Supplies, drugs & other prices at Nacogdoches Memorial Hospital

Nacogdoches, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $22 $74 0.6×
Admin hepatitis b vaccine (G0010) $22 $72 0.5×
Admin influenza virus vac (G0008) $26.50 $87.50 0.6×
Admin pneumococcal vaccine (G0009) $22 $73.50 0.5×
Alcohol/sub misuse assess (G2011) $10 $32 0.3×
Alcohol/subs interv 15-30mn (G0396) $20 $67 0.5×
Alcohol/subs interv >30 min (G0397) $38 $125 0.2×
Annual alcohol screen 15 min (G0442) $11 $35 0.3×
Autolog prp not diab ulcer (G0460) $127 $424 0.1×
Behavior counsel obesity 15m (G0447) $15 $49 0.1×
Brief alcohol misuse counsel (G0443) $15 $49 0.1×
Brief chkin by md/qhp, 11-20 (G2252) $15 $49 0.5×
Brief chkin, 5-10, non-e/m (G2251) $8 $27 0.6×
Ca screen;flexi sigmoidscope (G0104) $109 $363 0.1×
Ca screen;pelvic/breast exam (G0101) $23 $75 0.2×
Cardiokymography (Q0035) $11 $36 0.3×
Catheterize for urine spec (P9612) $16 $52 1.7×
Colon ca scrn not hi rsk ind (G0121) $197 $657 0.2×
Colorectal scrn; hi risk ind (G0105) $197 $657 0.2×
Covid-19 lab test non-cdc (U0002) $32 $106 0.6×
Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation… (0446T) $1,089 $3,630 0.3×
Demonstrate use home inr mon (G0248) $38 $128 0.3×
Depression screen annual (G0444) $11 $35 0.3×
Dermal filler injection(s) (G0429) $55 $182 0.0×
Devlopment test interpt&rep (G0451) $6 $20 0.1×
Diab manage trn per indiv (G0108) $31 $104 0.6×
Diab manage trn ind/group (G0109) $9 $29 0.6×
Direct refer hospital observ (G0379) $503 $84 0.8×
Drug test(s), presumptive, with definitive confirmation of positive results, any number of drug classes, urine,… (0007U) $71 $236 0.6×
Ed svc ckd grp per session (G0421) $15 $49 0.5×
Ed svc ckd ind per session (G0420) $63 $210 0.6×
Ekg tracing for initial prev (G0404) $4 $12 0.1×
Elec stim other than wound (G0283) $21 $70 1.7×
Elec stim unattend for press (G0281) $8 $25 0.7×
Electromagntic tx for ulcers (G0329) $6 $21 0.6×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $10,186 $33,953 0.9×
Extrnl counterpulse, per tx (G0166) $68 $225 0.5×
Fecal blood scrn immunoassay (G0328) $5 $18 0.3×
Fecal microbiota prep instil (G0455) $73 $243 0.1×
Followup eval of foot pt lop (G0246) $22 $73 0.2×
Glaucoma scrn hgh risk direc (G0118) $24 $80 0.6×
Glaucoma scrn hgh risk direc (G0117) $32 $108 1.1×
Group behave couns 2-10 (G0473) $7 $24 0.2×
Group mnt 2 or more 30 mins (G0271) $10 $32 0.6×
Hbot, full body chamber, 30m (G0277) $95 $315 0.7×
High inten beh couns std 30m (G0445) $16 $52 0.2×
Hospital outpt clinic visit (G0463) $333 $1,109 2.5×
Hpylori Detcj Abx Rstnc Dna (0008U) $369 $1,231 0.6×
Init/sub psych care m 1st 30 (G2214) $37 $122 0.4×
Initial foot exam pt lops (G0245) $37 $124 0.3×
Initial preventive exam (G0402) $95 $318 0.7×
Insert drug del implant, >=4 (G0516) $125 $418 0.3×
Insertion/replacement complete iims (0525T) $9,954 $33,181 0.5×
Intens behave ther cardio dx (G0446) $15 $49 0.4×
Intens cardiac rehab no exer (G0423) $68 $228 0.5×
Intens cardiac rehab w/exerc (G0422) $68 $228 0.5×
Interrog dev eval wcs ip (0521T) $566 $1,888 19.5×
Liver dis 10 assays w/nash (0003M) $311 $1,037 0.6×
Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin,… (0002M) $311 $1,037 0.6×
