1.9× |
| Tte w or wo fol wcon,doppler (C8929) | $2,113.95 | $2,487 | 2.7× |
| Visit to determ ldct elig (G0296) | $55.25 | $65 | 0.5× |
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.