Mnt subs tx for change dx (G0270) $18 $60 0.6×
Mra w/cont, lwr ext (C8912) $432 $1,439 1.2×
Mra w/o cont, lwr ext (C8913) $316 $1,053 1.3×
Mra w/o fol w/cont, lwr ext (C8914) $498 $1,659 1.4×
Obtaining screen pap smear (Q0091) $25 $82 0.9×
Off base opioid tx 70min (G2086) $221 $737 1.2×
Off base opioid tx, 60 m (G2087) $197 $656 1.1×
Oncology (colorectal), quantitative assessment of three urine metabolites (ascorbic acid, succinic acid and carnitine)… (0002U) $16 $52 0.6×
Oncology (gastrointestinal neuroendocrine tumors), real-time PCR expression analysis of 51 genes, utilizing whole… (0007M) $232 $773 0.6×
Oncology (hepatic), mRNA expression levels of 161 genes, utilizing fresh hepatocellular carcinoma tumor tissue, with… (0006M) $93 $309 0.6×
Oncology (ovarian) biochemical assays of five proteins (apolipoprotein A-1, CA 125 II, follicle stimulating hormone,… (0003U) $587 $1,957 0.6×
Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG, PCA3, and SPDEF), urine, algorithm… (0005U) $470 $1,566 0.6×
Open tx iliac spine uni/bil (G0412)
likely a partial charge, not the full procedure
$402 $1,339 0.1×
Open tx post pelvic fxcture (G0415) $755 $2,518 0.2×
Opps service,sched team conf (G0175) $407 $1,355 1.0×
Oth resp proc, group (G0239) $7 $24 0.2×
Oth resp proc, indiv (G0238) $6 $20 0.2×
Pattern erg w/i&r (0509T) $44 $146 0.2×
Pelvic ring fracture uni/bil (G0413)
likely a partial charge, not the full procedure
$588 $1,959 0.1×
Pelvic ring fx treat int fix (G0414)
likely a partial charge, not the full procedure
$556 $1,852 0.1×
Perc d-e cor revasc chro sin (C9607) $9,621 $32,069 0.5×
Perc d-e cor revasc t cabg s (C9604) $12,026 $40,086 1.0×
Perc d-e cor stent ather s (C9602) $12,026 $40,086 0.7×
Perc drug-el cor stent sing (C9600) $12,026 $40,086 1.0×
Pild/placebo control clin tr (G0276)
likely a partial charge, not the full procedure
$209 $698 0.0×
Ppps, initial visit (G0438) $95 $318 0.5×
Ppps, subseq visit (G0439) $75 $250 0.5×
Prostate biopsy, any mthd (G0416) $198 $660 0.5×
Provide inr test mater/equip (G0249) $34 $114 0.3×
Psa screening (G0103) $15.50 $51.50 0.8×
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) $445 $1,483 0.6×
Remot img sub by pt, non e/m (G2250) $7 $23 0.5×
Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision (0447T) $58 $194 0.3×
Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and… (0448T) $1,094 $3,647 0.3×
Remove drug implant (G0517) $122 $405 0.3×
Remove w insert drug implant (G0518) $227 $758 0.5×
Routine footcare pt w lops (G0247) $48 $159 0.2×
Scoliosis, DNA analysis of 53 single nucleotide polymorphisms (SNPs), using saliva, prognostic algorithm reported as a… (0004M) $49 $163 0.6×
Single energy x-ray study (G0130) $21 $70 0.2×
Therapeutic procd strg endur (G0237) $6 $19 0.2×
Tomosynthesis, mammo (G0279) $17 $57 1.3×
Trauma respons w/hosp criti (G0390) $740.50 $2,467.50 0.6×
Trim nail(s) (G0127) $13 $44 0.2×
Trluml peripheral atherectomy iliac artery ea (0238T) $14,665 $48,884 0.8×
Visit esketamine 56m or less (G2082) $371 $1,236 0.4×
Visit esketamine, > 56m (G2083) $529 $1,762 0.3×
Visit to determ ldct elig (G0296) $16 $54 0.2×
Wet mounts/ w preparations (Q0111) $9 $31 0.5×